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Home Elderly Care Finding a care home: what to look for in your selection

Finding a care home: what to look for in your selection

If you are faced with finding a care home for your elderly relative, there are lots of decisions to be made and things to consider. You will want to think about:

But most of all – will it pass the Mum test?  Would you be happy with your Mum (or Dad) living there, and would they be happy to live there?  Here is our guide to trying to make finding a care home a little bit easier.

Top tips for finding a care home

1. Which type of home?

There are different homes providing different levels of care and support, but there two main options – a nursing home or a residential care home.  A nursing home is a residential home but has medical/nursing care as part of its service. 

Residential care homes are essentially places to live, with some additional support as necessary. They can also bring in medical help when required, but they mainly provide assisted living, or  ‘social care’, help with washing, dressing and feeding as well as providing social activities for residents.

2. Location, location, location

A first priority is probably location – near to home, or perhaps nearer to you or another family member. Your parent may have identified a care home they would be happy to move in to.

It may be a very difficult decision to make, but considering a location convenient for you and family members to visit, can become very important.  If your parent becomes ‘marooned’ in a care home close to where they used to live when their friends and neighbours are no longer able to visit,  your visits become all the more important.  Distance can be a real challenge. 

There are a number of websites/sources of information to help you choose a care home. 

The Local Authority may have a list/map of care homes on their website;  you could also look at this location finder.

As part of your research we recommend that you 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.

3. Level of care needed

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 another new home should this be necessary at some point in the future.

Someone with a complex medical condition who needs regular nursing care will need to be in a nursing home which has a registered nurse on duty at all times.

4. 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.

Use our guide to choosing and viewing a care home that contains some useful questions to ask when you’re there and helps answer how to choose a care home.

5.Too much choice?

Choosing a care home is difficult as there are many. The CQC reports should help prioritise.  It is not recommended to go to a care home without seeing their most recent report and ratings.

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.

6. Bingo nights and more

Speak with residents and their families and ask if they are enjoying living there. What do they do during the day and in the evening?

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?

7. 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?  What happens at weekends? 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 certain drugs, like morphine.

8. Staff Training

Ask if the staff are trained in safeguarding, manual handling, first aid and hygiene – as everyone working within the home should have up to date training.

9. 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.

Finally, does it pass ‘the Mum test’?

Would you feel happy to leave your Mum in the home that you are looking at?  That’s the real test of a care home.  Some of the questions you might think about include:

  1. Does the entrance look cared for?
  2. Are you made to feel welcome by the staff ?
  3. Do the staff seem happy and competent?
  4. What facilities does the home have – garden/activity area etc?
  5. Are bedrooms personalised by residents?
  6. Do residents seem content?  Are they out and about in the home, or sitting in their own rooms?
  7. What does the menu/food look like?
  8. Is there a circle of chairs in a day room and a tv on constantly?
  9. Does it smell?

A word about care home fees

Funding a care home privately is expensive, depending on the location and the need, in the region of £1500 per week.  The component parts of care home fees are:

  • board and lodging – the payment for the room, meals and services
  • nursing/medical help – provided by the NHS directly to the care home which onward charges you/your parent or the local authority if they are contributing to the costs;

The Local Authority may part or fully fund a care home resident.  This will depend upon a funding assessment. If this is the case, then they will likely choose a care home that fits within their budget guidelines and be less than a privately funded care home place. 

If you are able, and willing, you can “top up” the local authority payments so your parent is in a care home more of  your choice. 

If your parent is eligible for NHS Continuing Care then all care home costs will be covered by the NHS, including the board and lodging element. 

Funding a care home place is complicated.  Even if you are funding it yourselves, discuss different room options with the provider as you may well be able to negotiate the cost for a smaller room/less view etc. 

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, NIHealth 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.

There’s more expert help in finding a care home from Healthwatch UK, the Which? magazine team and The Alzheimer’s Society

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.