Live in care · Clinique Alpa
Stranger in the House Care for Your Parent
Written by Dr Mitesh Parmar, MBBS MRCGP. Published 29 August 2026.
The spare room has been a spare room for 20 years. Coats, a treadmill nobody uses, boxes from the last house. The sticking point is often not money. It is a stranger in a house that never had one. Families search stranger in the house care late at night because they can talk about fees in daylight. This part they save for the kitchen, after the person has gone to bed.
The question they ask is whether live in care will work. The question they mean is whether they are about to give the house away to someone they have not met. That fear is information, not a problem to be talked around.
If your parent has said they do not want it, that is an answer, not a negotiation.
What a stranger in the house care decision is actually about
It is about privacy in the bathroom. About who puts the kettle on. About a radio that has always been on the same station. About a marriage that still has a shape, even if one of them now needs help with shoes. Home is not a building. It is everything in it that is theirs.
A live in carer needs a private bedroom, use of a bathroom, and meals as part of the household. They sleep in the house at night. They are not sat awake on duty. They take a daily break, agreed with you. That is already a lot of another adult, in rooms that used to be only family. Pretending it is a small change is how families walk into week one unprepared, then blame the carer for being present.
The first fortnight is where trust is built or spent. Continuity in week one costs less than repairing it in month six. That is not a slogan. It is what families tell us when it has gone well, and what they tell us when it has not.
The person receiving care has to be in the conversation. Not as a courtesy at the end. Some people would rather a care home than a stranger at breakfast. That preference is not stubbornness. It is a value. A plan that overlooks it will be resisted, whatever else it gets right.
What we actually look at when a family calls
What families tell us is that nobody names the stranger problem in the first five minutes. They talk about the fall, the discharge, the missed tablets. Then, quieter, someone says the house has never had anyone else living in it. That sentence should slow the call down, not speed it up.
We walk the home. Not to inspect it. To see whether another adult can live there without taking the house off its owner. Where would they sleep. Where would they sit at 4 in the afternoon. What happens when visitors come. Whether a pet is part of the household or will be treated as a problem. Whether the person wants chat or calm. Language. How the family actually uses the front room.
We ask about the nights, because a stranger who is kind in daylight can still feel like an intrusion at 2 in the morning, when someone calls out and a voice they do not know answers. We go through the medicines as they are really taken. Mobility, mood, appetite, 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. The carer who then moves in is not a doctor and not a nurse. Personal care, meals, prompting and giving medicines as set out in the plan, company, the ordinary running of the house. Nursing stays with the district nurse, the GP, and the specialist teams.
You meet the carer before care begins. If it is wrong, it should be changed. Read how matching and cover are arranged before you agree a start date you cannot picture.
When a few visits a week stops being enough
Hourly visits keep the stranger problem at arm's length. Someone comes, helps, and leaves. The house returns to being theirs. That can hold for a long time. Then it does not.
- Nights have become unsafe, or the family carer is now up so often that they cannot work the next day.
- Medicines are being missed, doubled, or left in the box for someone else to find later.
- Weight is dropping, or meals are becoming toast because cooking takes too long.
- Falls, or near falls, that are being laughed off in the same sentence.
- The person is still in their own home, but the home is no longer being lived in. It is being endured.
- The daughter or son who is coordinating this has become the second person we would worry about.
When to call us sooner is when those are already true and the only thing delaying the call is the spare room. A care home remains a fair option when they have said they do not want a stranger living with them, or when the house cannot take another adult. We say so. Families do not thank you later for talking them past a no.
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. That assessment is charged separately. If you then start a long term live in care package, the fee is credited against the first month.
We match on need and experience first, then on the way the household actually runs. We do not promise that it will be one named carer for ever. Carers work in planned blocks and take time away. Cover is arranged by the office. You should not be left to find a replacement yourself. The first fortnight decides more than the brochure does. Judge those two weeks honestly.
What a carer does, and does not do, is on the live in care page. The numbers sit on the costs page.
You are allowed to be uneasy about this. Uneasy is not the same as no. It is a reason to go slowly, meet the person, and keep the right to change it.
Start with an assessment of the person and the house, not a photograph. Read our how it works 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.