Residential care - how to chose and why don't they put their bloody prices on the website

[KatyMac]

Please email us for our prices - no I dobt want to email 25 of you and wade through answers I want 5 or 6 to visit/talk to

Care commission reports are fine but I ran a nursery and know how biased reports can be

Aaarrrggghhh!

And dementia care? My uncle is fully mobile, energetically so - he walks for miles

But is starting to become a risk to himself and others

Locking him up seems wrong but I cant travel 2 hrs each way to plug his mobile in or sort out replacement bank cards

He is so depressed

Has he had assessments to see what level of care he needs, whether he can stay at home with carers. He would also need a capacity assesment to see how much he understands anout his care and can agree to moving into a carehome plus a financial assessment to see what he woukd need to pay. Does anyone have poa to help with these decisions.

I have health and social care poa and my cousin & I have applied for financial poa (we've had the letter when they give us 3 weeks to refuse)

He will be self funding

SS have explained if he goes in too early it could cause problems if he runs out of money before they are prepared to pay

But he has discussed suicide, is irratic and distressed - day to day living is stressful and complicated with 2 carers visiting

We were concerned he wasn't taking his medication so we got a dosiset & then we worked out he was taking too much so now it's in a locked box

So now he goes out when they are due so they ring me, I have to try and find him & I dont have any emotional energy atm

His capacity is changeable within one sentence he has moments of clear thinking when he is terrified and then he reverts to a loop of minor issues that distress him

He is open to moving closer but thinks living independently in a bought flat is possible - I am pushing renting and I'm concerned about multiple moves

No fees is probably like gym memberships where they have variable pricing & want to get to do a sales process.

What about extra-care flats?

He could then buy in more care as needed plus company & oversight.

Extra care is what I think I need but ideally on a site where we can move to dementia care when he needs to

But extra care is a bit like hens teeth near here

I get the sales pitch but I don't have time/energy

I want him in an average home mid way between me & my cousin so we can both (in theory) visit

He is probably on the autistic spectrum and that and dementia is crippling plus he saw his mum follow the same path but the 'extra care' time was spent with my parents & I can't have him here

He is busy telling his carers he is staying with me for Christmas when another family member is brining him for a family meal on Wednesday - he cancelled them for the week (they are still going)

And I hadvthe police on the phone on Thursday with a suggestion that the current arrangement is no longer suitable

I would start with a needs assessment from social services. They have detailed knowledge of local facilities and can advise on appropriate settings.

CQC are useful. It is true that well run homes can game the system to get top results, but the reports do highlight the poor ones.

Word of mouth from locals with family members in care homes.

Sounds from your description that he is at a bit of a tipping point. He does not need full time care or even carers coming in multiple times a day but would benefit from regualr support.

Could you get a local private carer to go in for a couple of hours a day? There are a lot of carers who worked for private companies who are fed up and will take private contracts where they can offer longer, better quality support and earn more. Disadvantage is that if they are sick they can not come but he sounds as if he can still cope on his own.

We had a really good experience with Driving Miss Daisy a couple of years ago. They are all trained and regulated. They were just lovely. They picked DF up and basically took him out for the afternoon to do what he wanted. Not cheap - but a lot cheaper than a care home . And an extra 6 months at home can save you £30,000 if you are self funding. They are a franchise though so might not be everywhere.

His sheltered accomodation is £300 a month in fees
His twice a day carers are £850 a month

Residential care is 4 times that!

If we added in a carer 3 times a week for 4 hours would be another £700ish so that could work

Is he claiming attendance allowance as he is self funding. If he is already in sheltered accommodation do they run other types of accommodation for people with higher needs. Has he seen his g.p or district nurse recently to assess his physical and mental health. What part of the country are you looking at, someone nere might have local knowledge.

