AIBU - to consider opening a private residential care home for the elderly?

[Fizzielove]

The governments idea of care in the community is a joke (IMHO) and lots of elderly people who would previously been able to go into residential care are now being forced to remain in their homes - often causing a lot of stress on family.

The reason there are no residential homes is because the government has closed / is closing all the state run homes and outsourcing to private nursing homes. Often an elderly person does not need nursing care but at the same time is too vulnerable to remain at home. From my experience there is a serious gap in the social care system.

AIBU to think of opening a private residential care home after I was told be a Social Worker that she would be able to fill it?!

Is this a sector you are familiar with? A lot of private care homes shut because they were in old buildings that couldn't be converted to bring them up to new standards and because their is a huge shortfall between what the government is willing to pay for care, and what decent care costs.

If you have found a financial equasion that solves this problem then by all means go for it.

Theres plenty of residential homes around (at least in both my parents area and local to me) - the issue is that in order to make a profit, and provide a good enviroment, care, and so forth, the fees have to be high. And social services can't/won't pay that for people who can cope with drop in carers.

What experience do you have? If you would be providing good quality care within a sustainable budget, great. If you're trying to cash in on a market opportunity with no relevant experience, then I think it would be exploitative - this is the last part of many people's lives.

We had family friends who ran a home. They gave it up when the level of beurocracy became so ridiculous that they needed to employ a full time member if staff just to deal with the endless reams of paperwork and meetings. There were new directives every week, each one costing large sums to implement.

Do you have experience? Elderly people in residential care home may still need help showering, dressing, toileting etc, its not just a case being available in case they fall.

Is that not warden assisted living is though? Plenty of that where I am.

You need lots of experience and lots of cash to do this. Everything will have to be in place before people will start paying for it.

Will it private where the people living there pay for it? How much do you estimate the cost will be, how many people in your area can afford those fees?

Is there a large amount of trained staff in your area? Who will run HR, the kitchens etc. If you live in a rural area this will be more difficult?

Have you found a site? How many bedrooms, what facilities etc

All this needs to be considered, it's not just a case of....there are not many in our area....lets do it.

Have you got enough money to make it like Quartet because that place was lovely

I am not wanting to do this just to make money! I've had terrible experiences recently with my grandfather, and my dad is now 83 so no doubt I'll have them agin! I'd like to run a small home that is cosy and where the residents are treated with dignity and respect!

Never mind making money. First thing to work out is if you can provide a decent standard of care and break even! Providing care to a standard that affords dignity and respect cost money, that's the point that people are trying to make.

Do you have professional experience in this field, or even experience in employing people or running a business?

Have you got extensive experience managing care homes or similar? If you have the funding, training, experience and in depth knowledge of what running a care home entails then of course YANBU. If you don't then I'm afraid you are rather naive to think it will be successful purely because there aren't many homes locally. You're talking about taking on responsability for the care of a highly vulnerable client group likely to have complex health needs and potential safeguarding issues. Not to mention a huge amount of bureaucracy.

Ok so I'm dreaming..... I just wish I could!!

In my experience, a great proportion of older adults prefer to remain in their own home as long as possible. The next best option is living independently in extra care sheltered housing.

So non-profit?

Do you know how much it will cost to even break even?

How much it will cost to build or convert a building?

You have to have those standards high from the beginning to attract the people who can pay for it. That has to come out of your pocket first. To maintain high standards with great care will cost a lot of money.

You need trained care staff, kitchen staff, maintainence staff, supervisors, accounting, family liaison.

The kitchen staff alone will need at least one person trained to a high standard to ensure the meals are balanced and suit the residents needs. For example people on a soft diet. Kitchen equipment that satisfys environmental health (standards are very high when cooking for the vulnerable) and someone who can do all the paper work and health and safety that goes with it.

What about a daycare rather than a home? Lots of people do want to help their elderly family members to stay in their own homes but obviously can't give up their other responsibilities, like their jobs, to care for them in the day. I guess it could be run somewhat similarly to a nursery? Do you have experience in aged care or childcare?

The reason that the demand for residential care (as opposed to nursing home care) is dropping is because the vast majority of older people would prefer to stay in their own home with a care package to support them.

It is very difficult to break even if you are a private, stand alone residential home. For example, you have to ensure that your staff are fully trained, but with only one home you couldn't justify having an in-house trainer, so you'd have to buy in training from other companies, which is expensive.

Can I ask what care experience you have? It's very different being a care worker to running a care home.

Sorry op you are dreaming

The reason that lovely, affordable, small, family care homes don't exist is because they are not economically viable.

Most older people want to stay in their own homes. Those who move into residential nearly all have some degree of dementia or heavy physical needs otherwise they would stay at home.

