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When to consider a care home
It may feel like a last resort but, if the available support isn't quite enough, a care home could offer security, familiarity and a ready-made community.
Is it time to look at care homes?
Helping a relative move to a care home is a big decision. In some cases, it will mean leaving behind a family home where they’ve lived happily for many years. It’s vital to make a sound choice.
Typical reasons for choosing full-time residential care can include:
- a significant deterioration in physical health or mobility, often caused by illness or a fall
- loss of help that was previously provided by a partner, relative or neighbour
- an illness that is hard to manage, such as advancing dementia, which limits the ability to stay at home safely
- loneliness, isolation or depression.
Making the right choice
Ideally, you only want to make this choice once. Naturally you’ll want to do everything you can to make sure your relative’s needs are met and that they’ll be happy. The first decision depends on the level of care that your relative needs. There are two main care options:
- Residential care homes cater for people who need frequent help with personal care, and who can no longer have their needs met at home.
- Nursing homes are suitable for those with more complex medical and nursing needs. They provide medical care from a qualified nurse who is on site 24 hours a day.
Seven steps to finding the right care home
- Get a needs assessment from your local authority (see the section Care in the home). This is a free, professional assessment of the type of care and support needed. It will help you and your relative choose the right care home for their needs.
- Use the Which? Care services directory to find details of care homes in your chosen area. This might be near their current home to make it easy for friends to visit, or close to you, so you can pop in regularly.
- Check the care home inspection reports. In the UK there are four watchdogs charged with inspecting and reporting on care providers (see below). The reports are publicly available and give valuable insight into how well a home is managed and the level of care. If you are looking for care services in England, our directory gives the provider’s inspection ratings at a glance, as well as a food hygiene rating and a link to the latest CQC Care Quality CommissionThe independent regulator for care homes in England. inspection report.
- Ask friends and family for specific recommendations (homes run by the same company can differ considerably).
- Contact suitable care homes and ask for a brochure and details of costs. Discuss whether your relative will be self-funding or council funded, and ask whether there are places suitable for their specific needs.
- Visit. It’s important to see how comfortable your relative finds being there. Talk with the manager, and see how staff and residents are with each other. Download our checklist of the key questions to ask when you visit.
- If possible, arrange a trial stay so that your relative can experience the home first-hand.
Contracts: what to look out for
The contract will be between the care home provider and whoever is paying for the care. There are three likely scenarios for payment:
- Self-funding: if your relative is paying for their own care, the contract will be between them and the care home.
- Local authority funding: if a local authority is paying for your relative’s care, the contract will be between the local authority and the care home.
- Shared payment: if you or someone else is paying a top-up fee to the care home (see the section The cost of care), there will be two contracts – one between the local authority and whoever is paying the top-up, and another between the local authority and the care home.
A good contract should clearly list all fees and explain who is responsible for paying them, and when. This should include any ongoing fees, plus a breakdown of charges for additional services, such as meals, laundry, personal care and the TV or phone calls. It should also specify the type of accommodation, the level of care, and what is and isn’t covered by the home’s insurance.
It’s worth getting independent legal advice if you have concerns about a care contract. Check out our detailed online guide to care home contracts.
Each part of the UK has its own independent body responsible for keeping a register of care homes, and for checking them to ensure that they meet national standards:
● England: Care Quality Commission (CQC)
● Northern Ireland: Regulation and Quality Improvement Authority (RQIA)
● Scotland: Care Inspectorate
● Wales: Care and Social Services Inspectorate Wales (CSSIW)