How To Choose The Right Care Home
Choosing a care home for yourself or a loved one is a significant decision. But with dozens of care homes in the North West Bristol area, how do you choose the right one?
How long does it take to find a care home?
Finding the right care home can take time, so if possible, don’t leave it until it’s an urgent issue. It takes an average of five weeks to find a care home – plus a further two weeks to move in. The most popular care homes may have waiting lists, so some forward planning is very wise.
What types of care home are there?
There are different types of care homes, and which is most suitable for you will depend on your needs. Some will focus on one type of care, while others will offer a combination. This can be useful if your needs change.
1. Residential homes
Residential homes are for people who would like some help with personal care such as washing, dressing and meals. They can be a great way to beat loneliness. There will often be a dedicated team of wellbeing and activity coordinators, allowing residents to continue enjoying hobbies and even trying out new ones.
2. Nursing homes
These provide specialist medical support for individuals with complex care needs or in need of nursing care. A registered nurse is available 24/7 to support residents and ensure they receive appropriate care and treatment.
3. Specialist dementia care homes
These homes have features such as simple layouts to make it easy for residents to find their way, sensory gardens to help stimulate senses, and qualified dementia nurses.
4. Alternatives to a care home
There are other options if moving into a care home seems a step too far. If you need a little more support around your home, or think you might in the future, extra care housing (also known as assisted living), sheltered housing or retirement housing could be worth considering.
These are a sort of halfway house, giving you your independence but also the peace of mind that support is available if needed.
Key considerations when choosing a care home
1. Health and care needs
Your health and care needs are the main factor, so use this to narrow down the type of home to consider.
To help with this, start by contacting your local authority. Your local authority will carry out a care needs assessment. This determines the type of care required and ensures your needs are aligned with the support the care provider can put in place.
The needs assessment is free, even if you plan to pay for your care privately, and anyone can ask for one.
2. Location
Location is another key issue. You might want to find a home near where you (or the person in question) currently lives, so it’s easier to maintain friendships and community connections. Or it might be preferable to relocate near to family so it’s easy for visits.
3. Cost
Costs can vary significantly. The average residential care home in England costs £949 a week – equivalent to £49,348 a year. The average nursing home costs £1,267 a week, or £65,884 a year. Bear in mind that there have been inflationary increases since these figures were compiled, and in affluent parts of North West Bristol the average will be much higher.
How CQC ratings work
The CQC ratings can also help you narrow your search. These are determined by the Care Quality Commission, the independent regulator of health and social care in England. It inspects care homes in England, sometimes turning up unannounced, giving them a rating (outstanding, good, requires improvement and inadequate) based on factors such as safety, effectiveness, and leadership.
These ratings can give a good indication of what you can expect, but we would warn against making decisions based solely on them. The ratings should give you reassurance of standards but, ultimately, they are a guide only. A care home with a good or outstanding grade may not have been inspected for five years, while one with a lower grade may be in the process of making improvements. You do need to make your own call.
What to consider when visiting a care home
The best way to find the right care home is by visiting them. It’s like buying a house and first impressions count. Everything from the welcome you receive and how the staff treat the residents to the way it smells should influence your decisions. You might even want to go at short notice or unannounced to get a proper feel for the place.
It's also worth having some questions ready to check whether the home meets your needs, although ultimately you need to find out whether you, or your loved one, will fit in. If you’re a sociable person, ask about the activities that are laid on. If you like gardens, make sure you look at the grounds.
You can also use this visit to find out more about how the home is run.
Questions you may want to ask include:
How long have the staff been there?
Does the home cater for different dietary needs?
What are the visiting hours, and when can you visit?
You should also try to speak to some of the residents and staff to get their thoughts.
How to prepare for future care costs
It’s wise to factor the cost of care into your financial plans. No one can tell whether they’ll need long-term care, but the latest figures show that most of us spend the later years of our life in poor health and/or with disabilities.
