Care Advice - Finding a Care Home

‘Finding a Care Home’ – a free guidance leaflet from Comparecarehomes.com

Revised in 01 September 2009

Quite often, a move into a care home is suggested because of some crisis - maybe an illness or a fall - but it is not always the only solution. Think about why you are considering moving into a care home. Is it mainly because other people advise it? Or do you really want to make the move? Your family and friends, or people like your doctor or social worker, can help you to work out what you want to do. But it is up to you to make the final decision about what is best.

It is important to know that there are alternatives that should be considered. Sheltered housing may be the ideal choice for you, or you may prefer to get help to stay in your own home with help from services such as meal-on wheels, or through adaptations to make life at home easier – this is often called ‘home care’. It is also possible to just have a short stay in a care home for a trial period, for instance if you are recovering from an illness or wish to give your carer a break. This is often called ‘respite care’.

Types of care home

If you think that a care home is the right choice for you, it is important to make the move as positive a step as possible. Moving into a care home can be a big relief for people who've been struggling at home or have become isolated. Care homes can offer a secure and comfortable environment and the opportunity to be in the company of other people.

It is important to note that there are various types of care home:

Residential Care Homes	Residential care homes provide accommodation with 24-hour on-site staff there to help with such things as personal care like bathing and changing. They also offer a safe environment to recover from illnesses or minor conditions that do not require intensive medical attention.
Residential Care Homes with Nursing	A nursing home provides a service similar to a residential care home with the added benefit of trained nurses available 24 hours a day to cope with residents and patients that require a higher level of care such as patients that suffer Dementia, Huntington’s disease, Parkinson’s disease or physical disabilities. A nursing home is generally more expensive than a residential home.
Specialist Care Homes	Specialist care homes that have specifically trained staff and homes that are specially adapted to cater for specific illnesses or conditions. This may include palliative care for the terminally ill. These are typically the most expensive type of care home.
Holiday Care Homes*	Are a relatively new type of care home, that typically operate in warmer Mediterranean destinations. This type of care home provides all of the facilities of a residential care home, but combines it with a holiday experience for the user.

* Note: At present comparecarehomes.com does not offer a Holiday Care Homes comparison function.

In England, The Care Quality Commission (CQC) inspects all registered care homes, rating them and writing detailed reports of their findings. You can read these reports on-line on the CQC website. It is important to note that The Care Standards Act 2000 created a new independent body for Wales, the Care Standards Inspectorate for Wales ('the Inspectorate'), with responsibility for regulating, inspecting, monitoring and setting standards for all agencies and establishments providing social care, including care homes in Wales.

How do I choose a care home?

Everyone is different, and it is difficult to provide comprehensive guidance in relation to this question. For the vast majority of people going into care, the three most important considerations are cost, care services offered, and location.

Our best advice is to first decide which town/area you would like to live in, and whether you would like to be close to home and familiar surroundings, or whether you would prefer to move to a different area, to perhaps be closer to family and friends. There are over 25,000 elderly care homes in the UK, and this figure is constantly growing. This growth is enabling people to be more flexible in their choice of care home, allowing the person going into care increased freedom to chose where they wish to stay. The comparecarehomes.com website includes a postcode search function, which will display all registered care homes in relation to the location selected, and will display them in a list, with the closest shown first.

In relation to cost, it is obvious that good quality care can be expensive for some, the choice of care home will ultimately be decided mainly by price. This is especially true if the cost of your care is being funded by your local council, who may set limits on the funding available to you. Our advice pages on care home funding explain this process in more detail, and how you may challenge the decisions of local authorities if you feel that their financial decisions have unduly restricted your choice of care home.

To summarise: Local Councils will pay the fees of residents who own less than £13,500 in assets. Those with more than £22,250 in property, money and shares are liable to meet all the costs of care, less any state benefits to which they are entitled. The NHS will typically also contribute £103 a week towards nursing costs.

However, a council must pay the full fees for the first 12 weeks that people are in care, if their assets, minus the value of their home, are less than £22,250.

Local Council Funding - Your right to choose a home

Even if the local council is arranging and paying for your care home, you should have some choice as to which home you move to. It should not be a case of you moving to where you are told there is a place.

Your local council may suggest a particular home to you, or offer a choice of homes. However, you may not like the suggested home when you visit it, or you may have a particular home in mind. If so, you can ask the local council to arrange a place for you in the home that you prefer. If you do move to a home outside your local council area they will still be responsible for arranging payment.

If you choose a home that is in another country in the UK you will need to ask your local council if they can make a special arrangement. You will be assessed under the rules from the country you are moving from. However, if you are in Northern Ireland and you want to move to England, Scotland or Wales the situation is more complicated. We suggest that you contact one of the leading charities such as First Stop for more advice on this issue.

Apart from the restrictions mentioned above, you should be able to move to the home of your choice as long as:

your chosen home has a place available;
it is suitable for your assessed needs;
the home will enter into a contract with the local council under the council's usual conditions; and
it doesn't cost any more than the local council would usually expect to pay for someone with your needs.

What to look for in a care home

Care homes that provide nursing cost on average £35,100 a year, according to the latest report by Laing and Buisson, the health data specialists. For that price, the residences should be caring and homely, but not all are. Clare Kirkman, author of How to get Good Care Services, has worked in the care home industry for 24 years.
First, she advises, do not place too much importance on how the home looks or its star rating, which is only a snapshot. Managers and staff may have changed since the inspector called. Ask if you can speak to other families and residents and if the home has a system for dealing with complaints. If they claim never to have complaints, they are not being realistic or honest.
Bigger, purpose-built homes may look better, and smaller cosier establishments more dated, but the latter may spend money on other things, such as outings or fresh flowers. Toilet odours or residents looking unkempt and slouched in their chairs, with nursing staff too busy to attend to them, should raise concerns.
Ideally, Kirkman suggests, you should ask to have lunch or dinner with the residents. You should inquire about staff training, and if a resident's physical or mental condition changes, will he or she be cared for indefinitely there, and the visiting hours, meal times and whether snacks can be provided, and what outings or activities are put on.

Comparecarehomes.com has created a questionaire to help you ask the right questions when viewing a care home.

Arrange a "trial" stay

Once you think you have made up your mind we recommend that you arrange a trial stay at the home before you commit yourself to a permanent move. Homes should be able to offer you a short stay from a few days up to a few weeks.

This advice page has been compiled with advice from the following sources:

Alexandra Blair, Making sure the price is right for care, The Times Newspaper, January 16, 2009`