24 Jul 2017
Author: Stephen Breen
With one in four care homes and one in three nursing homes failing on safety standards, finding the perfect care home for a loved one is nothing short of a challenge. Whether you’re looking for a care home for yourself or a family member, we take you through everything from funding and care home alternative to choosing a home and the legal documents you should make now.
Alternatives to care
Care homes are expensive and standards extremely variable. Consider all alternatives available to you before making the decision to leave your home – high-intensity domiciliary care for example allows you to stay in your home with daily help from a carer. Having a live-in carer is another option, or moving into sheltered housing where help is close at hand if you need it. Properties can be fully fitted out with equipment to aid your daily routine and alarms/sensors in case you have an accident. Those with more complex needs may wish to consider extra-care sheltered housing where both meals and personal care are provided.
Residential care or nursing home?
If you’ve never needed care before you might not appreciate that there is a difference between a residential care home and a nursing home. Residential care homes do not need to employ nurses and although you’ll continue to get support from your GP and community nurse, this may be insufficient if you have significant healthcare needs.
Are you eligible for funding?
If you’re set on finding a care home, you’ll need to work out your budget which begins with finding out whether you are (or your loved one is) entitled to financial help. NHS Continuing Healthcare Funding may be available if your condition is sufficiently serious. This pays for the full cost of care regardless of your assets or income. However, funds are limited and for that reason Local Authorities tend not to mention this, instead performing a means test at the outset. You’ll also find that there’s a lot of misinformation and misunderstandings about the funding so it pays to do your research and insist on an assessment, the outcome of which you can challenge if you need to. If you’re helping a loved one, it really helps to have a Lasting Power of Attorney in place for them at this stage so you can be fully involved in the process.
If Continuing Healthcare Funding is not available, the next step will be a means test. Those with assets of less than £23,250 will get some help towards the cost of care from the Local Authority – while those with assets under £14,250 will get all of their care paid for.
Note that if you have a partner who occupies your home, the home won’t currently be taken into account when performing the means test. If you’re single, you may be able to delay selling your home to pay for the cost of care until you die. This is achieved by placing a charge (like a mortgage) on the property. If you’re not sure whether the move to care will be permanent, this leaves the door open for moving back home. On the other hand, if you’re certain it will be, you can rent your house out and benefit from the rental income in addition to the increase in value before it is sold, giving you more to pass on to your family.
It’s also worth knowing that even if the person gets full funding, they may still be asked to pay a contribution if they have a preference of care home. Given that so many care and nursing homes fall below standards, there’s a good chance you will have a preference and will therefore have to pay at least something towards your care.
If you’re not eligible for any help, be prepared for the fact that care and nursing homes will charge you more than they charge the Local Authority. The average cost for someone funding their own care is £618 a week, but the Local Authority will pay just £486 for the same room.
Identifying a home
Once you know your budget, it’s worth asking around for recommendations. The Care Quality Commission is also a good place to find homes, with each property inspected and rated. Visit the home’s website and read the full CQC inspection reports for each property on your list to make sure they are delivering a good standard of service. Search on Google for the name of the care home to see if there are any negative reviews or damning newspaper stories.
Visit the home and assess both the welcome you receive and how the other residents behave. Do they seem happy and content? Is there plenty for them to do? Remember that you will only see a snapshot of their daily life so it’s worth asking about mealtimes and activities. Speak to the managers, staff and other families to give you a full picture of what the home is like. Use Age UK’s checklists to guide you through asking the right questions.
If you (or your loved one) still have mental capacity, now is the time to make or update your Will. If you don’t have a Will and you lose mental capacity, the only way forward will be a statutory Will which is a lengthy, complex and expensive process. A diagnosis of dementia doesn’t necessarily mean you can no longer make a Will – speak to our Later Life Planning team for guidance.
If you’re reading this guide for a loved one, now is the right time to obtain a Financial Decisions Lasting Power of Attorney to help them with their affairs. This will enable you to manage their finances and property while they are in care. If they decide to receive care in their own home, a Health and Care Lasting Power of Attorney is also advisable. This will enable you to deal with medical staff, care providers and social services on their behalf and to make decisions such as where they should live in the future.