Many domiciliary care services offer night care and living in care. Supported living schemes that are registered as domiciliary care services will also provide night cover where this is required. Night care in a service user’s own home might involve waking care or “sleeping-in” where the carer is on call rather than on active duty for the hours involved. Not all night care might involve regulated activity; for example, in night sitting where sometimes a volunteer will attend a person at night and who would call for help if needed.

A domiciliary care service might also offer living-in care, whereby paid carers move into the person’s accommodation. Live-in carers might carry out their work on their own with or without relief from other carers or there could be a team of live-in carers working in shifts. Much depends on the individual situation and its needs.

Night care can occupy up to half of a 24-hour care regime provided by the domiciliary care service. Yet there has been relatively little attention paid to the management and practice of night care or night cover in the care literature and it does not appear to be a strong focus of inspections.

Where some form of night care is planned, the needs of the person should be carefully assessed so that the provision can fully address the identified needs in person-centred ways. In many home care situations, the needs of informal carers will need to be considered, particularly where the planned service acts as a form of respite, for example, to give the informal carer a good night’s sleep, free from their normal caring duties.

When providing these services, the domiciliary care provider must develop and implement effective night care and living in policies and strategies to make sure that service users and informal carers experience the benefits.

This topic provides an overview of the care management and practice issues to be addressed.

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