The gp says he can't have more 'memory meds' as it will affect his heart condition

He is in Bromley I am in Suffolk and recovering from covid (9 weeks in and barely out of bed)

My cousin wants to keep him out of care as long as possible but I'm the one the police/carers/gp ring and I have no resilience atm

If he has the space at home, and disposable income, it is worth looking at live in carer. It does not cost as much as people think. They do however need a 2 hour break every afternoon.

Nothing useful to offer I'm afraid but you are a brilliant and caring niece. Many people would be very lucky if they had family like you. I hope you get it sorted for him.

Can you speak to the pharmacy who does his prescription? They will likely have a good idea of the care homes in the area.

I remember your other thread. There are several extra care housing schemes in Bromley which look very nice. Blenheim Court is warden flats for sale but has Durham Court on site which is extra care. There are flats in Bromley Common for rent, Regency Court is extra care for rent but they all need to go via the local health authority or social services. Regency Court was 1150 pcm when I enquired.

They vary a lot in price but start at £500 for those with very minimal care needs (more of a full board hotel with laundry type situation) once they need help with washing and dressing fees quickly mount up to a thousand or more per week. It's worth requesting (forcefully) a continuing care assessment citing the need for the police to be involved, if he's eligible you do not pay any fees, otherwise a new social services assessment is the way forward but he will pay unless his total estate is under £23k

Well the police made a safeguarding referral to ss

Continuing care is very hard to get. You need to demonstrate a need for daily nursing decisions. From what you say, I’d be surprised if your uncle would qualify.

Care home prices depend partly on room size, so vary according to which room becomes available at the critical time

…..even if you do qualify for the continuing care element you still have to pay the residential costs if you are self funding, so the saving is quite limited.

I think he will be paying for himself for some time

If he has the funds then he can apply for attendance allowance and funded nursing care if he requires nursing input. Its not really locking him up, its about his safety and living in the most suitable accommodation.

What is important to him? Food? Is he sociable or private? Will he want to join in activities or want to be left to his own devices?

I assume he has a diagnosis? Has he bought in to the residential home idea?

When looking for Mum who loved her food and had all her marbles and was very sociable and wanted to be as close to me as possible we asked to go for lunch at the homes we were considering and assessed the nosh, the wine and the ambience.

Costs were very similar for all the local homes - but some rooms were more expensive than others, and the cost of care varies depending on needs, which is why they can’t quote.

If he has dementia at some stage he’s going to need a nursing home, not just residential home. To prevent him having to move home later on you might want to make sure the home has both nursing and residential care.

But starting out with a live in carer does sound like a good idea.

If it's decided he definitely needs residential
care , go and look round a few.
Don't go on how fancy they are , see if the residents look happy, speak to staff and relatives.
See if you can find one where he won't have to move if his dementia becomes worse ( some have an EMI unit attached ).

Unfortunately I don't think you will be able to look around any of the homes.
We have found it difficult to actually get in to see a resident family member.
At the moment only 3 named visitors are allowed per week.
Plus each person is only allowed twice a week.
We are in Cheshire and pay £1014 per week. FM doesn't have dementia.
We are given nearly £200 per month for nursing care but this is paid directly
to the home from social services.
And for this they don't even have their own bathroom.

I think the extra care is the best option if I can find a rented one or one connected to residental care & maybe a dementia unit

There seems to be something suitable in the next town over so I'll ring them tomorrow

He isn't bothered about food - he loves his piano and playing chess - he isn't social rally at all - quite emotionally solitary but not isolated like he is right now

A live in carer isnt possible - one room flat in sheltered accommodation

He has bought into moving close to us/between us but thinks he can sell his flat and buy another; I am only prepared to be involved if he rents

Occasionally he says he understands that he will only deteriorate and he needs to be somewhere safe.....30 secs later he talks about going on holiday by himself and living in a new flat

I know and I have asked my cousin to apply for it with my uncle

I'm not out of bed yet reliably and I cant travel down to Bromley to sort it out

The fact that his carers have his meds in a locked box is (I hope) a reasonable indication that he might need help