So I was looking at possible care homes…

[tobee]

My parents are currently relying on a live in carer and relief carers for the live in carer (which alone is 2 x hours a day). The live in carer started in mid March to look after dad (who has moderate dementia) as mum had a long hospital stay and then a rehab hospital stay for about 2 months. She had broken a femur and dislocated a hip replacement requiring 3 hour surgery. She’s 90 next month and dad is 91.

Although physios were optimistic that mum would gain more independence and so on, my sister and I are thinking it’s likely that this isn’t realistic. (Obviously if it is - problem solved). Paying for live in carer etc is not going to be affordable for many more months and they will have to sell their home and self fund care home to live there permanently. So I’ve been looking at care homes. But so many questions. These are my major ones:

1. how do you decide what you think is affordable? I can see some super duper homes that start at over £3,000 per week per person. All the way down to less than £1,000 per week. But how can you possibly guess how much they can afford when you don’t know how long they will live?

2. did people who have found care homes found personal recommendations are the way to go?

3. Anyone had to get care for both parents at the same time? Was it fairly easy to find homes that that could take 2 together? I’m not expecting it will be easy to find a double room.

4. I’ve found several nice looking places on a tentative online look but that’s all very well but they may not have spaces. How hard was it to find a home you liked with vacancies?

We’re in the south east of England by the way. Part of me wonders why people don’t just go for the most expensive option because why not? I’m slightly joking here but it’s all seemingly like guess work.

Obviously going to visit etc will tell me a lot but there seems to be about 70 bazillion care homes in this area so how can I make a short list? Looking online seems pretty superficial. All reviews on the site say it’s been fantastic for their “loved one” so far.

Sorry about weird formatting

The problem with going for the most expensive is that if/ when the money runs out and the local authority starts to pay they may cap the amount they pay. Sometimes they will let them stay in the same home but I guess they may get moved to a cheaper one which may be disruptive. I think they do make decisions in the cared for person's best interest though. Do your parents have a social worker involved or could you speak to someone at the council about options? Age Uk also have informative factsheets which explain the process and may have a care directory for your area.

What about equity release or similar?
Live in care is likely to be far cheaper than paying 2 lots of care home fees.

My understanding is you usually need at least 2 years of care home fees available if self funding in a care home, otherwise you will need the LA to confirm they would continue to fund.

I have worked in care homes for 10 years, from the care side to management side so I hope I can help you with this.

Firstly, most care homes will ask to see proof of 1-2 years funds to cover the costs, if you can afford that then once the money runs out the local authority will take over, as well as this depending on needs at the time there’s more options available for chc funding etc if there’s nursing needs they may qualify, the home would help with applying for this. When you go to look around homes make sure you ask the question of if the money runs out will the home accept the local authority rate, the majority will as not a lot of people can afford multiple years of care.

I've no first hand experience, but you can buy what is called an 'iimmediate needs annuity' which will pay a persons care fees until death - I'm not sure how it caters for inflation and increases in care home costs, but an insurance broker should be able to provide more info.

The expensive places may need evidence of your parents' ability to self fund for a minimum length of time after which they will accept the council rate when their money runs out.

My relative had to show at least 12 months of fees in liquid assets (proceeds of her house) but she lived in the home, in the same lovely room for nearly 10 years which was far longer than anyone expected.

We've got 2 dear friends in their 80s who moved into a care home together. Wife had care needs, husband didn't really, but was too frail to manage wife. They have two rooms next to each other, one has a double bed wardrobe, chest of drawers etc, the other table, chairs, small sofa etc from their home. They can have guests to the sitting room, he can do things there while she sleeps in the day, they have everything going on in the home. He goes off to help with the flower displays in the town (something he's done for years), knowing that she is being cared for.

