Choosing a Care Home

Many of our clients have found themselves in a position of looking for Long Term Care provision for a member of their family. This is usually for a parent or grand-parent but is increasingly becoming relevant for those planning for their own needs where they already live alone. The search often starts when the care required is beyond that which family are able or willing to provide or, where the individual requiring care, feels they are keen not to be a burden on their family.

Most would say they are keen to retain as much independence as possible for as long as possible, ideally, remaining in the familiar and comfortable surrounds of their own home. This tends to be workable where the care needs are modest, such as mobility problems. In which case, having one or two carers visiting the home in the morning and evening to assist with getting in and out of bed, washing, dressing and possibly preparing a meal, can usually be done well at the cost of circa two hours per day.

However, once care requirements accelerate to needing frequent interventions and/or observations through the day, the giving of medication, changing of dressings or dealing with the risks of dementia, then the costs of providing around the clock cover at home becomes prohibitive for most. The total costs of employing two full time carers working shifts, plus agency workers to cover days off, holidays and sick days, is likely to be of the order of £100,000 to £150,000 per year, depending upon geographical variation and what skill set is required.

The above takes no account of those who choose to move for the benefit of being in the company of others, for being alone after many years of living with a spouse can in itself be quite debilitating. Those in better health would probably choose to move to dedicated retirement complexes or sheltered housing, whereas those with poor mobility and/or greater care needs would move to a care home environment.

Given the bad press care homes have had in the press, it might be easy to overlook the fact that most care homes do not appear in the press as they deliver satisfactory or even excellent care. Establishing the right type of care home and how good it is will be key for most, unless the budget is tight, which it will be for those with modest means or those who are dependent upon Local Authority funding, (a subject in its own right).

Firstly, it is important to establish what ‘needs’ the individual has, be they accommodation, basic care or even nursing care. This needs assessment will enable a narrowing of care homes to those suitable to provide the appropriate care. If you are not sure, it may be a good idea to ask the Local Authority to undertake a Care Needs Assessment, (which can also apply to those wishing to stay in their own home). You can find out more here. In addition, for those with Dementia, it would be advise-able to consider homes who adopt the NAMASTE Care approach.

Having established what is needed from the home, you may have views which favour or dislike the ‘big chain’ care homes. To help you refine your selection process further, you might wish to follow the following path;

  1. In the first instance, use the following two links to help you establish the ratings applied to individual care homes and homes within a group by the Care Quality Commission and then the Carehome.co.uk website, which also factors in user reviews.
  2. When you wish to visit a care home, do NOT call and arrange an appointment, simply turn up on the doorstep stating you wish to take a tour, as you are trying to decide on a home. If they are not willing to do so, then you might want to ask yourself what they have to hide.
  3. Whilst taking the tour, note any unpleasant odours as well as the general condition of the property and the mood of the residents. Speak to the manager and find out what type of manager they are. Do they make sure they spend time at the ‘coal face’ or are they locked away in the office? Ask what the night time staffing levels are and what the minimum qualification split is for each shift. Does the home engage in the local community, such as church groups and activity programmes and if so, who is their activities co-ordinator and how good are they? If there are specific care needs, establish if they can care for them and how they do so.
  4. Once you have shortened your list, you might want to try to ‘drop in’ for an unannounced visit in the evening after dinner, to see what the mood and staffing levels are like.
  5. Another good filter is to get the opinion of those you know who have a relative in a local care home, or even live there themselves.
  6. Once you think you have made your choice, if you are in a position to do so, you might want to try a few weeks trial first, if the home is willing and able to do so.

Clearly nothing is guaranteed but adopting the above process, (which was also recommended to us by a lawyer who was a leading light in the Solicitors for the Elderly), is far more likely to lead to a satisfactory outcome and hopefully, make it a less stressful experience.