Choosing a care home
Most of us would prefer to stay in our own homes, in familiar surroundings and with our possessions and friends and family around us. If you are starting to think that you might need to move to a care home you might be surprised at the things you can do to support yourself in your own home; have a look at the rest of this site, and in particular at the section Staying In Your Own Home, and the pages on Extra Care Housing and Supported and Sheltered Housing, before you make a final decision.
However some medical conditions which require regular medical treatment, or mean that you regularly need support with day-to-day tasks, can make living at home very difficult. You may feel that you need more care than you are able to get at home, either from healthcare professionals or your family, or by using gadgets and equipment to keep you safe and independent. In this situation you may wish to consider moving into a care home in order to receive the support which you need.
Care homes are live-in facilities which provide food, accommodation and personal care for residents, as well as access to 24 hour medical care from trained medical professionals when required. There is usually an on-call doctor in case of emergencies, and other therapies and treatments such as physiotherapy are sometimes offered. Residents usually have their own bedroom with an en-suite bathroom and toilet, as well as access to a communal sitting room, dining room and often a garden.
Some care homes also offer short-term places, which might be useful for you if you are recovering from an illness or a hospital stay, or to give the person who usually looks after you a break (known as 'respite care').
Different care homes provide different types of support depending on your needs.
Care homes without nursing (also known as residential homes) differ from care homes with nursing (known as nursing homes) in that they provide a lower level of support, and are for people who don't have complex needs and are less likely to need regular or urgent medical attention. The staff in a such homes will generally be trained care workers rather than trained nurses, but should have all the skills required to provide the necessary support.
Some homes provide both residential care and nursing care. This means that if someone's care needs increase after they move into residential care they can continue to receive the right level of care without having to move again.
Care homes with nursing differ from care homes without nursing in that they support people with higher, more complex levels of need. A percentage of the staff on duty at any time will be trained nurses working alongside the trained care workers.
Care homes with nursing cost more because they provide a greater level of support. You will want to be sure that you are choosing a home with the right level of support for you. Some of the reasons which could mean that someone is more suited to a nursing home are:-
- an inability to stand or walk without the support of two people and specialist equipment such as a hoist
- incontinence of faeces or double incontinence (incontinence of both urine and faeces)
- complex medical needs such as the need for a 'PEG' feed to receive all food and fluids, or the need for regular (several times per day) medical treatment from a qualified nurse
- particularly challenging behaviour such as a tendency to be aggressive towards others
Some care homes, with or without nursing care, are also registered to provide specialist support for people with a diagnosis of dementia; this is known as EMI (Elderly Mentally Infirm) Care. Other care homes specialise in providing support to people with complex mental health problems, or to people with learning disabilites.
It is important to note that no-one with dementia, a mental health problem or a learning disability can legally be made to move into a care home against their will unless it can be proved:-
- that they lack the 'mental capacity' to make a decision on their situation
- that a move to a care home is the only way in which the necessary support can be provided to them
- that the move is therefore in their 'best interests'
Some care homes provide care both with and without nursing. These are known as 'dual-registered' homes. The advantage of these homes is that if someone's care needs increase after they move into the home they can continue to receive the right level of care without having to move again.
You may be eligible for financial support from your council to pay for the cost of a care home following an assessment of your needs. However your council will always look at other ways to help you first, and will try to support you to remain in your own home and stay as independent as possible.
If you are not eligible for financial support from your council you can approach most homes directly to organise your own care.
You can visit our page on Paying For A Care Home for advice on how you might pay for a move to a care home.
When choosing a care home, it is important to make sure that you choose one that will be right for you now and in the future.
Care homes are run by a variety of organisations, including private firms, voluntary sector organisations and local councils.
The Care Quality Commission (CQC) website allows you to search for all registered care homes in a particular area. All care homes should be registered with the CQC, an organisation appointed by the government to monitor the standards of care provided. The CQC visits registered homes regularly to inspect the facilities and the standard of care, and writes a report about the home which is published on the CQC website. This means that you can find out what a home is like and what services it offers, and decide if it's the right one for you.
The CQC have also produced a leaflet about the standards of care you can expect from a care home.
You can also get advice and information to help you make this important decision from a district nurse, a health visitor, your family doctor or your social worker - don't be afraid to ask.
The HousingCare website provides a searchable independent directory of care homes in your area.
If you are using a smart phone or tablet then you can download the free Care Homes app and search for local care homes that will meet your needs. We recommend that you check the most recent inspection report for any home on the Care Quality Commission (CQC) website before deciding whether it the the home for you.
Websites such as CareHomes.co.uk and GoodCareGuide.co.uk
invite people to review or rate care homes based on their experiences as residents or relatives or residents - check out the views of others about individual care homes, or share your own experiences.
You can also search for local care homes in our People who can help section.
You may also find it useful to look at this map (correct at April 2014) which shows most of the care homes currently providing support in Westminster, Hammersmith and Fulham, and Kensington and Chelsea. If you see a care home in an area that looks interesting to you you can check the CQC site for more information.
If you live in Kensington and Chelsea then we have produced a list of care homes in the borough.
Once you've identified a few homes that you think might suit you, you will probably want to go and visit them to see what they're like, and meet the home manager, nursing staff and other residents.
There is usually a six-week trial period after you move into a care home, to make sure that it is the right place to meet your needs, and that you are happy there. If during this period you decide that it's not suitable for you, you can consider other options.
If your council has assisted you to move to the care home then after 6 weeks they will arrange a meeting with you, any relatives and friends that you want to be there, and the care home staff - this will give everyone a chance to discuss your situation, and for you to voice any concerns you have.
If you decide to stay at the care home after the 6-week period you will need to think about what to do with your previous home. If you were previously renting a property then you will probably need to end the tenancy, particularly if you have been claiming housing benefit towards the cost of the rent.
The Independent Age website provides information about choosing a care home, how to pay for it, settling in to your new home and what happens if a care home closes. They also offer free advice guides about finding the right care home.
The Which website offers advice on what to think about when considering a move to a website.
Care UK have produced a helpful guide called Preparing for a move to a care home : advice, suggestions and practical support
The Relatives & Residents Association offer advice and support to older people moving into a care home, and to their relatives.
Healthwatch have produced an article and video on "Five steps to follow when choosing a care home"