You need skilled, trained staff to care for these people but you will not be able to afford to pay them well because the council funding is on average £100 per month less than the cost of providing care. Therefore you will get less good staff who are not committed, there will be high turnover and constant worry about quality. Some will be really bad apples who steal the drugs or are abusive and you will need to get them out quickly but legally before they damage anyone so you will need to pay for HR support.

You will need purpose built premises with ensuite facilities as that's what CQC and families expect. You need to clean and maintain the premises to high standards. If you buy the premises with a commercial mortgage you will worry every month if you have enough money coming in fees after costs to pay it.

You will need to fulfil standards on infection control, food hygiene, medicines management, health and safety, employment law, deprivation of liberty and on and on.....

You will need a lot of financial expertise (or buy this in) to manage collection of fees, payroll, pensions, suppliers, producing accounts, paying tax.

The only way to make enough money to have a lovely, quality place with well paid, happy staff is to only accept private residents (council fees are too low) and charge a lot of money. However it is a competitive market and in order to attract private residents you will need a top notch place and a great reputation, marketing etc

Of course the social worker can fill a lovely care home with local authority funded residents paying rock bottom rates 10x over but either the home will not be very lovely or it will make a big financial loss.

These are the realities. You can figure out how I know.
It upsets me when people think that care home owners are raking in a huge profit as they really are not. Overheads are very high and fees are less than costs in many cases. Many small homes are going bust only big chains that can make economies of scale can survive.

People think fees are high but in actual fact it would cost you more to stay in a Travelodge for a year than a care home with no food or care included!

Think about a quality daycare facility, as pp have said, dire shortage of those!

I don't think daycare is any easier or cheaper to run. By the time people need and accept a day centre, they are much more likely to have dementia rather than being frail. The day centre my mum would attend if she didn't hate it so much (and therefore tries to escape, gets very agitated) provides bathing, chiropody, hairdressing, falls prevention/physio, and a range of activities. But being part of a care home means that they share a lot of the overheads.
And of course transport is an issue as well

""Often an elderly person does not need nursing care but at the same time is too vulnerable to remain at home. From my experience there is a serious gap in the social care system.""

I've worked in Residential and Nursing homes, had relatives that ran them and worked in the Community.

I think, like a lot of people that you have been wrongly advised, if implemented according to the Law, the Community Care Act works well and if there is a Medical need you can get Care funded.

The biggest disgrace is that you've got to fight to get what you are entitled to and that Professionals withhold the truth.

There have been major cuts in the budget, so whoever can be left at home, or under "Residential" when they should be under "Nursing", often are, until an accident occurs, or their repeatedly having to be admitted to hospital and start "Bed Blocking".

You can make a profit running a Care home, lots were bought, as a money making scheme (usually by overseas investors) and have gone on to lose their licence.

How much "we" expect families to do, is an ongoing debate, it's been going on since the early 90's, when the Homes went to private owners and the LA paid for the Care.

There isn't a gap, the policies and duties aren't made clear to Service Users and their families.

Plus, Carers for their Parents don't see themselves as such and remain unsupported, except for a few Charities.

This Government don't recognise the valuable role (to Society and the Individual) Carers deliver.

I can assure you that you cannot make a profit running a care home AND have decent standards AND accept local authority rates.

The only ways to do it are

1. Accept only or nearly all private funders
2. Cut costs to the bone; serve crappy food, pay minimum wage to staff, don't put on any activities.

Most providers go for a sort of middle way of trying to get a proportion of self funders to subsidise the local authority fees and manage to run a decent service that way.
It does also help to be a big chain so that you can make economies of scale on supply contracts and share staff between homes.
It is in no way a get rich quick enterprise.

Tbh the way to make money in the care home sector is to build a care home and lease it to another mug to run it whilst keeping the rent and equity in the property. Only snag is you'd need several million quid to build it.

Locally there is a dire shortage of nursing home beds with all homes locally accepting only residents with minimal needs ( not nursin care). In practice this is totally not the care and many of them meet the criteria for nursing home placement.

The homes did used to be nursing homes but due to funding shortfalls and the difficulties recruiting staff ( trained and untrained ) to manage nursing care, converted to the 'easier' option.

Yes, exactly what we are considering doing

Why?
Because to run nursing rather than residential beds you need qualified nurses. Qualified nurses usually do not want to work outside the NHS because although pay may be the same benefits eg pensions are not and there is less prospect of promotion and less peer support.

We have been trying to recruit a night nurse for the last 6 months but no-one is interested. We either have no applications or people with dodgy CRB checks or other problems. It's costing a fortune in agency fees.

The county council woefully underfund the nursing beds. Although the rate is higher than the residential rate it does not reflect the increased staffing costs at all. For nursing we need more and better qualified staff and the fees don't cover it.

We figured out we'd be much better off to convert all the beds to residential as although the fees would be lower the costs would be much, much lower and far less hassle. Only reason we don't do it is loyalty to our staff and our existing residents but basically the nursing beds are a loss making enterprise.