Table of Contents for Easy Navigation
Please click one of the Chapter Titles below to jump to the relevant section
- Residential Care Homes vs Nursing Homes
- Determining the Type of Care Required
- The Cost of Care Homes
- Selecting Care Homes
- Things To Check Before Visiting a Care Home
- Visiting Care Homes
Choosing a care home for a loved one can be, for many, an extremely difficult thing to do. Not only are emotions running high about the possibility of a family member needing professional care, but with so many factors to consider, it can become an incredibly overwhelming process.
From having to work out the cost, decide on a location, determine the type of care needed, and most importantly, the happiness of your loved one, there are a variety of elements that are involved in selecting the ideal care home. With approximately 5,500 care home providers in the UK, operating around 11,300 care homes for the elderly, knowing where to start is daunting – but that’s where we come in.
With several years of experience in the health care sector, and with 3 successful care homes across England, here at Encore Care Homes, we think the process should be kept as simple as possible for everyone involved. That’s why we’ve written this ultimate guide. It walks you through every step of selecting the ideal care home.
Residential Care Homes vs Nursing Homes
Before beginning your search for a residential care home, it’s important to understand the difference between residential homes and nursing homes, so that you can make the right decision for your loved one.
Both types of home offer accommodation, home cooked meals, 24 hour care, supervision from trained staff, and assistance with personal care needs. The only real difference between the two is that nursing homes also have registered nurses on duty at all times. Due to this, nursing homes are able to provide care to residents with more complex needs than those in residential homes.
In most cases, both nursing homes and residential homes are able to provide care to dementia residents, although nursing homes would be more suited to individuals in the later stages of dementia when complex care is required. Nursing homes are able to care for residents as their condition progresses and they require more nursing care; meaning residents are able to remain in the same care home and do not have to move if their needs change.
Residential Care Homes
All care homes are staffed for 24 hours a day to ensure residents are always protected and looked after. Many of the staff members will be qualified health care assistants that have received a qualification in Health and Social Care at Level 2 or 3.
All care home managers are legally required to have a qualification in Management, as well as a Level 4 qualification in Health and Social Care. This enables them to not only understand the care that residents require, but also to ensure that it is carried out correctly at all times. They do not require nursing experience, but experience as a health care assistant is vital.
In residential care homes, staff offer assistance with a variety of tasks including washing, dressing, toileting, and mobility. Staff can also assist residents with eating and drinking, and participating in social activities.
Each resident has their own personalised care plan, created by the care home managers, that outlines their needs and the type of care they require. They outline the resident’s medical history, their likes and dislikes, and information about loved ones, as well as any medications they are required to take. Case notes are recorded by the staff on duty at the end of each shift that highlight how each resident is feeling that day, whether they require any extra assistance, and any activities they participated in.
If, at any stage, nursing interventions are required, either for medication or injury, district nurses are called out to provide the necessary care and complete any care that general health care assistants aren’t qualified to do.
Nursing Homes
Similarly to residential care homes, nursing homes provide all the care that residents require, although, the care is supervised by registered nurses that are on duty at all times.
Nursing homes are more suited to individuals that have complex care needs and will require frequent medical attention. This is because nurses are available to carry out specialist care 24- hours a day.
Due to the fact that residents in nursing homes often have complex needs, nursing homes usually have a range of specialist equipment that allows staff to provide the necessary care with ease. This includes adjustable beds, hoists, standing frames and more – all of which offer support for individuals with mobility issues.
Determining the type of care required
The next stage involved in choosing a care home is to determine the type of care your loved one requires, and is likely to require in future. For example, if your family member has a condition such as dementia, it’s likely they will continue to deteriorate over time. This means their care needs continue to increase, so it’s important to find a home that can accommodate.
There are three main types of care that care homes and nursing homes can provide: palliative care; dementia and Alzheimer’s care, and long -term residential care. Each type focuses on a different set of care needs, which is why it’s important to know which type your loved one is in need of.
Palliative care
Palliative care is a specialised type of care that was created for people suffering with serious illnesses or conditions. Its aim is to provide relief from the side effects of the illness, such as pain and stress, and to improve the quality of life for the patient and their family.
Although palliative care isn’t just offered to individuals with a terminal illness and can in fact be used to help people recover from illness, it is usually the type of care provided to individuals that have a terminal illness and are coming to the end of their life.
Palliative care can be used to improve your loved one’s life at any age. It combines pain and symptom management with emotional and spiritual support; ensuring your loved one is treated holistically, and not just for their illness.
