Live-in care contracts: how councils and the NHS buy live-in care
Councils rarely tender live-in care as a standalone contract; they usually buy it as a service type inside a home care framework, while NHS integrated care boards arrange it for people eligible for continuing healthcare. Essex's Live at Home 2025 framework listed 24 hour and live-in care as one service type, and Reading's Home Care Framework 2025 defined live-in packages in their own schedule. Bids are scored on price and quality, with safeguarding carrying real weight.
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Live-in care is usually a service type, not a separate tender
Most councils buy live-in care as one service type inside a wider home care or domiciliary care framework, so searching only for the words live-in care will miss most of the work. Two recent notices on Find a Tender show the pattern. Essex County Council's Live at Home 2025 framework, a six year framework split into 12 district lots, broke each lot into service types: personal support, night awake, night sleeping, 24 hour or live in care, carers support and carers break. Bidders had to choose one price point per service type, per lot, from a pricing matrix. Reading Borough Council's Home Care Framework 2025 described live-in care as packages where a care worker lives with an individual in their home so that support can be available 24/7, and pointed bidders to a dedicated schedule, Schedule 11, for the live-in requirements. The lesson is to read the framework structure as well as the title. A home care framework can carry a live-in lot or service type with its own specification, its own rate and its own questions. If you want live-in work from a council, you usually win it by joining the home care framework and pricing the live-in service type well.
See also: how to apply for a live-in care tender, domiciliary care framework applications, home care contract bidding.
How the NHS buys live-in care
When a person is eligible for NHS continuing healthcare, the integrated care board arranges and funds their care at home, so the buyer, the rules and the portal all change. ICBs buy continuing healthcare home care through arrangements such as dynamic purchasing systems and frameworks. NHS West Yorkshire ICB, for Leeds, awarded places on a continuing healthcare home care dynamic purchasing system under direct award process B of the Provider Selection Regime, publishing the notices on Find a Tender. Some areas buy jointly. NHS Derby and Derbyshire ICB ran its continuing healthcare and continuing care homecare frameworks together with Derby City Council and Derbyshire County Council, which means one application can open both health and social care referrals. Neither of those notices names live-in care as a separate lot, so do not assume an ICB will advertise live-in by name. Treat a continuing healthcare home care arrangement as the route in, then check the specification for how the ICB handles packages that need a worker present around the clock. Continuing healthcare packages are clinical, so expect closer scrutiny of competence, supervision and escalation than in a council framework.
Read next: continuing healthcare homecare tenders, the Provider Selection Regime explained, NHS and local authority tenders compared.
Direct payments and personal health budgets bypass the tender
Part of the live-in market never reaches a tender, because the person holds the budget and chooses the provider. Under section 31 of the Care Act 2014, an adult with a personal budget can ask the council to meet some or all of their needs through direct payments to themselves or a nominated person, and where the conditions are met the council must make those payments. The NHS has a matching route. NHS England says adults in receipt of NHS continuing healthcare have a legal right to have a personal health budget, which can pay for ongoing care and support to meet assessed health and wellbeing needs. For a provider this changes the sales job. Framework work comes through a council or ICB brokerage team, ranked or allocated by the rules of the framework. Direct payment and personal health budget work comes from the person and their family, often with advice from the council or ICB. A strong live-in business usually needs both: a framework place for commissioned packages, and a clear, public description of the service for people who buy it with their own budget. Your framework evidence and your public information should tell the same story.
Related: complex care tenders.
Registration: why an introductory model cannot bid
To bid for commissioned live-in care you need to be the CQC registered provider of the personal care. An agency that only introduces self-employed carers does not qualify. The CQC's guidance says introductory agencies do not need to register because they have no ongoing role in the personal care workers give after the introduction. An agency with an ongoing role, such as recruiting, training, supervising or managing the care workers, falls within the regulated activity of personal care. Council tenders turn that distinction into a pass or fail gate. Essex's Live at Home 2025 notice required every bidder to be registered with the CQC, with each location used to deliver the care registered for the domiciliary care service type and the regulated activity of personal care. It also required the registered branch to sit within Essex or within 5 miles of the county border. So check three things before you look at the questions: that your registration covers personal care from a domiciliary care location, that the location meets any distance rule, and that your rating meets any stated threshold. An introductory model, however good, fails the first gate of a tender like this.
See also: CQC rating requirements for care tenders, selection questionnaires explained.
