Moving into a care home
This guide aims to give you an idea of what to think about when you or a relative is moving into a care home or nursing home. Please let us know if there is something we should add to this page. We have tried to give you as much information as necessary, but we apologise if something is incorrect.
1. First step - get assessed
Before you start looking at the different care homes, you should contact your local council (social services department) and ask them to assess your needs. They are able to give you financial support for moving into a home. Even if you are happy to pay for a home yourself, it is easier to get the council to assess you before you move, and you may need that financial assistance at a later stage.
The assessment is usually done by someone from the social services part of the local council. They will discuss what help you need and your current health. You may want to invite a family member or friend to be with you for the assessment. You may also want to have a think about what you want, as they have to take your views into account. This could be things such as where you want to live. It is usually helpful to write down a list of questions prior to the visit.When the local council has assessed you, they might decide that the best way is for your to move into a care home. If so, they are responsible to arrange and pay for your care (if you are not able to do it yourself). There is a complaints procedure if you are not happy with the assessment. Contact you local council for more information.
If the local council believes that you require nursing care, they should organise an assessment by a nurse. Should the nurse agree that you require nursing care, the NHS will pay an amount directly to your nursing home. See the table below for how much they may contribute. There is a complaints procedure here too. Contact your local NHS unit for more information. Please note that not all care homes provide nursing care.
Payment of fees
If your local council pays part or all of the costs, they will pay the care home directly. If you have to pay part of the fees, you will have to pay this money to the local council.
On the other hand, if you are deemed to have to pay the full fees yourself (i.e. your savings are above the upper level listed above), you will have to pay the care home directly. If you are not able to manage this, the local council must help to arrange a place for you.
Top-up fees
Some care homes cost more than the local council is willing to pay. If your council is supporting you, you might be able to move into such a home, provided that you can find someone else (such as a relative or a charity) who is willing to pay the additional fees. Make sure that you are covered in case the care home fees go up.
Checklist for care home fees
You might want to make sure that you understand the following aspects of the care home fees and costs. It is much better to ask in advance, than worry about whether you are able to afford future fees or costs.
- What exactly does the fees include? How often can the fees be raised?
- Can you get a care plan showing exactly what care you will get. Will you have a written contract with the home, signed by all parties?
- Are there any extra charges,in care you fall ill for example (e.g. physiotherapy)?
- Are there any extra charges or do you have to pay for toiletries, incontinence pads, etc.?
- Will the care home insure your possessions or will you have to do this yourself?
3. Choosing a care home
This is a very important choice. Read as much as you can about the different homes, and ask friends and relatives if they can recommend a home.
Read up on relevant care homes
All care homes are set up to help with personal care, such as help getting dressed, personal hygiene and meals. If you require substantial nursing support, you may need to look at nursing homes (homes with special nursing care). Ask a care home if you are not sure that they can cater for your specific needs.
English homes are regulated by CSCI, and they will inspect every home at least every three years. You are likely to find a report on possible care homes on their website. This website can also help you find a home in the location you are looking for. Outside England, you may want to visit the Care Standards Inspectorate for Wales, the Scottish Commission for the Regulation of Care or the Regulation and Quality Improvement Authority in Northern Ireland.
Once you have found a few care homes that you like, ask them to send you a brochure. The homes should be happy to let you visit, to give you an idea of the home and the facilites. It might be a good idea to ask a family member or someone whose opinion you trust, to come with you. As this is an important decision, it is worth getting a second opinion.
It is also worth ensuring that the care homes you are considering are in the right location. Would it be easy for your friends and family to visit? Is the home near the shops, social club, library, park, church, religious centre or other places you would like to visit, so that you can either walk or get their by other means of transport?
Visiting a home
When you visit, there are a number of things that you should consider. Do not be afraid of asking a lot of questions, the staff at the care home should be happy to answer them. You may want to prepare a list of questions, to ensure that you get answers to everything. Here is our suggested list of things that you might want to look out for:
- Cleanliness
- Friendly and helpful staff
- Does the care home feel homely, or rather institutionalised?
- Is it nicely decorated, or rather tired and old-looking?
- You may want to talk to people who already live in the care home to give you an idea of what it is really like there. Do they seem alert and occupied, and are there activities going on. Alternatively, are they just dozing in front of the TV?