Dementia and Alzheimer’s care
Many residential care homes and nursing homes specialise in providing care specifically to those diagnosed with dementia. Due to the fact that there are several types of dementia, the care needs of every individual differ.
Staff will consider the type of dementia your loved one has, and assess how the condition affects them in their daily life, in order to determine what needs to be covered in their personal care plan.
Caring for someone with dementia doesn’t just include personal care, it also covers the management of behavioural changes; such as aggression, confusion, and other symptoms of the condition. That’s just one of the reasons that choosing a home that is staffed with people who have dementia experience is vital.
Long term residential care
Long-term residential care is a brilliant option for individuals that are, for the most part, relatively independent, but may require some assistance with daily tasks such as cooking. It refers to people receiving long-term care in a residential setting, rather than in their home.
Most long-term residents continue with many aspects of their life, including attending church, spending time with family, and going on days out. The residential home simply takes the place of their own home and allows them to have access to any care they need.
The cost of care homes
There’s no doubt that paying for your loved one to live in a care home is expensive, and for many families, it’s a worry that they won’t be able to afford to pay for long- term care. However, there are several options available that can make covering the cost of care easier for all involved.
There are two main ways to fund care home fees, which include self-funding, and state funding. Some local authorities will contribute to the overall cost of the care, although, the resident and their family are expected to pay a fraction of the fees. The cost of care can also be covered by selling property and other assets.
What are the different funding options?
There are two main ways to fund care home fees, which include self-funding, and state funding. Some local authorities will contribute to the overall cost of the care, although, the resident and their family are expected to pay a fraction of the fees. The cost of care can also be covered by selling property and other assets.
Self-funding
Self-funding care is when the person moving into a care home has sufficient funds to pay for the care they require. The funds needed to pay for the cost of the care will be taken from savings that the resident has. Once the resident’s amount of savings drops below the £23.5k threshold, local authorities will then begin contributing to the cost of their care.
Will the person receiving care be expected to sell their property?
Social Services will lend the resident the money required to pay for the care charged against their property. However, there are usually limitations to the amount they will contribute, and their funding could have an impact on the welfare benefits your loved one is entitled to.
One option to be explored that doesn’t involve Social Services is renting out the property to private tenants. This could provide the additional income needed, although, as the home owner, the resident will still be expected to pay for the cost of maintaining the property in the same way any private landlord would.
Is there financial help available that isn’t means tested?
If you loved one doesn’t meet the requirements for local authority funding and have to fund their care themselves, Attendance Allowance is paid at £53 per week for anyone needing care in the daytime or night-time, or £79.15 per week for those requiring 24-hour care. This allowance is non-means tested and non-taxable which means the total amount given can be used to put towards paying care home fees.
Furthermore, regardless of whether your loved one’s stay in a care home is temporary or permanent, if they require nursing care, they may be entitled to receive NHS Funded Nursing Care which contributes towards the cost of the required care. The amount paid by the NHS is £109.79 per week, and it is paid directly to the care home your loved one is residing in. If the needs of the resident are solely health care, full funding from the local Primary Care Trust is also available, following a full assessment to determine their eligibility.
State funding
State funding, also known as local authority funding, is when the local authorities pay for the cost of the care home because the resident doesn’t have sufficient funds to cover it. The only downside to state funded care is that your choice of care homes is more limited – the quality of care will still be of a good standard.
In order to qualify for state-funded care, the resident must have less than £23.5k in capital. If this is the case, local authorities will contribute towards the cost of the care home. However, if the resident has capital below £14,250, they will be entitled to the maximum amount of support from local authorities. They’re income, excluding £23.90 per week, will also be put towards covering the cost of the care required.
If the state is paying, do older people have a choice of care home?
Regardless of whether the care your loved one requires is state funded, they still have a choice in which care home they would like to reside at. Their chosen home must be able to provide care that meets their individual needs, comply with any terms set by the local authority, and not cost more than they would usually pay for someone with the same or similar care needs.
What if the home costs more than the authority is willing to pay?
In case your loved one finds a care home that costs more than the local authority is willing to pay, they will allow a third party to contribute to the overall cost of the care, as long as they can prove their ability to cover the payments long term. The individual moving into the care home is unable to top up the fees themselves if their capital is below £23,250.
Care home cost by location
Although the national average cost of a residential care home is £29,270 per year, the cost actually depends on a variety of factors – one of which being its location. For example, the cost of living is much higher in London than it is in the North West of England. This means that it costs significantly more to maintain and staff a London care home, and to take care of residents, than it does in a North West care home. If the family member that will be moving into a care home lives in the South of England, be prepared to pay more for their care.
