Live in care · Clinique Alpa
Live in Care Not Nursing, the Honest Scope
Written by Dr Mitesh Parmar, MBBS MRCGP. Published 29 August 2026.
Families get into trouble when they buy care and expect a ward at home. A discharge nurse used the word support. A sibling heard nursing. By the time someone searches live in care not nursing, there is already a wound chart on the kitchen table and a hope that the person moving into the spare room will know what to do with it.
The question they ask is whether the carer can do everything the hospital did. The question they mean is whether they are about to be left holding clinical work they cannot do, at 2 in the morning, with a number that goes to an answerphone.
Clinique Alpa is registered for personal care. That is the honest scope. Wound care, catheters, clinical procedures stay with district nurses and the GP. We work alongside the NHS. We do not replace it.
What live in care not nursing actually means in the house
A live in carer lives in the house and supports the person through the day. Washing, dressing, continence, meals, prompting and giving medicines as set out in the plan, help moving around, household tasks, company. They sleep in the house at night. They are not awake on duty all night. They are not a nurse. They are not a doctor.
They do not give clinical procedures. They do not run a syringe driver. They do not change catheters. They do not dress wounds or carry out other clinical procedures. If those things are part of remaining at home, they belong on a district nurse list, a GP plan, or a specialist team, with names and times, before anyone moves in. A carer can notice that a dressing is wet and ring the right person. Noticing is not the same as doing the procedure.
This is not a lesser service. It is a different one. A ward has registered nurses, a buzzer, and a drugs trolley. A house has a kitchen, a stair, and one carer who also needs to sleep. Pretending those are the same is how families find out, on a Sunday, that the thing they bought cannot do the thing they needed.
What we actually look at when a family calls
What families tell us is that nobody used the word nursing until something leaked, blocked, or needed a needle. So we ask it early. What does the district nurse currently do. What did the ward do that has not been handed over. Is there a syringe driver, a catheter, clinical procedures, wound care, or a feed going in by tube. Who is coming at the weekend. What happens if that person does not come.
We walk the home. Stairs, bathroom, the chair they actually sit in, whether a carer would have a private bedroom. Nights. Medicines as they are really taken. Mobility, memory, mood, appetite, continence, skin. What a good afternoon still looks like. The existing family rota, and how close it is to breaking.
A doctor from our team carries out that assessment. Most domiciliary providers have no clinician anywhere near the care plan. That is the functional difference. It does not turn the carer into a nurse, and it does not turn Clinique Alpa into a medical treatment service. The assessment produces a care plan the carer works to. Clinical tasks stay where they belong. If the picture is nursing, we say live in personal care will not hold it. A care home with nursing, or a different NHS package, may be the honest next step.
Read what a live in carer helps with, and what they do not do, before you brief a sibling that everything is covered.
When the line has already been crossed
Visits from a district nurse and a few hours of home care can hold a lot. Then they do not. The signals are practical.
- A wound, catheter, clinical procedures, or syringe driver is being managed by family, because the nurse comes on weekdays and the problem does not.
- Someone is asking the visiting carer to do a clinical task they are not there to do.
- Nights need frequent hands on help, so one carer cannot also do the day.
- Medicines that need a nurse to give them are being treated as if they were tablets in a box.
- The person is going back into hospital because the house cannot do what the ward was doing.
- The daughter or son has become the unofficial nurse, and the unofficial nurse is exhausted.
When to call us sooner is when you are already translating hospital language into hope. If the need is personal care, we can talk about live in support. If the need is nursing, you need the NHS conversation as well, not instead of honesty from us.
How care is arranged here
Clinique Alpa is a CQC regulated domiciliary care provider. We work across Enfield, Edmonton and the surrounding boroughs. Live in care starts at £1,650 a week for one person, subject to assessment and the level of need. The fee rises with heavier support, broken nights, care for a couple, and more complex needs. You get a written quote after the assessment, not a number invented on the first call.
The first conversation is with a manager, not a call centre, and there is no obligation. If live in care is unlikely to suit, we say so. The person is then assessed and we write the care plan with you, including where NHS teams stay involved. That assessment is charged separately. If you then start a long term live in care package, the fee is credited against the first month.
You meet the carer before care begins. We match on need and experience first, then on how the household runs. We do not promise one named carer for ever. Cover is arranged by the office. The first fortnight is where the line in the plan is tested against the line in the house. If family are still being asked to do clinical tasks, the plan is not the plan.
The sequence sits on how it works. The numbers sit on the costs page.
You are allowed to want a nurse in the house. You are not helped by being sold a carer under that name.
Get the line drawn in the plan, in writing, before anyone moves in. Read our live in care page, or call 020 8882 8088 or 07777 594448. Live in care from £1,650 a week, published in full. If the person has fallen, cannot be woken, or is severely breathless, call 999. Subject to availability.
Written by Dr Mitesh Parmar, MBBS MRCGP, registered manager of Alpa Care Ltd, a CQC regulated domiciliary care provider working across Enfield and Edmonton. This article is general information, not personal care advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.
If you would like to talk something through, call 020 8882 8088 or see how it works.
Live in care from Clinique Alpa is provided by Alpa Care Ltd, registered with the Care Quality Commission for personal care, provider ID 1-9691685023.