Trying to find a care home for yourself or a loved one is a significant decision, and one that requires a lot of thought, as well as research. It is not simply a matter of choosing a nicely decorated environment, which is of course part of the consideration, but also involves understanding how a particular care home or nursing home can meet the physical, mental, emotional and social needs of the person requiring care.
No matter what is most important to you for your own personal circumstances, in all cases you will want to find a care home that offers empathetic 24-hour care and support, experienced care staff and qualified nurses (in the case of a nursing home) and where residents are safe, happy and well cared for. In this article, we will provide you with a step-by-step guide on how to choose the right care home to ensure that your loved one’s health needs and personal preferences are fully met.
When should someone go into a care home?
Many people we meet who are exploring options for their loved one’s future care ask us the same two questions; ‘How do I know if I am making the right decision?’, or ‘when is the right time to move someone into a care home?’. These questions usually come from family members who have the task of finding a suitable care home for a loved one who cannot make that decision themselves, such as someone living with dementia, and is associated with the guilt they feel about ‘putting someone in a home.’
Many years ago, ‘putting someone in a home’ was just that – there were limited choices, and most offered the same kind of environment that many older people feared they would end up. I remember my own grandparents and parents warning me when I was young, ‘I’m not going into an old peoples’ home.’ But like many things, care homes and nursing homes are almost unrecognisable from the old stereotypes and have evolved to be places where residents enjoy state of the art environments and facilities, restaurant quality food and dining and a social life that would rival your own!
The answer to these questions is that there is no right or wrong decision in terms of timing and the only consideration needs to be what is best for the person needing support, and, if you are a carer looking after a loved one in your own home, what is best for you.
Understanding your care needs
Once you have reached the decision that it is time to start looking for a care home or nursing home, where do you start? The best starting point in choosing a care home is to look at what needs your loved one has, to narrow down the many options that will be available to you. Do they have a specific medical condition that requires specialist nursing care, or do they just need the support of assistance with the Activities of Daily Living (ADLs), like washing, dressing and mobilising? Perhaps they have a dementia diagnosis that requires their safety to be prioritised or where they need more cognitive stimulation and emotional support?
In some cases, particularly if the NHS or your local authority are already involved with your loved one’s care, you will have an assessment that outlines their specific health needs and level of support required. But don’t worry if you don’t. All care providers are required to carry out a care needs assessment before anyone moves into their home, and, just by describing the kind of things your loved one needs help and support with, will give them a really good idea as to the type of care needed.
As a rule of thumb, residential care is for people who need assistance with, or prompting to carry out, the everyday things that we take for granted like going for a shower, dressing, getting up and about due to mobility problems or even eating and drinking. Nursing care, as it suggests, is care that requires intervention by a qualified nurse such as very complex medication regimes that go hand in hand with ongoing medical diagnoses, or the use of specialist equipment such as breathing apparatus. Dementia care can be residential or nursing and is determined in the same way as above along with them having a specific diagnosis of dementia.
Whilst it is important to consider the current needs of your loved one, it is also strongly recommended that you consider how those existing needs may change over time to ensure that the environment you choose, can meet those needs as they change. For example, the needs of someone living with a progressive illness, such as dementia or Parkinson’s will inevitably increase as the disease progresses and so whilst a residential care home might be fine now, in twelve months, those needs may change so that nursing care is needed. At Gold Care Homes, many of our homes provide both residential and nursing care, or if they don’t, a sister home in the same location will, meaning that we can generally support people through whatever comes next.
Researching Care Homes
Once you have decided the type of care your loved one might need, start researching care homes in your area that can meet them. If you can, try to seek recommendations from friends or family who may have previously used local care services or who know someone who has. The personal experience of people who have been in the same situation as you can be invaluable when it comes to finding the right care home. Similarly, local support groups and healthcare professionals deal with care and nursing homes regularly and will often be able to make suggestions as to those that could potentially be suitable – it is important to note that they cannot recommend one care home over another, but their ability to signpost suitable services will certainly point you in the right direction.
Don’t worry if you don’t know someone personally though. Most people looking for a care home will start their search online and this is still a very good place to start. Searching for suitable homes in your area on any search engine will present you with numerous options, and many care home providers will appear in your search results. Heading to a provider website, like Gold Care Homes, will allow you also to carry out a location search to find your nearest home.
In addition to individual care homes and care providers featuring in your results, online directories such as https://www.trustedcare.co.uk/ and https://www.carehome.co.uk/ can also be a helpful resource as they not only allow you to find a care home or nursing home local to you, but they also contain reviews from residents and their family or friends, who have used the service. These are independently checked and verified and will allow you to get a well-rounded view of the home based on user experiences.
You will also want to be assured of the quality of the service provided at the homes you are considering. Care and nursing homes in England are regulated by the Care Quality Commission (CQC) and as such, carry out inspections to ensure that they are meeting all the relevant standards.  The CQC rates care homes as Inadequate, Requires Improvement, Good or Outstanding across five key areas known as KLOEs (Key Lines of Enquiry). These are whether the service is safe, caring, responsive, effective and well-led.
