A guide on things to consider if you or a relative of yours needs to move into a residential care home or nursing home.
Introduction
You may need a level of support and long term care that cannot be provided in your own home. In this case, a care home may be the ideal choice. Your local council’s social services department can provide information about what services are available and how to get them.
When going into care, there are many different types of care home to choose from.
Some offer full time nursing care (nursing homes), whilst others just provide personal care and support with everyday activities (residential care). They can be run by local councils, private businesses or not-for-profit companies or voluntary organisations.
Choosing a care home
You have the right to choose your care home. Finding one that is right for you might take some time. You should make sure the care home you choose has the facilities, equipment and staff with the right training to meet your needs.
Each local council sets amounts that they normally pay for someone with your assessed needs. If you want to move into a care home that is more expensive, you may need to pay the difference.
- See Choosing a care home section below.
Types of care home
There are different types of care homes. Some offer full time nursing care, others support people with a specific disability or medical need.
If you are currently receiving treatment on a regular basis from a qualified nurse, you may need a care home with nursing. Your district nurse or hospital staff will be able to help you decide.
- See below for types of care home
Covering the cost
Care home fees are a worry for a lot of people. Care homes providing services and facilities appropriate to particular disabilities can be expensive.
Health and care professionals will assess your needs and help you find a care home that meets those needs.
They will then do a financial assessment to work out how much you can afford to contribute towards the costs.
Temporary stays in a care home
There are many circumstances in which you might have a temporary stay in a care home.
For example:
- To recover from an illness
- Following a stay in hospital
- As a break for you and/or your carer
- For day care
- For assessment – to see if you can manage with care at a home or need care in a residential setting. This is called a section 47 assessment and it is made by your local council along with your GP or the health authority.
- As a trial stay – to see if a care home suits you before committing to a longer-term arrangement; something that may be possible according to Department of Health guidelines.
- While waiting for a place in your preferred care home – if there is a waiting list.
Care homes and benefits
Moving into a care home permanently or for a short time can affect the benefits you receive. Your benefits will usually form part of your contribution to your care home fees, so it is important to make sure you are claiming all the benefits you are entitled to.
Care homes and hospital
Some people move to a care home directly from hospital – perhaps if they are newly disabled. You cannot be discharged into a care home against your will and you have the right to choose your care home.
A hospital stay may become necessary while you live in a care home. See link above “Care Homes – Effect on Your Benefits”
Care home standards
The Care Quality Commission is the independent regulator of health and social care in England. It registers and inspects health and adult social care services, including care homes. It also protects the rights of people detained under the Mental Health Act.
If the local authority is responsible for placing the person you’re looking after in a care home or for creating a care plan for them then it is possible to use their statutory social services complaints system to make a complaint about the home. If the local authority complaints procedure does not resolve the complaint, it may be possible to use other complaints methods, such as the Local Government Ombudsman (LGO). If you do complain to the CQC or local authority, they should liaise with the care home to ensure that you receive a co-ordinated response.
When you move into a care home you should be made aware of the complaints procedure. If you have any problems, you can complain to the care home directly or to the Care Quality Commission .
See also:
Scotland’s National Care Standards
Care and Social Services Inspectorate – Wales
The Regulation and Quality Improvement Authority (RQIA) – Northern Ireland
Self Funders
Self funders are people who pay for their own residential care costs.
See:
New complaints service launched for ‘self-funded’ adult social care
Choosing a care home
Once you have made the decision to move into a care home you need to begin the process of choosing the right one for you as this can often take some time.
Your local council can help you choose a care home and, after a financial assessment, may contribute towards the cost.
Your right to choose
You have the right to choose which care home you live in. If your local council is helping with your fees you can still choose as long as:
- your choice is suitable for your care needs
- there is a place available
- they can agree a contract with the care home to make sure you receive the support you need
- the cost is not more than the local council normally pays for someone with your assessed needs
Visiting care homes you are interested in
If possible you should visit care homes that you are considering to make sure they meet your current and possible future needs. You might like to have a checklist with you of points that are important to you in case you forget to ask something.
Things you might want to consider:
- are staff adequately trained to care for people with your disability or needs?
- is it accessible?
- is appropriate equipment available – for example handrails, hoists, adjustable baths and armchairs?
- can you keep your own doctor?
- can your food and dietary needs be met?
- can your religious or cultural needs be met?
Talking to staff, residents and managers can help you get an idea what living there might be like. You should feel able to visit more than once.
Finding the right care home
Finding the right care home can take some time. If you have specific or complex care needs it can sometimes be difficult. Charities and organisations related to your specific disability might be able to offer advice about choosing a care home.
There are relatively few care homes able to meet the needs of younger disabled people – your local council should be able to tell you about those in your area.
The Care Quality Commission (CQC) inspects all registered care homes and writes a report on what they find. Reading the reports of the care homes you are considering might help you make a choice – you can read them online on the CQC website.
On the CQC website you can search for care homes with and without nursing care. You can also look for care homes that provide care for people with:
- learning disabilities
- physical disabilities
- sensory impairments
- dementia
- mental disorders
National minimum standards issued by the Department of Health state that care homes should offer trial stays. This may include the chance to meet staff, have a meal and an overnight stay.
You can search for care homes in your area on the CQC website.
Find out about local residential care
Your local council’s website should have details of the care homes in your area as well as the CQC website.
What if the care home does not have a place?
You can arrange to go into a different care home while you wait for a place or arrange for services at home. If your local council is helping with costs then they can help you with either of these options.
What if you want a care home in a different area?
You may wish to move to a care home in a different local council district to the one where you currently live. This could be because you want to be near to relatives or the place where you grew up.
If you have been assessed as needing care and your local council has agreed to pay for you, then they are responsible for your fees if you choose a care home somewhere else.
Under certain circumstances your local council may be able to pay the care home fees if they are more expensive.
Choosing a care home for someone else
If the person you care for is not able to express their choice then the local council should take your preferences into account.
Types of care home
There are hundreds of different care homes in the UK offering many different types of services. Some offer full-time nursing care, others support people with a specific disability or medical need.
Care homes can be run by local councils, private businesses or not-for-profit companies.
Your local council can help you find a care home to meet your needs.
Charities that offer support for particular disabilities can be very helpful and may have lists of care homes that offer specialised support and experienced staff.
An important consideration when you are choosing a care home is whether you need one that offers nursing as well as personal care.
Services you should expect
You may choose to go into a care home ( residential or nursing ) if you can no longer manage in your own home. Services you should expect at a care home include:
- meals and accommodation
- help with personal care like bathing and dressing
- staff available 24 hours a day
- physical and emotional care
- care through short illnesses
Care homes with nursing
If you have a disability or illness that means you need nursing care on a frequent basis then a care home with nursing might be more appropriate. A qualified nurse will be on duty 24 hours a day.
You have the right to choose your care home but it must meet your needs, so if you need a care home with nursing – you may not be able to move into one that cannot provide nursing care.
You may qualify for full NHS funding of your care home. You will have to meet your health authority’s criteria. You can ask them for a copy of these.
Specialist care homes
You may choose to move into a care home that provides specialist care for your particular disability or needs. This might include specially trained staff or adapted facilities.
Your local council should have lists of specialist care homes or ones that might offer services appropriate to your needs. Charities can also be very helpful in finding the right care home.
Resources:
Interactive map – showing the quality of care homes in the counties of England
https://www.carehome.co.uk/ – The leading UK Care Home review website