- General sense of calm, not the light panic resulting from an understaffed home
- Closeness to friends and family (easier to visit)
- Do they have reglemented hours of meals, bedtime, etc, and if so, would these times suit you?
- Religious beliefs - do they accommodate/share your beliefs?
- Smoking rooms - if you are a smoker, do they have an adequate smoking room? Is there a smoking policy in place?
- Is there a nice garden where you can sit in summer?
If you are not able to get to the homes, you can ask a family member to visit the homes you are interested in. It may be possible for a person from the care home to come to you, to help you decide.
Daily life in the care home
Many care homes will have quite strict meal times with limited menus. If you have any special dietary needs, make sure that this is can be catered for. If possible, you should ask to try the food. What does the home offer outside of meal times - will you be able to get food or a snack? It is important that you are happy with the foods in the care home of your choice.
Some homes will have very strict times for getting up, getting to bed, etc. Check what the policy is in the care or nursing homes you are considering. Would this suit you?
Will your visitors be welcome at any time, or are there set "visiting hours"? Some homes are quite welcoming towards visitors, even providing visitors a place to stay overnight. This is particularly important if you are likely to have visitors from further away. Are there any policies on you leaving the homes to visit family or friends, or do you have to alert staff long time in advance? Some homes may not be happy to welcome children, and this might be another question to ask.
What activities does the care or nursing home provide, either on its premises or by way of outside trips? Will you be able to indulge in your favourite activities at the home? Will you be able to decide for yourself what time you get up and go to bed?
Some care homes allow animals, so if this is important to you, you might want to ask about their policy on animals. Some homes allow visitors to bring pets, so you may want to enquire about this. If you have a pet, but do not want to or you are not able to take it with you, you may want to talk to the Cinnamon Trust about finding a new home for your pet.
Care home facilities
Most care homes offer you an individual room, but not all rooms come with an ensuite bathroom. Would you be happy to share a bathroom with someone else?
Will you be able to stay in the same room or is it likely that you have to move? Some people are happy to wait for a better room (or maybe one with an ensuite bathroom, whilst others may prefer to only move once. In your room, are you able to personalise it with your own furrniture? Is it possible to entertain people in your own room, and will you have your own kettle to make tea or coffee for your guests.
Depending on your needs, you may need specialist equipment, such as bath aids or wheelchair access. Make sure that the care home is aware of your needs (bring the council assessment report) and that they can meet your specific needs.
There a a number of important areas that you need to consider before making the final decision to move into a home.
- How secure is your place in the care home? Will you have a contract guaranteeing your place?
- Will the home be able to take care of you if you needed more care one day, or would you have to move to another home?
- In the event of the home having to close, or be transferred to another provider, how would the home ensure your interests are a priority?
- In case of problems, how can you raise complaints? Is there already a residents' committee and a relatives' group set up?
4. Getting ready to move into a care home
What clothing should I bring?
What clothes should you take? There is likely to be less space in the care home than you had at home, so there is bound to be some clothes that will have to be left behind. Ask the care home about how much space you will have, they are usually able to give you an answer before you move.
Think about whether there are clothes you are unlikely to wear again. Now might be the time to look through the old clothes and decide to give away or throw stuff that you have not worn for years. Charity shops are only too happy to take quality clothes that you do not need any more.
Order name tags?
Order name tags from My Nametags in advance (by phone 0800 3 213 203 or go our order page), and turn up on the first day with things already labelled. Most care homes use a common laundry, so it is important to label the clothes. Our iron-on name tags iron-on in seconds, so they are quick to apply to clothes. As they are guaranteed not to fall off in the wash for 10 years, care home staff like them too. You may want to ask the care home staff whether they prefer you to put the name and room number, or if the name is enough. Click here to go to the My Nametags order page.
Time to get a mobile phone?
How are the telephone arrangements in the care home - will you have your own telephone in your room? If you do not have a fixed line telephone, you may want to consider a mobile telephone (even if you never had one before). This allows your friends and relatives to easily reach you wherever you are in the home. They should still have the general numbers for the home, but a mobile might be worth while to consider.
Life in a care home
It can take some time to get used to living in a care home. A number of things will be different from what you have experienced in your own home. If you have any concerns or problems, the best might be to talk them through with the manager or carer. If this does not resolve the issues, there are various helplines that might be able to offer advice, such as the one from the charity The Relatives and Residents Association.