Finding a care home – this key question could save thousands of pounds

Choosing a care home that is right for your relative can be difficult – not just because you never really know what a place will be like until you live there, but also because there are funding issues to consider.

The health and social care authorities may suggest a particular care home to you.

Be cautious with any recommendation they make. Unfortunately their suggestion is likely to be financially motivated: if they think they may have to pick up the bill, now or in the future, they’re likely to simply recommend the cheapest.

Ask this question before choosing a care home

Whether or not you’re currently applying for NHS Continuing Care funding, bear in mind that you may do at some point in the future. NHS Continuing Care covers 100% of the costs of care in a care home and it means your relative has to pay nothing.

So here’s one crucial question to ask before you make a decision about a particular home:

Find out from the care home manager whether the home you’re considering has any residents funded through NHS Continuing Healthcare. If they don’t at the moment, ask whether they have done in the past.

If the home does have residents who are funded in this way, then there’s no reason why the NHS wouldn’t also fund your relative in the same way at that particular care home – assuming your relative is eligible. If the NHS already funds people there, they can’t argue with your choice of care home.

If the care home doesn’t have anyone funded through Continuing Healthcare, it doesn’t mean your relative won’t receive the funding. It just means the NHS could potentially argue about the choice of home. They may for example claim that it’s too expensive. However, this is an argument that doesn’t necessarily hold water and you can challenge it.

If your relative has health needs, ask their social worker or care home manager to initiate an NHS Continuing Healthcare ‘Checklist’ assessment. This is the first assessment that should be carried out when someone needs full time care – before anyone asks you about money.

If anyone says an assessment is ‘not worth it’ or that your relative ‘won’t qualify’, stand your ground and insist on an assessment.

The 7 most outrageous reasons for not receiving an NHS Continuing Healthcare assessment

How to choose a care home

Christmas can be stressful at the best of times, and the same can apply to other feast days, festivals and celebrations. Needing to spend time with an elderly parent or relative in a care home as well can add to the pressure.

You may be wondering how to make things special for your relative at Christmas – and how to manage everything else too.

If you’re in this situation – or you have been before – we’d love to hear your tips. To kick off, here are some suggestions you’ve shared with us before…

• If you can’t visit your relative on Christmas Day itself, have Christmas at the care home on a different date. Depending on your relative’s state of health, they may not realise it’s not the actual day, and yet you can still show your love just the same.

• Have Christmas lunch at the care home with your relative – or take some festive food in with you and ask the home if you can set up a table in a quiet corner just for your family. As well as being nice for your relative, by eating with them at the care home, however difficult, you can observe mealtimes and notice how much assistance your relative needs.

• Where possible, involve your relative in planning something or preparing something for Christmas, however small. For example, if they can still hold a pen, it may simply be signing a couple of cards for old friends (and it doesn’t necessarily matter what your relative’s signature actually looks like). Or perhaps you could help them wrap a gift for another member of your family. Playing an active role, even if only briefly, may help them retain some sense of purpose and value. And if these are all things they used to do, it may help trigger some good memories.

• Take a Christmas gift for the care home staff; it can be a nice way to maintain good will, and some staff may be working all through the holiday.

• If it’s difficult to think of what to give a relative in a care home as a gift for Christmas, you could make up a book of old photographs to help trigger memories, or pull together some images of their favourite holiday destinations.

Do you have some tips and ideas to share with other families? Leave your comments below.

Choosing the right care home for an older relative is not always easy, and it’s important to ask good questions when visiting for the first time.

Your questions will probably cover all sorts of things, such as activities within the care home, opportunities for exercise and therapies, the rooms, care for specific health needs, eating and drinking, funding – all sorts.

Leaving a relative in a care home can be challenging for the whole family, and good communications with the home – and within the home – is vital for peace of mind all round.

In today’s article we’ve adapted chapter 8 of our e-guide, How To Choose A Care Home, and outlined 10 things to ask a care home about various issues to do with communication…

