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 It is perhaps no wonder that in those situations they become even more withdrawn and disengaged.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.

Current media reports show that Southern Cross Healthcare, which runs 750 care homes right across the UK, is facing serious financial difficulties. If a solution can’t be found, over 30,000 elderly people may have to be rehomed. It’s a distressing situation for all.
Finding a care home can be difficult – and it’s hard to know if you’re making the right choice. It’s vital to ask good questions when you visit, especially about the financial stability of any care home company, how they operate and the morale of the staff.

These 7 key questions will get you started:

1. Does size matter?

Bear in mind that the size of a home, the corporate brand name and any official inspection reports don’t necessarily reflect the quality of care or the day-to-day life that people actually experience in the home. Bigger is not always better, and well-known brand names don’t necessarily provide better care. That’s why it’s vital to visit the home in person – preferably more than once and at different times of the day. It’s also a very good idea to ask people you know in the local area whether they know someone who is resident in a particular care home – and then to ask that person’s family for their views and feedback on the home.

2. How does the care home respond on the phone?

You can gauge a lot from phoning a care home. Do they have time to answer the phone? Is it answered by someone who knows what they’re talking about? Is there a lot of background noise? What questions do they ask you? This is just as important as what you ask them. Do they offer to send you their brochure? How professional do they sound?

3. What’s the manager like?

A good manager will have a very positive effect on his/her staff, and that also filters down into the care given to residents. A defensive manager, on the other hand, may have something to hide – even if it’s their own lack of experience. An overly confident manager may not listen to new ideas or complaints. Again, it comes down to your own judgment and instinct. Does the manager also own the home? If not, how long has he/she been in post? What’s his/her background?

4. Who owns the care home and how stable is the company?

Today there are a relatively small number of large companies who own the majority of care homes in the UK. Is the company financially stable? Are they likely to invest in upgrading the home as and when it needs it? Are they committed to providing care for the long term? It’s heartbreaking to hear of care homes closing and residents having to be split up and sent elsewhere. Find out as much as you can in advance.

5. What percentage of nurses or carers on any given day are brought in from agencies?

Agency carers and nurses are not based at the care home. Instead, they’re a bit like office temps – they go to whichever home needs them on the day, and so they may not know you or be familiar with your needs. The greater the percentage of permanent staff at a care home the better it will be for you.

6. How many fully qualified nurses are there as part of the permanent staff?

What are their specific qualifications? And what about the qualifications held by the other care staff? What’s the staff/resident ratio during the night? What about the ‘after lunch slot’ when staff are taking their own lunch break? And how long has the longest-serving member of staff been at the home?

7. What insurance does the home have?

This could be contents insurance for your possessions, accident insurance, public liability insurance and/or professional indemnity insurance. Does this include insurance to allow staff to help people walk and exercise, etc. If not, and if you’re not very mobile (or you have an accident), the care team is unlikely to help you keep your joints supple and mobile and you may have to pay for regular physiotherapy.

It’s the less obvious questions that give you a better idea of what the home will really be like. Read more here about going into a care home.

And remember, just because you have some savings or a property doesn’t necessarily mean you have to pay for care – no matter what the care home, Social Services or the NHS may have told you.

The NHS has a duty to provide fully-funded NHS Continuing Healthcare (covering 100% of care home fees) for elderly people who are in full-time care primarily for health needs. Read more about going into a care home.

If you have health needs, when you first go into a care home you should be assessed by the NHS for NHS Continuing Healthcare funding.

Elderly people in care homes who have health needs because of accident, illness or disability should be assessed for NHS Continuing Healthcare funding.

This should happen within the first three months of being in care – although ideally it should happen before you go into the care home, and certainly before you pay any care home fees.

NHS Continuing Healthcare Funding is provided by the NHS and covers 100% of your care fees.

If you haven’t been assessed for this, you can ask for an assessment. If you have been assessed, and it resulted in NHS Continuing Healthcare being denied, you can appeal. Read more about NHS Continuing Healthcare and Registered Nursing Care Contribution.

In addition, if you’re paying for your own care and you were means-tested when you went into care, the value of any property you own should have been disregarded for the first 12 weeks of your care.

How To Get The NHS To Pay For Care

Did you know that the NHS is obliged to pay 100% of your care home fees if you need care primarily for health reasons? Just because you have savings doesn’t necessarily mean you have to pay…

Our NEW updated and easy-to-follow guide helps you cut through the confusion and claim what you’re entitled to. Read more…