Choosing a care home

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Care homes are one of the most common providers of end of life care. Understanding the services they provide and how to choose the right home is vital.

Care homes and who they are for

A care home is an establishment that provides personal care and health care in a residential setting. Care homes are mainly for elderly people who can no longer cope with living independently in their own homes.

There may be a number of personal and health reasons why moving into a care home should be considered including needing increasing help with day-to-day tasks, easing damaging strains on the family, chronic ill health, frailty and confusion.

Crisis in the care home industry

Southern Cross was until September 2011, the largest provider of care home places. It then ceased trading, due to poor management decisions and the cutback on local authority spending. Residents in its homes were found places in other care homes.

If the person requiring to be cared for in a care home can't afford the payments, the responsibility for paying falls to the local council in which the person lives.

Cutbacks mean councils are paying less, and so the sector is under huge pressure as care providers can't reduce the service they provide to residents without a justified storm of protest. There is now a widely recognised crisis in the care home industry.

The government, with some reluctance, has announced a White Paper on all aspects of caring for a growing number of elderly people in March 2012. Decisive action and reform of the funding system is required as soon as possible.

Choosing a care home

There are over 21,000 care homes in the UK. To select the appropriate care home, it is essential to shortlist about five or six, and visit them to answer the following questions:

• Is the location convenient - can family and friends get to it easily?
• What are the times and rules for visitors?
• Does the atmosphere, the temperature, the rooms, the day-to-day care facilities give the right impression?
• Are the staff friendly, efficient, calm, positive?
• What specialist training do staff have, and how many of the current staff have had specialist training?
• What is the home’s recruitment process - staff on the payroll or agency staff, or if both, what ratio?
• Does the home look and feel clean and tidy?
• Is the home convenient for access to local amenities, such as shops, parks, social venues?
• What are the common rooms like?
• Does the home have adequate disabled access?
• Do other residents seem happy and content?
• Is security good?
• Is it too close to dangerous and noisy roads?
• Are there set bed times and getting up times?
• What are the daily menus, and does the food seem of good quality and appropriate portions?
• What times are meal times?
• Can people choose to eat together or in their room if they wish?
• What are the daily routines?
• What outings and in-house events are organised and how frequently?
• What personal belongings can be brought into the home?
• What is the policy about pets?
• Is there a smoking policy?
• What health services such as chiropody, podiatry are available?
• How are medicines prescribed, delivered and stored?
• What is the routine to ensure medication is taken correctly? 
• Is there a designated GP or do residents keep their own?
• What is the procedure for hospital/medical visits?
• Is the latest Care Quality Commission report available to read there or take a copy away?
• What is the complaints procedure?
• What are the fees, and what do they include and exclude?
• What are the possible extra costs?
• Is there a deposit to pay?

Care home costs

If the care the patient is or will be receiving is classed as health care rather than social care, it may be entitled to some NHS funding.

Otherwise, residential care home costs vary across regions, but the national average annual price for a place in a care home is £21,060. (Source: Social Services Performance Assessment Framework Indictor AO/B13).

Care Quality Commission

The Government set up the Care Quality Commission to inspect and report on care services and councils.

Part of the purpose of this arms length independent agency is to improve social care and stamp out bad practice.

There are separate inspectorates for England, Wales and Scotland.

Useful guides

Better Caring is a useful guide to over 21,500 care homes in the UK, and Directgov has advice on all aspects of care homes.

Age UK also provides useful information.