However, although some care homes are significantly more expensive than other depending on where they’re situated, the amount of financial assistance an individual can receive from the local authorities is the same.
Selecting care homes
When you’ve determined the type of care your loved one requires and know whether or not their care will be paid for by the local authorities, or self-funded, it’s then time to start looking into the care homes in your location.
Have a look online at some of the homes situated nearby, go on their websites, and find out which types of care they offer. Make a list of any that meet your criteria and have values and goals that you agree with.
If you’re struggling to figure out where to start your search, there are a number of different websites that can compare a variety of care homes for free. These websites offer an overview of several care homes and should give you more of an idea of the homes in your area that could adequately meet the care needs of your loved one.
Care Home Advisor
A great website for comparing care homes is Care Home Advisor. It acts as a directory for care homes across the UK and scores them out of 100 based on feedback from the Care Quality Commission.
Each listing contains snippets of information about the home, a photograph, and the scores it received from the Care Quality Commission. It offers an overview of several local care homes and provides contact details for each one.
Overall, Care Home Advisor acts as a one-stop-shop for anyone searching for residential homes or nursing homes and can be a great starting point for anyone that’s unsure on where to start their search.
Location
One of the next things that needs to be taken into consideration when choosing the ideal care home for your loved one is its location. Most areas have several care homes and nursing homes for families to choose from. To prevent you falling in love with a care home that is situated too far from family and friends, make sure you only look at the homes that are within a short distance from your location.
Putting your loved one in a home that’s nearby also means that you’ll have the option to visit them with ease, continue including them in family activities, and ensure they’re comfortable being in an area that they’re familiar with.
Size
The size of care homes and nursing home varies: Some homes will only be able to accommodate 10 residents, where as others can accommodate over 50. Try to consider whether your loved one would be more comfortable in a home with less residents, or whether they would prefer the company of more people.
If you do decide that a larger care home is more suitable, make sure that there are enough staff members on shift at all times to look after the number of residents. Understaffed care homes can lead to the care needs of residents not being met and therefore being unsatisfactory.
Type of specialised care in the care home
Another vital consideration is the type of care the residential home or nursing home specialises in. If you have a loved one that requires more complex care, it’s vital that you select a home that can successfully meet their needs and offer them the best care and treatment possible.
Nonetheless, if the individual moving into the care home simply requires long-term residential care, there’s no need for them to move into a home that only deals with complex care.
Not only should you think about the kind of care your family member currently requires, but also the kind of care they may require in future. For example, if your loved one is living with dementia, they will deteriorate over time due to brain health decline, which means they’ll begin to require more hands-on care. Finding a home that accommodates for this is beneficial.
Things to check before visiting a care home
Once you’ve spent time researching into different care homes online and have made a list of a select few that are of interest to you, the next step is to make appointments to visit them.
Visiting the care homes that you think may be a good fit for your loved one is a very important part of choosing a care home because it enables you to understand the dynamics of the home, meet the residents and staff, and determine whether or not it will be suitable for the person that requires the care.
The Care Quality Commission (CQC)
The Care Quality Commission is the independent regulator of all health and adult social care carried out in England. Their role is to ensure that the health and social care services individuals are provided with are safe, effective, compassionate, and of a high standard.
Their team of professionals register care providers; monitor, inspect, and rate care services; protect the individuals using the care services; and voice their views on major quality issues in health and social care. From dementia care and nursing care, right through to general health care, the CQC ensure that all fundamental standards of care are met in every establishment. Not only does this make it easier for families to choose care for their loved ones, but also gives them piece of mind that their loved one is in good hands, with access to the care they require.
If any care homes or medical establishments don’t meet the standard of care expected, the CQC will either provide a list of improvements the establishment has to implement, or close them down, taking away their ability to provide unsatisfactory care.
Some of the fundamental standards put in place by the CQC are:
- Person-centred care
Your loved one must receive treatment and care that is tailored specifically to their needs and preferences. For example, if they struggle with some physical activities, or if they have any ongoing medical conditions, this should be mentioned in their personalised care plan, and a course of action should be outlined and implemented.
- Dignity and respect
Your loved one must be treated with dignity and respect whilst receiving any type of care and treatment. This includes being given privacy when requested, being treated as equal to others, and given any support with maintaining independence.