An inspection usually takes place over one to two days, and inspectors will look at how the service is performing in the KLOEs by reviewing documentation, speaking to staff and relatives. They also observe care practices in the home.  If you are going to consider the inspection rating as part of your criteria in choosing a care home, it is important to make sure that you spend time reading the full report so that you have the full details.
Finding a good care home with a trusted team is crucial for ensuring the well-being and happiness of residents.
Find a care home in your budget
As well as making sure the care home you choose can meet the healthcare needs of a loved one, you will also want to find a care home that it is affordable for your personal circumstances. Care home fee ranges vary greatly, not only based on the type of care and facilities offered, but also depending on location in the UK.
You will usually find the approximate fees displayed on a care home providers own website, or in the online directories referred to earlier in this article. Care homes generally can’t confirm the cost of someone’s care until such time as a care needs assessment has been carried out, but they will always be able to give you a guide on what you can expect before you make the important decision as to whether to shortlist them.
It is also strongly recommended that you seek independent financial advice when looking at long-term care options. Organisations such as SOLLA (The society of later life advisors) can provide assistance in finding a suitably qualified later-life planner to discuss your personal circumstances and make sure that you are receiving any benefits you may be entitled to.
Creating a shortlist
After you have spent time researching care homes that meet your requirements, you should have a shortlist of potential care homes. The next step is to narrow down this list, to select the homes that are most suitable for your loved ones needs, that fall in or around your planned budget and in the location you desire.
To narrow down your shortlist, decide what is most important to you and your loved one. Meeting the physical needs of your loved one is a priority for any home you choose, but what else would you want to make it ‘the one’? It may be that you want ease of visiting, so wish for the journey to be within a specific distance from your home or workplace to enable visiting your loved one easier and to allow you to visit more frequently. Perhaps you want peaceful gardens at the home to allow your loved one to spend time in the fresh air and amongst nature. It could even be that you need the home you choose to be pet friendly, so that family furry friends can also spend time visiting.
Decide on your top 5 ‘must haves’ and compare the first shortlist to see how they stack up against them to come up with your final shortlist, and the homes that you will now visit.
Visiting the care homesÂ
It is often suggested that you should visit a care home without making an appointment so that you see the home exactly as it. Whilst it is an option, in truth it is not always the best option.
Care and nursing homes are very busy places and everyone in them have a variety of duties to tend to on a daily basis, with the care of their residents taking priority over everything else. Visiting without having made an appointment may mean that you will be unable to speak with the person in the home who is best placed to answer your questions. As such, this could mean that you leave the visit without obtaining the information you went there to get.
Making an appointment will allow the care home manager, or other member of the home management team, to set time aside to meet with you to ensure that you leave their home feeling fully informed.
Ahead of visiting the homes on your shortlist, you may wish to make a note of some of your questions so that you don’t forget to ask them. Your questions will likely relate to the following areas, but they should be based on the things that are important to you and your loved one.
Care and staff: Enquire about staff qualifications, training, and the staff-to-resident ratio to ensure there is enough support available. As you are walking around the home, observe the staff with other residents. Are they friendly, compassionate, and attentive? Do residents seem happy and engaged?
Activities and wellbeing services: Enquire about the range of activities on offer. Are there opportunities to socialise with other residents and with the wider community? Would the programme on offer interest your loved one?
What other services are available that exist to improve the lives of the residents living there? For example, can your loved one access hairdressing services? Do they have access to people and services that will allow them to continue to practice their religion? Ask for a copy of the weekly or monthly activities programme so that you can take it home and read it in more detail.
Food and dining:  If you visit over a mealtime, you may be able to evaluate the quality of the meal options provided whilst you are there. If not, ask to see a copy of the daily and weekly menu. What is their approach to food and dining and are their residents involved in the development of the menus themselves? Can the home meet any dietary, cultural and personal preferences your loved one may have?
Making an informed choice
Once you have visited the homes on your shortlist, you should have all of the information you need to help you make an informed decision. If you are still undecided, then make another appointment to visit again, perhaps staying to speak with some of the residents or current family members, or to sample the food or activities which most care homes will be happy to accommodate. If it is possible to include your loved one in the decision-making process, make the next visit with them.
In the event that you cannot involve your loved one, you will need to consider what you have learned about the care home options you have shortlisted and weigh up the pros and the cons of each of them. However, the most important thing you should do, is consider how you felt during the visit.
This may sound strange, but what you saw during your visit and how you felt will be your best guide in finding the right care home. A caring environment can be felt from the moment you walk in the front door. If you were greeted with smiles from the staff you encountered, met happy and well-kept residents who seemed content, and the home met all of the ‘must haves’ on your list, odds are you have found the right care home.
Additional resources
https://www.ageuk.org.uk/information-advice/
https://www.independentage.org/first-steps-getting-help-your-care-needs-england-and-wales
https://www.alzheimers.org.uk/get-support/publications-factsheets
https://www.trustedcare.co.uk/
https://societyoflaterlifeadvisers.co.uk/
https://www.carersuk.org/help-and-advice/
Alzheimer’s society Dementia Support and Advice Line 0333 150 3456
