A Choosing the right care home can be a minefield- emotionally, financially and logistically. That is where WhereforCare will be able to help you out as it can help to cut down on the endless rounds of care home visits before making a decision. However, there are still going to be other considerations to bear in mind when choosing a care home for the first time

What is the difference between nursing and residential care?

Nursing homes, or care homes with nursing, are provided for residents who require a high level of nursing care and ongoing medical attention with regular, often weekly visits from a G.P, whilst residential homes are more appropriate for residents with basic mobility and who prefer a degree of personal independence.

Medical provision is limited in residential homes and any nursing care for minor ailments is generally provided by a District Nurse who attends the residential home on a regular basis. Many care homes provide a range of services from residential care through to nursing care and specialist care, for example for the young, physically disabled.

Both nursing and residential homes should still provide a relaxed and comfortable setting for their residents and although nursing homes are often larger and increasingly purpose-built, every effort should still be made make it feel like a residents’ home.

I’m still not sure either of those apply to me…

Although often thought of as ‘old people’s homes’ or ‘convalescent homes’, care homes are becoming increasingly diverse in the services they offer and now range from ‘care villages’ for the over 55’s with cinemas, pubs and bowling greens as standard, to specialist homes for the young physically disabled (or YPD) which offer a younger atmosphere with large screen TV’s, internet cafes, and even swimming pools.

There are also homes which specialise in providing dementia care, respite care or palliative care, not to mention those for specialist services such as brain injury or multiple sclerosis. If you are still in any doubt as to what you are looking for, feel free to read through our discussion boards where you can talk and get advice from other in similar circumstances, and then if you are still unsure, click on the ‘contact us’ part of the website where we will do everything we can to help.

A - Type of care required: Seek the advice of the medical and social services professionals who are familiar with the person in question in order to assess the level of care required, i.e. would a nursing home or a care home which offers both nursing and residential care be more suitable?

- Geography: It is important to engage close family members and friends in discussions regarding the choice and location of care home- if two siblings live 100 miles apart, are you better off getting a home which is equidistant from each or realistically deciding that one person is likely to manage a great deal more visits than the other, so therefore a home closer to them would be more suitable? Try and ensure that the person entering care is consulted as much as possible- it might be that you feel they would be better off nearer to you but actually, if they stayed in their own community they would have a much better level of social interaction than moving them closer to you

- Food and Hospitality: Make sure that the food on offer is to the individual’s liking or that the home is very flexible in the food it provides. Ask for several sample menu’s- a home which has wording such as ‘week 3, day 5’ on their menu’s is likely to have a continually rotating menu which might not change from year to year! -ask the question. Equally, if the individual entering the carehome has always eaten supper at 6pm yet the carehome serves it at 5pm, is there flexibility for change? It might well be that the individual entering the home might begin to enjoy eating at 5pm, but it should be their choice, not someone else’s.

- Financial requirements: Last but not least, take professional financial advice to plan the most cost effective method of payment for long-term care. Bear in mind that there are different ways of paying for care in a care home. The total cost is typically met by a contribution from different sources and the level of assistance you can expect will depend on personal finances. Check entitlement with the local Social Services Department- Remember! You are entitled to choose any home that you feel is right for the individual concerned- it is up to all departments involved to ensure that this becomes financially viable which may involve contributions from third parties. (see information on funding and the discussion board on funding for more information.)

A - Firstly always be wary of homes where you are asked to book an appointment unless a very good reason is given for doing so- the same standards should be delivered regardless of whether there are visitors or not.
- Can you see a copy of the latest inspection report and Statement of Purpose.
- What is the care staff/resident ratio, particularly at night time?
- What training procedures for staff are in place, for example, are they required to study for NVQ’s in Care?
- What percentage of agency staff do they employ? and what training are they required to have? ( no-one wants to see continually changing faces when they are being looked after)
- What languages do the staff speak in the home (if English is not the individuals’ first language)
- What payment system does the home operate and are there any ‘hidden’ extras?
- What complaints procedures are in place?
- Can you see a copy of the activities programme? (This should ideally arrive in a brochure pack- look at the timing of an activity and try to visit at that time. This will help decide whether activities are ‘just for show’ or really do happen regularly.)
- What links exist with the local community?- Do they have regular church services, groups such as rotary visiting the home or can residents be taken to these groups?
- Can residents bring items of familiar furniture/treasured belongings with them? ( the answer to this should always be yes- after all, this is their home)
- Are favourite pets allowed to visit/stay?
- How flexible are mealtimes; what typical foods are served; is there any flexibility regarding alternative menus? Can you eat meals with the resident when you visit?
- Does the home organise trips out to the shops/pub/theatre?
- Are there any specific ‘visiting times?’ –again, if this is the individuals’ home, visitors should not be restricted unless a very good reason is given for doing so.
- What makes this carehome different from others?
-Is there a trial period on either side?
-Are there any additional expenses to the weekly fee?

