Choosing a Care Home: A Case Study

Shan’s mum, who is nearly 92, currently has carers visiting three times per day to help her wash and dress; bathe and eat; and get to bed in the evening.

However, as her mum’s condition deteriorates, Shan is now looking for a care home for her mother. She has had some experience of looking for a care home before, having previously looked around for homes for her great aunt, an elderly friend and also for her father-in-law.

Shan explained a bit about her mum’s requirements: “Now I'm looking at residential non-DE care homes, but with the possibility of needing nursing in near future - if not now. The hospital says that Mum does not yet have dementia, although I wonder a bit, as her memory problems are increasing. That’s why I am looking for a potential combination of residential leading to nursing and DE; planning for the worst and hoping for the best!”

Care homes registered in the DE category are specifically for people with dementia. DE care homes used to be known as EMI care homes. EMI is still sometimes used but the correct term is DE.

Concerns and Issues

Shan admits that the location of her mother’s potential care home is an issue. She explained: “My biggest concern is that if Mum has to go into care she will be in her local area (by her choice) and I'm over 150 miles away. I will only be able to visit about once a fortnight and this is still probably more often than my sister will see her. I am also somewhat cynical, and believe that the residents who get best care are those who are visited most often.”

Shan says she has found the costs associated with finding a care home to be “huge”. She said: “The only homes that I've seen that I'm reasonably happy about cost around £1,000 per week. Obviously this means that mum's house will have to be sold, as I simply cannot find that sort of money. I don't care about an inheritance, other than minimising taxes. There are more complicated financial issues too as I hold a mortgage over mum's house, which might possibly even mean I have to foreclose on this to ensure that we can get the money for mum's care. What a ghastly prospect.”

Finding the Right Home

Using her past experience of finding care homes, Shan outlined how she goes about choosing a care home: “I don't bother with local authority lists because they are unreliable. The Commission for Social Care Inspection (CSCI) website can provide a list based on postcodes so I've used these. I always turn up to visit care homes unannounced, and if I’m told I have to make an appointment, I don't bother. I understand and applaud those care homes that say I've called at a difficult time - their priority is caring for residents and I don't mind waiting around until someone has some time for me.

“Getting personal recommendations is very difficult, although when I have the opportunity I ask visitors that I see going in and out - this is just a random sampling but useful (and no-one's objected).

“I will look at the CSCI reports but only take notice if the home is low graded; having had my father-in-law in a home that I know was excellent, the CSCI report calls it just “good”. I feel that the professional inspectors' reports can only be subjective and based on a tick list. I don’t feel there is much point asking social services people for their opinions - often they haven't seen the inside of more than one or perhaps two homes, and usually only those funded by the local authority.

“I have found the most useful indication of the quality of a care home is the attitude of the staff. I look at staff facial expressions (not the person showing me around, but those doing the actual caring work). Often they look as though they're doing a job, just getting on with it. The best homes have staff that look happy, chat with residents with respect and as equals, smile etc.”