Considering a move into nursing or residential care is a big decision at what is often a difficult time. There are so many elements that need to be factored in so you can be confident of making the right choice for you or your loved one.
To support you in your search, we’ve put together this article based on the many questions we have received by those searching for a care home over the last 40 years.
There is also a handy Care Home Checklist which you can download and take with you when visiting homes for a tour. This helps you compare homes and find the one that ticks all the right boxes.
The first and most important consideration at the beginning of your search for a care home should be to understand whether a home is going to be able to meet the care needs of you or your loved one.
There are several different types of care service offered within care homes, which can owned by private providers, local authorities or voluntary organisations. Not all care services are are available within every home, and some specialist homes may only offer one type of care service, such as dedicated dementia homes.
Having a good understanding of your care requirements will quickly help you to eliminate any care homes that may not be able to meet your needs.
The types of care are:
Residential care services are designed to provide a comfortable and relaxed home environment. This type of home would be suitable for someone who is perhaps looking to maintain an independent lifestyle within a community, and receive day to day support with things such as laundry, cooking or housekeeping.
Assisted Care is for residents who require a little extra daily support to maintain their physical care and comfort. This can include personal care such as washing and dressing, and the giving of medication by specially trained staff member.
Care homes that are capable of providing nursing care will be able to support residents who have more complex medical needs and longer term conditions that require day to day management. Some nursing care homes have Registered Nurses on-site at all times, whereas others bring in outside nursing support as and when required.
For those living with dementia, there will be a need for dedicated dementia care. These homes will have staff trained in dementia care and have facilities specifically designed to create a safe, calm and engaging environment.
If you’re not sure where to start, talking with a professional such as your GP or social services will help you to gain a better understanding of the care type that would be needed.
They may already know your family member and in any event are best placed to assess the need for residential, nursing and dementia care. They can also talk through any other options that may be available.
Although a care home can’t replace a family home, it can offer a warm, safe and comfortable environment where residents can feel at home. Having an idea of what is most important will help find the right one.
Personal living spaces will vary from home to home. The size of bedrooms can differ widely, as can the facilities available such as en-suite bathrooms, lounges and kitchenettes. Some homes will allow you to bring your own furniture and other cherished possessions to add that personal touch, however it’s important to check what can be brought to the home first.
Communal living spaces are often the heart of a home, where residents can spend time catching up over coffee and cake, take part in a range of activities or spend some quiet time reading a newspaper or favourite book. A welcoming care home environment should always include attractive and carefully designed day spaces or communal areas. Spend time viewing these spaces to make sure they are warm, welcoming and homely environments that residents enjoy spending time in.
Some care homes have additional facilities such as hairdressing salons, cinema rooms, therapy rooms and libraries, and this is also important to consider when searching for a home.
When considering the facilities, take a look around to see how well maintained they are. Is the garden well maintained? Are the walls, carpets and furniture as stain-free as you would expect? And does the building itself look well maintained?
Food and drink are critical to our health and well-being in so many ways. Care homes should be able to cater for a wide variety of dietary needs, and should take into account individual needs, preferences, allergies and cultural and religious backgrounds.
An enjoyable dining experience is also an important consideration. Residents should be able to choose where they enjoy their meals, whether in the communal dining rooms or the privacy of their own room. Some homes will allow guests to dine with residents and even cater for special occasions in a private dining room.
Malnutrition is a risk for the elderly as tastes, preferences and appetite change. It can have a wide-ranging impact on health, and therefore screening for the risk of malnutrition in care settings is important for enabling early and effective interventions. You may want to request information about the care home’s screening processes for the risk of malnutrition and their process for early and effective intervention.
It is important for residents living in a care home to do so as independently as possible. This helps to maintain a sense of purpose that is vital for an older person’s wellbeing and overall health. Residents should have the opportunity to try new activities and continue with life-long hobbies and interests should they wish to do so.
National Institute for Health and Care Excellence (NICE) set quality standards to help care homes improve the quality of care they provide. Their quality standard for ‘Mental wellbeing of older people in care homes’ states that care homes should offer residents the opportunity to participate in meaningful activities that promote their health and mental wellbeing.
These Activities should be both structured and spontaneous and available for groups of residents, or for individuals. They should also involve family, friends, carers, and the wider community wherever possible. Activities range from daily living such as dressing, eating and washing, to leisure activities such as gardening, singing, arts and crafts, and even day trips out into the local community.
During your visit, request some more information about the variety of activities and how often will they will be available. You may also be able to join the home during one of their community events/activities, where you will be able to see first hand what the care home will be offering.
It is important for care homes to involve residents, family and friends throughout the decision making process of care. Providing a supportive setting that enables the resident to express their wishes helps to maintain their sense of personal identity, and creates a more positive experience of the transition into a care home.
There should be a care plan created which identifies the specific needs and preferences of the individual and provides staff with information about their personal history, interests and beliefs.
Care homes should also have suitable processes in place for ongoing care, recognising the signs and symptoms of physical and medical problems that may arise, involving GPs, physios, dentists and opticians where appropriate, and informing family members of any changes.
During your search for a care home, ask about admission into the care home, how care plans are created, if they have any examples to view, who is involved and what processes are in place for the ongoing maintenance.
All care homes will be rated by the Care Quality Commission (CQC), and these ratings can help guide your choice. There are four possible ratings given to care homes: outstanding, good, requires improvement and inadequate.
Care homes are normally given these ratings based on each of the five key questions that are asked during an inspection.
By law, care providers have to display the ratings given to them in the places where they provide care, as well as somewhere that people who use their services can easily see them, and also show their rating on their website.
You can find out more about their rating system here.
Reading the reviews left by relatives, friends and residents who have had first hand experience of the services provides a good insight into life in the care home. Reviews can be long, short, useful and not so useful. Some reviews can be detailed, packed with useful insights that will provide useful information for your search.
These should be available in marketing materials provided by the care home as well as their website. Reviews will also be available to read online at websites such as carehome.co.uk, Trustpilot, and Google search.
You can speak with the care sector regulator, the CQC, which maintains lists of care homes and publishes independent reports online. You can use the CQC website to search for care homes in your area and view their inspection reports. Age UK also provides some useful information to help and find a care home, as well as other options that you could consider in your search.
For specific questions relating to someone who is living with dementia, the Alzheimer’s Society provides useful information, from advice to real stories as well as latest research in dementia.
To support you in your search for a care home, we have put together the following checklist that highlights the key areas to consider when viewing different homes, and help you make the best informed choice.