A

The Minimum Standards for Carehomes, as defined by the Department of Health and the section 23(1) of the Care Standards Act 2000 and which apply to all care homes providing accomodation and nursing or personal care for older people, can be found in their entirety at the following link: Publications Policy and Guidance.
However, a basic guide to the standards is as follows:

Importantly, compliance with national minimum standards is not in itself enforceable, but compliance with regulations is enforceable subject to national standards being taken into account.

The main focus of the National Minimum Standards for Care Homes for Older People is of the impact on the individual of the facilities and services of the home, and are grouped under the following key topics:

Choice of Home
Health and Personal Care
Daily Life and Social Activities
Complaints and Protection
Environment
Staffing
Management and Administration

The standards themselves are numbered and each standard is preceded by a statement of the intended outcome for service users to be achieved by the care home.

Whilst the standards are qualitative, i.e, they provide a tool for judging the quality of life of service users, they are also measurable in that regulators will look for evidence that they are being met through:

discussions with service users, families and friends, staff and managers and others;

observation of daily life in the home;

scrutiny of written policies, procedures and records.

Please visit the above link for more information on this topic.

A

www.counselandcare.org.uk
Counsel and Care is a national charity getting the best care and support for older people, their families and carers. We do this by providing advice, information and financial support and by influencing future policies, services and funding.


Government Inspection Reports
If you are looking for an inspection report on a specific home go to www.csci.org.uk for homes in England, www.carecommission.com for homes in Scotland and www.csiw.wales.gov.uk for care homes in Wales.


TO CLAIM ONLINE FOR ATTENDANCE ALLOWANCE:

www.dwp.gov.uk/eservice ( if you can't 'click through' the link, cut and paste it to your browser).


ELIGIBILITY CRITERIA FOR CONTINUING CARE
In order to check the eligibility criteria for continuing care ( free nursing care) in your area use the following link

www.nhs.uk/England/AuthoritiesTrusts/Sha/list.aspx

(if you can't 'click through' on it, cut and paste into your web browser).

www.careaware.co.uk
Useful non-profit group in terms of any aspect of care funding.


Disability aids from Mabels

Providing assisted retirement living, discount medical supplies, mobility aids, disability aids, disability equipment, mobility products uk & much, much more for seniors & senior citizens.

www.mabels.org.uk/disability-aids.htm

 

A There are various means of funding care- the first thing to do is to contact your local social services department who will explain your entitlements and carry out an assessment of your needs.
I’ve been given a list of care homes by my local authority- it does not include one that is highly rated on your site- why is that?
There are some local authorities who only provide lists of care homes that fall into the lower end of the financial bracket as regards fees- however, they have certain responsibilities under the National Assistance Act 1948 (Choice of Accommodation) Directions 1992 to help you to live in the home of your choice. If you explain to them your reasons for choosing a particular home, or why you require increased funding, they can generally be quite accommodating. However, you may find that you have to pursue a formal complaint with them, in which case it is useful to ask for a copy of their complaints procedure.

Will I have to give a contribution to the cost of my own care?

The guidelines as at April 2007 for paying for care are as follows:
As long as you have more than £21,500 in capital (your home counts as capital) or savings you will have to pay the full care home fees.Savings of less than £13,000 will be ignored, while amounts between £13,000 and £21,500 will be counted as though they produce income, thus meaning that you will have to make some contribution towards your cost of care. If you own your own home its value will be ignored for up to 12 weeks after you become a permanent resident in a care home(known as the 12 week disregard), but after that it will be included in your capital unless:

- Your husband or wife still lives in the house
- A relative over 60, or under 60 but incapacitated, lives in the house.

If neither of the above two circumstances apply, then property will is left empty will be seen as part of your capital and, if it is worth over £21,500 , you will have to meet the full cost of your care.
This will normally mean that you will have to sell your home to pay for your care. If you do not sell your house you will build up a large debt which would be eventually recovered on your death.'

A

Most people have a positive experience of care facilitiess but sometimes problems can come up and you may want to make a complaint.

You could ask a friend or relative, a voluntary organisation like the Citizens Advice Bureau or a charity to help you make your complaint. Complaining can help improve the quality of care home services.

You can clear up many problems by having an informal chat to a member of staff or the manager of the care home.

If you're not satisfied that the matter has been cleared up after an informal chat, you may want to make a formal complaint to your care home.

All registered care facilities must have a complaints procedure, which should have been clearly explained to you when you moved in. It must set out how residents or those acting on their behalf can complain about the service.

You can complain to the Commission if you're not satisfied with the result of your formal complaint to your care home. You can also complain directly to the Commission from the start.

You don't have to tell your care home that you have complained to the COmmission, but a full investigation might be difficult without them knowing. The Commission will write to you and let you know what they will do about your complaint.

In Scotland, this would be the Scottish Commisssion for the Regulation of Care. We have provided a link to their Complaints web page here:

Improving care in scotland

In Wales, this would be the Care and Social Services Directorate Wales (CSSIW). We have provided a link to their complaints webpage here:

Care Services Directorate

In England it would be the Commission for Social Care Inspection:

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