Finding the right care home : A guide to Elderly Care

Once you have decided upon the type of care, have undergone your needs assessment and know what you can afford then your next step is finding the right care home.

If social services are paying for some, or all of your fees then your care manager will have a list of suitable homes for you to visit. He or she can also help to arrange these visits or will engage a company to do so.

If you are looking for a care home in the independent sector and are paying for all of your care then you can choose any home you wish, phone them and arrange a visit.

Care home quality ratings and inspection reports

Whether you choose a local authority or private care home it is a good idea to read through inspection reports for these homes and look at their quality ratings.

The idea behind this is that care homes are regulated and inspected by official bodies which award a ‘star rating’or a similar award based upon their level of care. The more stars or awards a home has the better it is likely to be.

This is useful when comparing the types of services offered by care homes. The Care Quality Commission regulates care homes in England. They have an online directory of care homes which shows their star rating and includes an inspection report.

Their star ratings are:

• 3 stars: excellent standard of care
• 2 stars: good standard of care
• 1 star: adequate standard of care
• 0 stars: poor standard of care

There are other similar organisations within the UK which are:

• The Scottish Commission for the Regulation of Care
• The Care and Social Services Inspectorate Wales
• The Regulation and Quality Improvement Authority

It’s a case of reading through the inspection report and checking the star rating before you visit a home.

You will need to visit a few homes in turn before deciding upon which one for you. If you are being helped by your social services department then they will provide a list of homes and will help you to make any arrangements. If you choosing to pay for all your care then ask your GP, family and friends, or visit the websites of respected organisations such as the Care Quality Commission.

Visiting a care home

Draw up a list of homes you would like to visit and arrange this with each one in turn. Take someone with you - a friend or relative to look around the home. Take a list of questions with you (listed below) and ask the staff at the home as many questions as you need to.

Don’t feel rushed or pressurised into making a decision.

You will probably find that you know when a place feels right or not. It is similar to buying a house when you walk in through the door and know right away if it is the right house for you.

It is the same with a care home. You will get a ‘feel’for the place as you walk around and talk with others, staff and residents.

List of useful questions

We have divided this list up into sections which might make it that bit easier. There are so many things to ask as you walk around and it can be difficult trying to remember all of these.

The main issues are:

Are the staff fully trained, caring and capable of dealing with your needs?

Is the home accessible (e.g. wheelchair friendly)?

Does it cater to special diets?

Will it cater to any other needs such as religious or cultural?

Can you have your own GP?

Can you bring your own belongings and/or pets?

The following questions are meant as a guide only (source: BUPA).

Categories:

• Location
• Initial impressions
• Care
• Communal areas
• Bedrooms
• Meals
• Activities and events
• Staff
• Visitors
• General/Other

Location

1. Is it in attractive surroundings/nice area?

2. Is there somewhere for residents to sit outside?

3. Is it near or convenient for public transport (e.g. bus stops), the shops, post office, pub etc?

4. Is it easy for family and friends to visit the home? Can they park their car within the premises?

Initial impressions

1. Were you made to feel welcome? Is there a friendly atmosphere?

2. Is the home clean and well cared for?

3. Does it look ‘homely’and inviting?

4. Does the home smell pleasant (no unpleasant odours)?

5. Do the residents seem happy and well looked after?

Care

1. Is the type of care suitable for your needs?

2. Are you free to come and go as you please?

3. How often are your ‘care needs’ likely to be reviewed?

4. Are you or your relatives involved in decisions about your care?

5. Can the home provide care in the future?

6. Can you get up and go to bed when you want?

7. Do dentists and opticians visit the home?

8. Does a hairdresser visit the home and if so, how often?

9. What GP do residents see or can you continue to see your own GP?

10. How quickly will your relatives be advised if you are taken ill?

11. Does the home provide complementary services, chiropody and occupational therapy?

12. Do you have assisted bathing facilities?

13. Are you allowed to make a drink or prepare food if you get thirsty or hungry in the night?

Communal areas

1. Is there a quiet room without a television?

2. Is there more than one room where residents can see visitors?

3. Is there room where residents can relax?

4. Is there a safe garden?

5. Are there plenty of toilet facilities?

6. Is there a ‘smoking area?’

7. Is there wheelchair access?

8. Are there handrails in all the corridors and toilets?

9. Do residents have access to the Internet?

Bedrooms

1. Can you have a private phone in your room to make outside calls? If not then is there a phone in a communal area which allows you to make a call in private?