- Consent
Either the resident, or the individual acting on their behalf, must give consent before any care or treatment is carried out. If consent is not given, the care or treatment must not be carried out.
- Safeguarding from abuse
The resident must not suffer any form of abuse whilst receiving treatment or care, including but not limited to neglect, degrading treatment, inappropriate limits on freedom, and unnecessary or disproportionate restraint.
- Staffing
The provider of your loved one’s care must have enough suitably qualified, competent, and experienced staff that are able to provide care that matches the fundamental standards. Their staff must have access to support and supervision to assist them in their role.
- Display or ratings
The CQC rating given to the care provider must be on display and visible. It should also shown on their website, and the CQC’s latest report must be available to your loved one upon request.
If you’re interested in finding out more about the Care Quality Commission and the rest of the fundamental standards, head over to their website.
Check out the car home reviews
One great way to find out more about a specific care home from an outsider’s perspective is to read reviews on Trustpilot and Google, such as Carehome.co.uk. Family members of residents will be open about whether their experience with the home has been a positive one, and whether they have had any issues with them.
If the reviews are positive, it’s likely that the home is adequate, has happy residents, and provides a good level of care. If the reviews are negative, the best option is to explore a different care home or nursing home.
Visiting care homes
Visiting your selected care homes is a vital part of choosing the perfect residential or nursing home for your loved one. Regardless of whether the care provider’s online reviews are brilliant, they have an outstanding rating from the CQC, or they have a fantastic reputation, it’s important that you would feel comfortable sending you loved one to reside with them.
If you don’t like the atmosphere, are unsure on the personalities of some staff members, or don’t feel overly confident that your loved one would be happy living there, cross it off your list and visit a different one instead. You and your loved one have to be 100% satisfied with your chosen care home, so don’t worry if it takes visiting a few to find the right one.
What to look out for when visiting a care home
There are several things you should be looking out for when visiting a care home. 10 of these things include:
- Do the residents seem to be happy and well looked after?
- Is the home clean and well kept, and does it smell nice?
- Are any residents taking part in activities, or interacting with others?
- Do staff come across as kind and polite, and do they respect the privacy of the residents?
- Are the residents’ bedrooms nicely decorated?
- Are their quiet zones without TVs and music where residents can relax?
- Is there a garden that staff and residents can exercise in?
- Is the care home manager friendly with staff, residents, and residents’ loved ones?
- Is the home accessible for individuals with physical disabilities?
- Does the food the residents are eating look tasty?
Furthermore, you should bear in mind that if your visit has been scheduled, the care home staff will have made sure the home and residents are in the best possible condition in preparation for visitors. For a more accurate picture of the home on a standard day, try visiting it without giving prior notice as well. If it’s just as nice as when you came for a scheduled visit, it’s time to start asking questions about the home itself, the staff members, other residents, and the kind of care services they can provide.
Questions to ask when choosing a care home
Taking a list of questions with you when visiting your shortlisted care homes will ensure you find out everything you’d like to know about the home, the staff, the environment, and the care provided. Don’t be afraid of asking lots of questions: the more information you have, the more confident you’ll feel in your final decision.
Below, we’ve created a checklist of questions to ask during your visit. Simply download the PDF, print it off, and take it with you.
Things to do before making your final decision
Once you’re happy that you’ve found the right care home for your loved one, there are a few things you should do before making your final decision and signing contracts. These are:
- Read the care home inspection reports
Care home inspection reports are publicly available and can offer a valuable insight into how well a care home is managed, and the level and quality of care they offer. Not only will they enable you to see if any points raised by inspectors have been addressed, they’ll also provide an overview of staff turnover and the frequency of inspections.
If the home has a relatively high turnover of staff, it’s likely that staff members may be unhappy in their role at the home. If regular inspections are taking place, this could indicate that there have been a number of issues surrounding the home that are currently being monitored by the regulatory bodies.
- Try to arrange a trial stay
If your loved one would like to experience what living at the residential home is like, some homes will allow you to arrange a trial stay for your loved one. This is not offered across the board, but it’s still worth asking. If the care home won’t allow a trial stay, you may be able to request a respite stay in which your loved one will spend a few days at the care home to determine whether they would be happy there.
Doing this would give you and your loved one the opportunity to understand the home from the inside out, therefore assisting you in the final decision-making process.
- Ask further questions if there’s anything you’re unsure about
Even if you feel like you’ve asked several questions, if there is anything you are unsure about, don’t be afraid to ask. Care home staff will be more than happy to answer any questions and offer advice and guidance if necessary.