The latest Health Survey for England which looked at this question, published in 2022, found that around 30% of over 65s needed help with at least one daily living task. Among the over-80s, this figure rose to over 50%. We would encourage everyone to explore their care options. Know what’s available, the support you might receive, and the costs, makes it easier for you and your loved ones if you do need care in the future.
What care might you need and how much does it cost?
Long-term care takes many different forms. While it’s common to think of a nursing or residential home, care can also be delivered in your own home by a professional carer, or more informally by a family member or friend.
The amount of care required can vary too. It could mean round-the-clock nursing care, but it could also be a daily visit to help you get up or a weekly trip to a local supermarket for your shopping. It could even be part of a package offered through retirement or sheltered housing, where you can tap into support if it’s needed.
As there are so many different types of care, and a large range of providers, costs can vary enormously. The average residential care home in England costs £949 a week – equivalent to £49,348 a year, according to February 2024 figures. An average nursing home costs £1,267 a week, or £65,884 a year. There have been some inflationary increases since those figures were compiled, and in affluent parts of North West Bristol the average will be much higher.
Home care costs on average £25 an hour, but the amount you’ll pay depends on the type of care, where you live and when you need it. Don’t think of home care as always the cheaper option: having live-in carers can easily set you back £100,000-plus a year.
How to get help with the cost of care
To receive support for your care from your local authority, your assets will need to fall below £23,250. For care at home, this means test doesn't include the value of your property, but if it's residential care, the local authority might take the value of your home into account. Above these thresholds, you’ll have to foot the entire bill.
If you think you might qualify, contact your local authority. They’ll arrange a needs assessment, to determine care needs and the best way to support them, and a financial assessment, to assess eligibility for funding. Even if you're eligible, you'll usually still be expected to contribute towards the costs.
You can also claim Attendance Allowance if you are over State Pension age and have care needs because of a physical or mental disability or a health condition. It isn’t means tested. You could get £72.65 or £108.55 a week, depending on the level of care that you are assessed as needing.
The NHS might also help with care costs if you have complex health needs. In theory, NHS Continuing Healthcare can cover all care costs. Everyone with complex health needs to seek an assessment, but the threshold for being eligible for CHC is high and many people don’t get it.
Planning for future costs
While your future care costs can feel overwhelming you can treat these costs in the same way as more general retirement planning. For example, most people spend more in the early years of retirement on holidays and leisure activities, then when they slow down so does this ‘discretionary’ spending. When planning for care fees, perhaps keep the expenditure level so you can see what’s available for your later years.
A practical tip is once you’ve paid off your mortgage, you could put the amount you would have spent on mortgage repayments into a diversified investment portfolio to plan for future care costs. For example, if you paid off your mortgage at 60 and invested £700 a month for five years, you could have a pot worth nearly £108,000 by the time you’re 80, assuming investment growth of 5%. This could help pay for care.
Using your home to pay for care
As it’s one of your largest assets, your home could be part of the care funding equation. Downsizing could release additional funds for future needs. Or you could consider equity release. Equity release has fallen out of favour as interest rates have increased over the past few years, but it can still work well for some people.
It can provide an income stream or a lump sum, but it also enables you to stay in your own home. Where someone is moving to a care home, selling the home can often be the sensible option.
Some families may want to rent out the home to cover fees, but this can be risky, as rental income isn’t guaranteed and maintenance and repairs will also have to be considered.
Annuities for care fees
There are also financial products that could help with care fees. In exchange for a lump sum, a care fees annuity will pay a guaranteed amount to the care home or care provider, tax-free, for the rest of your life.
Each care fees annuity is individually underwritten, taking into account factors such as your age and health. This means they should be matched to life expectancy but, if you die prematurely, your estate could be out of pocket.
What next?
If you are a self-funder and you would like to discuss making a plan to pay for care, give us a call on 0117 3636 212 or email office@haroldstephens.co.uk to speak to one of our SOLLA Accredited advisers.