2. Can you bring your personal possessions with you such as furniture and plants?

3. Can you bring your pet?

4. Have you seen the room that has been allocated to you?

5. Is the room warm, welcoming and nicely decorated?

6. Are there en-suite facilities?

7. Does your room have a television?

8. Does your room have Internet access?

9. Does your room have a lock?

10. Are there lockable drawers/cabinets in the room?

11. Does your room have a call system?

12. Can you change rooms if you wish?

Meals

1. Do you have a choice of what to eat each day, and when to eat?

2. Does the home cater to special diets/religious requirements?

3. Is the food freshly prepared?

4. Can you choose to eat in your room or is there a communal dining room?

5. Are snacks available at any time of the day?

6. Are the menus rotated on different days?

7. Are residents consulted about what they would like to eat?

8. If you need help with eating then are there staff trained to do so?

9. Can your family and friends eat a meal with you?

10. Can you sit with whoever you like in the dining room?

Activities and events

1. Does the home have a weekly activity plan and if so, can you see it?

2. Are residents asked about any hobbies or interests they might have?

3. Are events such as birthdays celebrated?

4. Are residents encouraged to undertake exercise?

5. Can residents take part in any activities outside of the home?

6. Can you relatives/friends help out with any of the activities?

7. Does the home arrange trips out for the residents?

8. Does the home have its own transport?

9. Are religious needs met? Can residents visit their preferred place of worship?

10. Are there daily newspapers for residents to read?

11. Is there a library or access to a library?

12. Can residents help out with activities in the home such as cooking, cleaning or gardening?

13. Is there a residents committee?

14. Are there any photographs of activities in the home?

Staff

1. Are the staff friendly, caring and competent towards the residents?

2. Does each resident have their own personal member of staff who is responsible for their care?

3. Have the staff got time to spend with the residents?

4. What training do the staff receive?

5. How do staff find out more about a new resident? How do they know what the new resident likes or dislikes?

6. Does it feel as if an individual resident’s needs and wishes are met?

Visitors

1. Can you see visitors at any time of the day or are there set visiting times?

2. Can children visit you?

3. Can visitors stay overnight due to a long journey or if you are ill?

General/Other

1. Are there any residents/relatives feedback or testimonials?

2. Are there any ‘thank you’ letters displayed?

3. Is it clear what type of care home this is?

4. Did you read the latest inspection report?

5. Can a trial stay be arranged?

6. Does the home have a complaints procedure?

7. Is there a waiting list and if so how long?

8. What does the weekly fee include?

9. What does the home charge as ‘extras?’

10. Does the home insure a resident’s personal possessions?

11. What is their star rating?

Make notes as you visit. Think about the answers given during your visit and if you feel that they have been answered satisfactorily.

Here are a few things to consider following your visit:

• Was the home happy to answer all of your questions?
• Were the staff friendly and happy to explain what type of services they offer?
• Were the costs and charges fully explained and do they seem fair?
• Were you able to talk to other residents?
• Did they ask you many questions about your likes and dislikes (or the person you are caring for)?
• Can you follow your way of life or do you have to fit in with what the home wants?
• Did they give you a blank copy of the contract for you to review after your visit (applies to self-paying residents only)?
• Were you shown the latest copy of their inspection report?

If you were not happy with the answers given or there are more ‘no’answers than ‘yes’answers then think carefully about this home.

Don’t be put off from returning to the home to ask further questions. If you don’t feel that it is right for you (or the person you look after) then look elsewhere.

Signing a contract

If you are happy with the home and the fees then you will be given a contract to sign. Check the terms and conditions of this very carefully and make sure you understand it. Do not sign if you are at any stage unsure or not happy with a particular aspect.

If you are being helped with the costs by social services then check to see if they are happy with the home and the fees.

If you are paying for all of your care yourself then you will be given a contract to sign.

If social services are assisting you with the fees then it will compile a contract but you will a written statement showing the terms and conditions.

Contracts may vary but they should contain the following:

• Fees and what they cover
• Deposit and how much
• Any extras/services which are charged on top of the normal fees
• How the NHS contribution towards the cost is treated (see our paying for elderly care section)
• What notice is required before vacating the home
• How are temporary stays such as hospital stays charged
• Charges made after a resident’s death

If you have concerns about the terms of a contract then contact the Office of Fair Trading (see our links page).

One issue that bothers many people is that of having to sell there house to pay for their care home fees. This is a complex issue which is discussed in greater detail in our paying for elderly care section.

Your care home and personal possessions and/or pets

Before you move make sure you know your care home’s policy on bringing your own possessions and/or pets. Some care homes don’t allow pets and if you are devoted to your dog or cat it can be hard to think about giving him/her away.

Likewise, they may have set rules about what belongings residents can bring with them.

These are issues which must have been dealt with before you made a decision on the home and signed a contract.

Pets

There is a national register of care homes, retirement and sheltered accommodation, run by The Cinnamon Trust, which allow pets. This is a registered charity which deals with the needs of older people and their pets.

If your care home don’t allow pets then see if a member of your family or a friend will look them. It may be the case that the home will allow someone to bring your pet in to see you as part of their visit.

If not and there is no-one available to look after your pet then the RSPCA or the Dog’s Trust will be able to re-home your pet.

Possessions

Your home may allow you to bring in certain items of furniture but not larger items. If this is the case then you have five options:

• Put them into storage
• Given them away to family and friends
• Sell them
• Ask your social services department to take them
• Give them to a charity

Check with your local authority about this.

Changing care homes

If your needs increase then you may have to move to new home which can cater for these. If this is the case then social services will have to re-assess your needs to determine the level of care you now need.