1. When you visit, notice any particularly vulnerable, poorly or challenging residents. How do members of staff interact and communicate with them? If you were that resident, would you be happy with the nature of the interaction you’re seeing, and the time members of staff are spending with them?
2. Are there residents with speech impairment, such as people with Parkinson’s and other neurological diseases? What kind of two-way communication is there between staff and these residents? And do staff give residents time to get their words out?
3. Is there a residents’ association? How does this work? It may not matter if there isn’t one, but it’s worth asking. The best people to provide feedback on a care home are the people who live there.
4. Does the home organise relatives meetings? It’s very important for relatives to know what’s happening at the home – and to have some kind of forum for asking questions and raising concerns, if residents are unable to.
5. Is there a written complaints procedure?And who is responsible for following up/resolving complaints? Have you met that person?
6. Is there a suggestions box? Who submits ideas – and who reviews them? How many have been implemented recently?
7. Notice the different nationalities and accents/languages amongst staff – and residents. Will there be any problems understanding staff – or staff understanding residents?
8. What happens when residents receive post or phone calls? Does each room have its own phone – with a direct number? If not, is there a private room where residents can make and take calls? And if someone is physically or mentally unable to open their own post or hold a phone in their hand, how are they helped to do this?
9. Is there a suitable space for a computer in the residents’ rooms? And is there an Internet connection? You may not think this would be needed, but a computer can be invaluable for things like Skype – to facilitate talking with family, friends and grandchildren, and seeing them on the screen at the same time. It can enrich someone’s life greatly.
10. If residents are deaf and use British Sign Language, does anyone else in the home know it?
    Read more vital questions to ask when you’re looking for a care home. Explore our e-guide, How To Choose A Care Home.

Choosing a care home for an elderly relative is one of the most difficult things to do. There are many things to consider, and one of the most vital is the degree to which your elderly relative will remain engaged with life whilst there.

We’ve all seen the stereotypical pictures of elderly people in care sitting all day with little or no stimulation. It is perhaps no wonder that in those situations they become even more withdrawn and disengaged.

Care guidelines state that people should be involved in their own care planning, where possible, and be able to exercise choice in their lives. If we take food as an example for a moment, choosing from a menu is all very well, but if the fixed choices are institutional and uninspiring, or simply not what someone would normally choose, then mealtimes – a vital positive element in a day – are no longer enjoyable.

In the same way, if the choices for day-to-day activities and daily routines are already prescribed, there’s limited opportunity for real engagement. That’s perhaps why so many elderly people describe life in a care home as being ‘like a prison’.

Studies show that having a greater sense of purpose leads to more sustained cognitive function in elderly people. This would suggest that it’s far better all round to have elderly people, where possible, involved not simply in choosing from a menu of care and activity options, but actually creating those options in the first place – and in so doing strengthening their sense of value and purpose.

This will more than likely manifest itself in stronger health and wellbeing.

You can’t really know for sure what a care home will be like until you’re living there, but there are careful questions you can ask to get a better feel for how things will be.

• How much do residents get involved in the day-to-day operation of the home? For example, if your relative likes gardening, what opportunities are there for them to do that at the home – and get involved in deciding what needs doing in the first place?
• If your relative has a hobby or special interest, how easy would it be for them to continue with that at the care home?
• Does the home have any pets? Or can residents bring their own? Resident animals can be a wonderful, stimulating tonic.
• Ask to see an activity programme – and find out how often residents actually go out, not just into the garden but out to somewhere different. Is there a specific named person responsible for planning and organising activities? Are there photos on the walls of various trips? How old are they and who decided what they would be?
• Does the home have its own transport, suitable for wheelchair users? This is vital if promises of trips out are to be upheld.
• strong>A care home brochure may say that the home ‘encourages independence’.Ask what they really mean by this and how exactly they do it.
• How can residents who are immobile get involved in activities in the home? A client of ours chose a care home for her father on the basis that it had a home cinema room. However, she later found out that none of the carers actually took him there.
• Are there musical instruments available to play? And are books and newspapers readily available?

Explore more tips about choosing a care home.

Find out what’s happening with each Southern Cross Healthcare care home

If your relative is in a Southern Cross care home, you may be concerned about who’ll be taking over the home, now that the Darlington-based Southern Cross group has collapsed.

The group has, until now, been the largest UK care home operator, running 752 care homes with 31,000 residents. However, the care homes themselves are now being reclaimed by landlords and the running of the homes transferred to new operators.

This process should be complete by the end of October 2011. However, not all homes have secured new operators, which raises the question what will happen to the residents of those particular homes once Southern Cross ceases trading.

This article in The Guardian newspaper lists the different Southern Cross care homes and outlines what’s happening with each one.

Southern Cross has 97 care homes in Scotland, 34 in Wales, 25 in Northern Ireland and just under 600 in England. The biggest landlord, NHP, will run 249 homes as a joint venture with Court Cavendish.

London & Regional, the second biggest landlord with 90 homes, will assign the running of the homes in the north of England to Orchard Care Homes and to Minster in the south east of England. Loyd’s Property is another landlord with 54 homes, but as yet without an operator.

250 homes will be transferred back to landlords who are also operators, including to Four Seasons. However, those homes for which an operator can’t be found may end up closing, leaving families and elderly residents facing uncertainty and painful upheaval.

If you have a relative in a Southern Cross care home, you may decide to move them somewhere new. It can be a difficult process – and it’s often hard to know whether the new care home really will provide good care for as long as your relative needs it. Our practical guide, How To Choose A Care Home, gives you some vital questions to ask a care home manager before you make a decision.