Families face care crisis as soaring costs drive providers out of business

Leading healthcare operator warns ‘If bigger operators like us are feeling the strain, it’s also impossible for smaller live-in care providers to survive’ 

Across the UK, families who rely on vital in-home care services are at risk of losing the support they depend on, as smaller live-in and domiciliary care providers are being forced to close their doors under rising costs, warns Noble Live-In Care, part of City & County Healthcare Group (CCH), the UK’s largest provider of community-based care.

While much public attention has focused on care home closures, the impact of some care providers closing doors is being felt even more acutely in family homes.

These providers allow people to remain living safely and independently at home, but rising operational costs are pushing many to breaking point. 

Kirsty Prendiville, head of operations at Noble Live-In Care, said: “Recent budget decisions are putting immense pressure on smaller live-in care providers, ones that have spent years building their community and carer to patient relationships.

“This year, the Department of Health and Social Care outlined plans for the handback of care contracts from struggling care providers which really hit home – the industry is in crisis and it’s the families that are impacted first and foremost.”

Even as a larger provider, we feel the brunt of these increases, so it’s no surprise that smaller companies struggle

She adds: “Families tell us every day how much they want their loved ones to stay in the comfort of their own home, supported by carers who know them well.

“But many smaller providers simply cannot keep going under the weight of rising wage bills, National Insurance contributions, and fuel and transport costs.

“Even as a larger provider, we feel the brunt of these increases, so it’s no surprise that smaller companies struggle.

“Families are, in some cases, left scrambling for care – sometimes with less than a week’s notice.”

Noble Live-In Care highlights in detail the mounting pressures for some care providers: 

• Employer National Insurance contributions have risen to 15%, up from 13.8%, adding a significant additional cost for every member of staff. For smaller care providers operating on tight margins, this increase alone can represent tens of thousands of pounds annually
• The threshold for employer NI contributions has fallen, meaning providers now pay National Insurance on a broader portion of their staff wages. This change hits smaller agencies hardest, as they typically have a lean workforce and limited ability to absorb extra costs without passing them onto families
• The National Living Wage has increased by 6.7%, further raising payroll expenses. For small providers, this affects existing staff costs and can force difficult decisions about recruitment and retention, risking service disruption
• Public transport costs for care workers rose by 4.6% in March 2025, impacting carers who travel between clients’ homes daily. Many smaller providers cannot subsidise these rising costs, creating both financial strain and logistical challenges in maintaining consistent care schedules
• Fuel costs have increased by 6.4%, hitting both providers and care workers who rely on cars for home visits. For live-in care providers, whose staff may need to travel significant distances to reach clients, these increases translate into higher service costs and reduced flexibility, ultimately affecting families who depend on reliable, home-based care

Combined, these factors are creating a perfect storm for smaller live-in and domiciliary care providers: tight cash flows, rising staff costs, and limited room to increase fees for families who are already facing high care expenses.

For many providers, continuing operations without support or financial relief is becoming increasingly hard.

“At Noble Live-In Care, our scale and backing from City & County Healthcare Group allow us to absorb costs that would cripple smaller entities,” said Prendiville.

This year, the Department of Health and Social Care outlined plans for the handback of care contracts from struggling care providers which really hit home – the industry is in crisis and it’s the families that are impacted first and foremost

“It also enables us to take a leadership role in the sector, advocating for change and supporting families when others cannot.

“This isn’t just about providers, though – it’s about families who are suddenly left without the care they rely on.

“We need urgent collaboration between government, regulators, and providers to safeguard community care.

“Without action, more families will face the distress of seeing loved ones left without support.”