Digital live-in care on rise as councils miss support

More families are using digital platforms to arrange live-in care as official figures show that many older people who request adult social care do not receive council-arranged support. Unmet need is slightly higher in rural areas.

Analysis of the Government's Adult Social Care Activity Report for 2024 to 2025 found that 38.5% of people aged 65 and over who requested support did not go on to receive council-facilitated care. In rural areas, the figure rose to 39.8%, compared with 37.4% in urban areas.

The figures cover requests that did not result in long-term community care, long-term residential or nursing care, or short-term council-funded support, such as reablement. Requests that resulted only in information and advice, signposting, or services not provided are also counted as not resulting in council-arranged care.

Platforms that match carers with families have positioned themselves as an alternative route into care, particularly where local provider capacity is stretched. They typically connect self-employed carers with households and use digital matching tools during the placement process.

Elder, which describes itself as the UK's largest live-in care platform, says activity on its system points to growing demand outside major cities. Carers arranged through Elder made more than 6,800 journeys across England in 2025, with an average travel distance of 100 miles per placement.

More than 2,100 of those placements were in rural areas. The figures cover live-in care placements made during 2025 and use one-way travel distance to the care recipient.

While the national data suggests a modest rural-urban gap, results vary sharply between councils. Comparisons also suggest that unmet need does not simply track demand.

County Durham, a rural authority, received about 10,000 care requests from people aged 65 and over. St Helens, an urban authority with a similar number of requests, recorded 61% of people not receiving council-arranged care, around six in 10 people, compared with around one in 10 in County Durham.

In the live-in care market, providers say distance and workforce availability can make traditional visit-based services harder to sustain. Live-in care involves a carer staying in the person's home for a placement, rather than making several short visits each day.

"Families are increasingly looking beyond traditional council-arranged care," said Pete Dowds, founder and CEO of Elder. "Our technology allows us to safely match carers and families across wider areas, which can be particularly important in rural communities where home care options are limited."

Rural pressures

Rural England faces demographic change alongside constraints in the supply of care. Around 9.7 million people live in rural England, and these areas have an older age profile than urban areas. More than a quarter of residents in rural communities are aged 65 and over, compared with fewer than one in five in urban areas.

Provider capacity has also tightened, with many home care providers delivering fewer hours of care, according to the statement accompanying the analysis. Longer travel times between visits can reduce the number of calls a worker can complete in a day, particularly in dispersed communities.

Financial pressures on councils add to the challenge. The County Councils Network estimates that county and large rural unitary councils face around £7 billion a year in additional service pressures, and says current government funding proposals cover 2p for every £1 of new costs.

Live-in care providers present the model as one way to reduce repeated travel associated with rota-based domiciliary care. For families, platforms can offer access to a wider pool of carers than a local agency list. For carers, the model can mean fewer separate visits and longer placements, though the sector has faced questions over pay, working conditions, and consistent oversight where carers operate on a self-employed basis.

Digital platforms say their matching systems expand the search area for placements and speed up the process of identifying suitable carers where local supply is limited.

Partnership calls

Dowds said councils and live-in care providers should work more closely in areas where conventional home care struggles to operate reliably, framing live-in care as an additional option rather than a replacement for council services.

"Local authorities are under enormous pressure, and this isn't about replacing existing services," he said. "But if we are serious about tackling the postcode lottery, we need to use every care model that works in practice. Live-in care can play a vital role in areas where other services cannot consistently reach people."

"Working in partnership would give councils more flexibility and help ensure older people aren't left without support simply because of where they live, or forced to wait until crisis point," he added.

The government's activity report is based on statutory returns submitted by local authorities in England. The data is likely to remain under scrutiny as councils and providers address rising demand, workforce shortages, and the impact of geography on social care delivery.