If you are having to find a care home, there are lots of decisions to be made and things to consider. location, cost, services, staffing, activities. But most of all – will it pass the Mum test? Would you be happy with your Mum (or Dad) living there? Here is our guide to trying to make finding a care home a little bit easier.
Which type of home?
Someone with a complex medical condition who needs regular nursing care will need to be in a nursing home who have a registered nurse on duty at all times.
Residential care homes can also bring in medical help when required, but they mainly provide ‘social care’ – help with washing, dressing, feeding as well as providing social activities for residents.
Location, location, location
There are various websites/sources of information on location of care homes.
The Local Authority may have a list/map of care homes on their website; you could also look at this location finder – https://www.carehome.co.uk/ . Definitely check the Care Quality Commission (CQC) website – not only will they give you a list of care homes nearby, they also provide reviews and ratings of them – which is absolutely critical.
Personal recommendation or referral in conjunction with the CQC review is perhaps the best way to find a local care home; speak to as many people as you can – The GP, friends and neighbours, social services – who has some experience of any care homes in the area you are looking at.
Your parent will have an assessment by your preferred care home to check that they are able to support them and their needs should they move in. It can be harder to find a home that can provide the care for someone who has particularly complex needs, so you may need to be flexible.
Top tips for looking at and choosing a care home
Level of Need
First of all establish the level of need and kind of care and home you are looking for. You may already have a care assessment by the local authority so you know what level of care and support you’re looking for.
Some homes have specialist Dementia units for example, which while you may not need these services yet, you would prefer not to move your Mum to a new home should this be necessary at some point in the future.
2) Viewing a Care Home
If you have the luxury of time, visit the care homes you would like to consider. If someone is being discharged from hospital sooner than you thought, or needs to move in to a home quickly this might just not be possible.
So – the best advice is perhaps to try and visit care homes before you actually need them. Easier said than done of course!
If you are in urgent need of a care home bed, the local authority may provide a weekly update of available beds. The local Age UK also sometimes has this service.
If you are able to visit, ideally you should be able to turn up unannounced and be given a tour of the place. This will depend upon the available manpower at the time – which might also tell you something about the home.
But you want to see the home as it normally runs to get an understanding of daily life there. If you can, return more than once at different times of the day. This may give you an indication of staffing levels, types of activities etc.
3) Too much choice?
When you visit, ask to see their most recent CQC report and talk it through with the manager; find out what the staff turnover is and the numbers of agency staff that may be used regularly.
Agency staff are no different from employed staff in terms of their qualifications to care, but it may mean that there is less continuity and cohesion amongst the staff. It is likely that the staff team will be supplemented by agency staff – but there needs to be a balance.
4) Does it pass the Mum test?
- Does the entrance look cared for?
- Are you made to feel welcome by the staff ?
- Do the staff seem happy and competent?
- What facilities does the home have – garden/activity area etc?
- Are bedrooms personalised by residents?
- Do residents seem content? Are they out and about in the home, or sitting in their own rooms?
- What does the menu/food look like?
- Is there a circle of chairs in a day room and a tv on constantly?
- Does it smell?
5) Bingo nights
Are there activities which would be suitable for your relative to participate in and are outings organised? Is there an activities co-ordinator on the staff- ask them what activities are taking place this week.
What is the dining room/eating facilities like – have a look at the menu and even stay for lunch perhaps. Is alcohol served?
6) Providing Care
How is medication administered? What other health and well-being services are available – toe nail cutting, dietary advice and help etc. What is their medical emergency procedure?
How does the staff rota operate over a 24 hour period and who is in charge at night? Who can give medication, particularly at night? You may find that they have to ask the District Nurse/GP to come in at night to give eg morphine.
7) Care Home Staff Training
8) Communicating with you
Ask how the home communicates with and involves relatives, particularly if there are complex needs to be considered. You want to know how you get involved in any care plan and ensuring everything is being done for your relative.
Care Home Q&A
Q: How do I find care homes near me?
A: Your local authority may have a directory on their website; you should also look at the Care Quality Commission website where you can search by location and then read reviews and ratings of care homes. Personal recommendation is also very helpful – from the GP, District Nurse or friends and neighbours.
Q.What questions should I ask the care home manager?
Our top 10 questions to ask are:
- What is your CQC rating and latest review?
- How many staff do you have? What is staff turnover, and how many agency staff do you have?
- Can residents personalise their rooms?
- What activities are there for residents?
- What is a weekly menu and what are the eating arrangements?
- How is medication given? What happens in an emergency?
- What health and wellbeing services do you provide (toe nails etc)
- Are there visiting times?
- How do you communicate with relatives and family about residents?
- Why would my Mum be happy living here?
Q: What is the cost of a care home?
A: This will depend on location and type of care home and the needs of your relative. For example, a Home providing specialist care such as a Dementia unit, is likely to be more expensive than a more traditional rest home. However, the average price of a care home per week in England is £630.
Q: Moving care homes?
A: You can, but it will depend on who is paying for the care home and why you want to move. If the local authority is paying then you will need to discuss with them alternatives and why. If you are paying for the care yourselves, then of course you can move – but it may not be the best thing for your Mum.
Q. How do I choose a good nursing home?
A. You should ask the question – does it pass the Mum test? Would I be happy to leave Mum or Dad there? Is it convenient? Are the staff friendly? What is the staff turnover? What’s the food like? What activities do they put on? Visit as many as you can, at different times of day, to get a sense of the place.
Q. What is the difference between a care home and a nursing home?
A. A nursing home has on site nursing care, whilst a care home mostly accommodates social care needs such as washing, dressing and mobility issues. The complexity of your parents needs will determine which type of home they should move to.
Q. Can you be forced into a care home?
A. Only in very specific circumstances, usually around mental capacity and ability to live independently at home. The GP can not force you in to a care home.
Q. Can you avoid care home fees?
A. In England if you have assets of less than £23,500 then the local authority is obliged to pay for your care, at home or in a care home. The NHS provides funding for care if you qualify for it with a “primary health need”. You may be able to work with the local authority to repay care fees on the sale of the family home after the death of your parent.
Further reading on Finding a Care Home
For information on care homes, you might like to look at the advice given by Age UK. For advice covering the rest of the UK, go to NHS England, NI, Health in Wales and Health Scotland.
Information on the regulation of care homes and care agencies is available at: England – CQC, Wales – Care and Social Services Inspectorate Wales, Northern Ireland – Regulation and Quality Improvement Authority and Scotland – Care Inspectorate.
You might also be interested in our section on making life better in a care home.
Do you have experience of choosing a care home? Maybe you would like to see how other people have made their decisions. Join the conversation in Age Space Forum.