Summary
- Personal care costs $28–40/hr (US) or £22–35/hr (UK).
- Live-in care runs $350–500/day or £950–1,500/week.
- Agencies cost more but cover vetting, insurance and absences.
- Continuity of carers matters more to families than hourly price.
- Request a needs assessment early — waiting lists are long.
Quick answer
Hourly home care costs roughly $28–40 per hour in the US and £22–35 per hour in the UK. Live-in care runs about $350–500 per day or £950–1,500 per week. Agencies cost more than direct hire but handle cover, insurance and vetting.
Levels of care
| Level | What it covers | Typical cost |
|---|---|---|
| Companionship | Company, errands, light housework | $25–32/hr, £20–28/hr |
| Personal care | Washing, dressing, toileting, medication prompts | $28–40/hr, £22–35/hr |
| Specialist (dementia, palliative) | Trained carers, care planning | $35–55/hr, £28–45/hr |
| Night sitting (awake) | Overnight presence and support | $250–400/night, £150–250/night |
| Live-in care | 24-hour presence, one main carer | $350–500/day, £950–1,500/week |
| Residential home | Full-time facility | $4,500–9,000/mo, £3,500–6,000/mo |
Weekends, bank holidays and short visits under one hour typically cost more per hour.
Agency or direct hire?
Agency: higher hourly rate, but includes vetting, training, insurance, replacement carers when someone is ill, and supervision. You are not an employer.
Direct hire: cheaper per hour, but you become the employer — payroll, tax, insurance, holiday pay, and no cover when the carer is unavailable. Workable for families with the time to manage it, risky when care is essential every day.
How to vet a provider
Funding
Both markets have partial public funding routes: means-tested local authority support and attendance-type benefits in the UK, Medicaid programmes and veterans' benefits in the US. Medicare and standard insurance rarely cover long-term personal care. Request a needs assessment early — waiting lists are long and assessments are free.
Conversations to have first
Warning signs
No written care plan, unwillingness to share inspection reports, a different carer every visit, vague pricing, and pressure to sign long contracts quickly.
Summary
Budget £22–35 or $28–40 an hour for personal care and far more for live-in support. Prefer an agency when care is essential daily, check the regulator's report, prioritise continuity of carers, and request a needs assessment as early as possible.