My mums accomodation is wonderful. Apparently the firm was started by people with a social services background, and designed specifically so that support can be ramped up as needs grow. The receptionists have a discrete list of people they tick off each morning, and check on if they don't see them. A weekly clean is included in the service charge, which seems to include monitoring things like use by dates in the fridge so they have a clear idea of when capacity is going and more support is needed.
Retirement Security Ltd, have a number of Courts around the country, if anyone is looking to buy a retirement flat. Unlike many such properties they seem to retain their value well.
For me the biggest improvement was not have to be the first one to take the call. When something happens, I am now told she is on her way to hospital, which is far better than the constant "drop everything and run" anxiety that I used to have when the phone rang.
Another huge advantage is that very sheltered costs a lot less than a home. Service charges plus an optional daily three course lunch, tea, coffee and laundry costs about £1,300. A good care home for a self funder over the past seven years would have been an awful lot more. Part of my desire to keep her there as long as possible is that there is every chance she will live a further decade. My parents benefited from rising property prices in the South East, but even so it will be quite an achievement to have funded my mother through 20 years of dementia care. So I am willing to put a lot of effort into solving problems as they arise, in order to keep her where she is.
But fundamentally as Meredinto says, it is based round my mother's needs. At the moment she believes she is independent, and she retains her dignity and sense of self. She may not be able to change channels on her TV but she can turn it on, so believes she has choice. She can leave her flat to go to the coffee lounge, and return when she had had enough. She has her kitchen, even if she does not realise that she no longer uses it. She puts the chain on her front door at night, without realising that her carer can circumvent this and enter each morning. Some of her furniture was bought when she first got married. The general agreement is that my mother is fiercely independent and that to the extent that a decision needs to be made between independence and risk, we need to accept/minimise risk in order to give her as much independence as possible. If my mother were more timid and if a lack of memory made her fearful, the balance would be in a different place. That said, I am aware that we are on borrowed time, and that within the next year or two professionals may well be telling me that she needs to change setting. (At which point, cost wise and in terms of familiarity - 24 hour care in her old home - currently rented out - may be the better option.)
One of the first things we did was ensure that she was on Social Services radar. In part because of wandering, but also for issues around hospital stays and discharge. She lives on Costa Geriatrica so the local supermarket also keeps a list of shoppers who can forget their way home.