Where live-in care contracts are advertised
Live-in care opportunities are advertised on Find a Tender and on the buyer's own portal, usually under a home care, domiciliary care or live at home title, with live-in care named in the detail. Under the Procurement Act 2023 a council procurement leaves a trail of notices you can follow. Reading's home care framework shows the sequence: a preliminary market engagement notice in July 2025, the tender notice in October 2025 and the contract award notice in February 2026. That first notice is the one to watch. Preliminary market engagement is where a council tests its model with providers, and it is your chance to explain how live-in rotation, rest cover and pricing work in practice before the specification is fixed. For searches, set alerts on home care, domiciliary care, live at home, 24 hour care and continuing healthcare, and register on the portals the councils and ICBs in your area use. Open arrangements matter too. Under section 36 of the Procurement Act 2023 a council running a dynamic market must accept applications to join at any time during its term, so a missed deadline is not always the end of the road.
Read next: how to find care tenders, using Find a Tender, what a DPS is in care.
What live-in care bids are scored on
Live-in care bids are scored on price and quality together, and the quality side leans heavily on safeguarding. In Essex's March 2025 tender notice, price and quality were each weighted at 50 percent. Providers bidding for the higher tier had to answer two safeguarding questions scored from 0 to 5 and reach at least 2 on each, or they stayed on the lower tier. Price works differently from visiting care. Where the council asks for one rate per service type, your live-in rate is a separate commitment, so build it from what the service really costs: the live-in worker, the cover worker for breaks and leave, supervision, travel for handovers and management time. The Care Act statutory guidance, at paragraph 4.31, expects council fee levels to allow providers to pay at least the national minimum wage and fund effective training, which gives you a principled basis for a sustainable rate. On quality, the live-in specific themes are continuity when the worker rests, lone worker safeguarding and managing complex needs at home. Our live-in tender guide covers how to answer each one, so here the point is simply to price and staff the model you describe.
Related: rate cards and fee uplifts in care contracts, how to apply for a live-in care tender, why care bids lose.
Primary sources: National framework for NHS continuing healthcare and NHS-funded nursing care (GOV.UK); Personal health budgets (NHS England).
The four routes to live-in care work
How live-in care reaches a provider in England, who pays, and what you need to win it.
| Route | Who pays | How you get the work | What you need |
|---|---|---|---|
| Council home care framework | The council | A place on the framework, often with a live-in service type and rate | CQC registration for personal care, a scored bid and a priced live-in rate |
| NHS continuing healthcare arrangement | The integrated care board | A framework or dynamic purchasing system place, or an award under the Provider Selection Regime | Clinical competence evidence and the ICB's selection criteria |
| Direct payment | The person, from their council personal budget | The person or their family chooses you | Clear public information and a service they can buy directly |
| Personal health budget | The person, from NHS funding | The person or their representative chooses you | Evidence you can meet the assessed health needs |
Not sure if you qualify for a tender? We check it for free, before you pay anything, and we only take bids we believe you can win. See our domiciliary care tender writing or text TENDER to get started.
Common questions
Do councils tender live-in care separately?
Usually not. Most councils buy live-in care as a service type inside a home care framework. Essex's Live at Home 2025 framework listed 24 hour or live in care as one of six service types in each district lot, and Reading's Home Care Framework 2025 set out live-in requirements in a dedicated schedule. Search home care frameworks as well as live-in titles.
Who buys live-in care for people with NHS continuing healthcare?
The integrated care board. It arranges and funds care for people eligible for NHS continuing healthcare, usually through its own home care frameworks or dynamic purchasing systems, and sometimes jointly with councils. Those awards follow the Provider Selection Regime.
Can an introductory live-in agency bid for council contracts?
Not for a contract that requires CQC registration for personal care, which is the norm. The CQC says introductory agencies do not register because they have no ongoing role in the care, while council tenders such as Essex's require the bidder to be the registered provider of personal care from a domiciliary care location.
Where are live-in care contracts advertised?
On Find a Tender and the council's or ICB's own portal, usually under a home care, domiciliary care or live at home title. Watch for preliminary market engagement notices as well, because they come before the tender and give you a chance to shape how live-in care is specified and priced.
What are live-in care bids scored on?
Price and quality, with safeguarding carrying real weight. Essex weighted price and quality at 50 percent each and set a minimum score of 2 out of 5 on two safeguarding questions for its higher tier. Live-in quality answers also need to show continuity when the worker rests and safe lone working.
How much does it cost to have Selective Care Match write a live-in care bid?
Your first tender is £795, with standard bids at £3,000. We only take bids we believe you can win. Our win rate is 96 percent, substantiated by our internal tracker. We start with a free eligibility check so you know you meet the registration and location gates first.
Got a tender to check?
Text TENDER to +44 7822 030677and we'll tell you free whether you'd qualify, before you spend a penny.