1. Educated guess, based on a combination of the person's prognosis, their savings, and the weekly cost. Bear in mind that people who move into care homes can live well and longer than you expect - 24/7 oversight, encouraged to drink and eat, GP calling in twice a week, socialisation. It is a lottery. A small handful of homes may have some kind of offer like if you pay full whack for two years then after that they will accept council funding, but that's pretty rare. If you think they will significantly outlive their money then you may have to focus on homes that will accept council funding, so they don't have to move homes later on.
2. No, you need to think hard about what's important to the person who is going to be living there and then do a drop-in visit. Eg if mum does not have dementia then make sure there are enough other residents without dementia to provide some social life, and check the social calendar. If mum loves food check the food - just arrive at lunchtime and ask if you can bring mum to lunch before you commit. If mum has quite advanced dementia then don't worry about the decor, focus on the staffing numbers, stability and ambience.
3. Several of the private care homes round here have double suites for married couples. Don't expect a 2-for-the-price-of-one deal though.
4. Brutally, there is regular turnover. We only had to wait a few weeks for a space to become available for mum.

Hope that all helps.

Thank you so much for these replies they are all really helpful.

Was just interrupted ironically by my parents live in carer saying that my parents had both tried to do dangerous things (walking without being watched) and my mum had lost her rag with my dad for going to bed without saying good night. So I had to ring mum to see how she was.

Honestly it’s like getting a call from your kids school saying your kids have misbehaved. It’s so flipping stressful. God knows how their carer manages the two of them! Although she’s qualified to do so .

My mum had dementia and was just about coping at home then she had a stroke . This left her unable to weight bear at all and doubly incontinent. She was in hospital for 3 months . The effects of the stroke meant she could no longer live at home. Firstly because her house wasn’t suitable for someone who could not walk or move independently and she them needed 24 hour care. We had to look at homes. Firstly we looked at all reports from the quality care commission which automatically knocked out some. Then we got the vacancies from the hospital social worker and we visited those that were in our area. We were fee paying and rented out mums house to go towards the fees. Even though the homes knew we were coming ( we made an appointment) we saw some appalling things. One one unbelievable visit we were talking to the matron in the reception area, when a door opened and out came a carer leaving in clear sight an elderly lady sitting on the toilet. Obviously we left immediately. The one we chose was not the smartest or the poshest ( one had wine and a cinema but mum was tea total and wasn’t able to concentrate on tv ). But it was spotlessly clean. The staff had all been there ages. They had a chef ( not major in itself you’d think but a lot of homes have the carers doing the food which means less care)and open visiting . My mum was there for 2 years, and it was definitely the right home for her. She died there pain free and her care was excellent.

I recently moved my mum from a residential care home to a nursing home as her dementia had progressed and the residential care home could no longer meet her needs. The care home staff recommended two care homes to me and I went to look:

Nursing Home 1: bright, cheery, purpose built a few years ago with all en-suite rooms and a combined lounge and dining room for residents with less mobility. The manager told me that if my mum’s money ran out I would need to pay a third party top up to keep my mum there as they didn’t accept residents who were only on the council funded rate.

Nursing Home 2: the self funding rate was only £100 less a week than nursing home 1. The home
was totally painted in magnolia with no decoration on the walls not even in the lounge. Older building so no en-suite rooms and the lounge and dining rooms were separate and quite a walk. The social worker who had done mum’s care needs assessment mentioned several times that there would be no third party top up needed from me if mum’s money ran out.

Presumably both were adequate in terms of care as they were recommended to me by her previous care home but the comfort, practical design and visual appearance between the two was stark. It was only £100 a week more to give her an en-suite room in a bright modern home with a great layout. I chose Nursing Home 1 as it seemed much better value and more suitable. She had enough money to fund it for over 2 years and I gambled that would be enough. She died after less than 4 months.

We are looking into this at the moment for MIL. She needs nursing care when she eventually gets discharged from hospital. She has no savings and no house to sell so we are relying on CHC if she gets it or council funding. We can’t afford to top up so I am very worried we will only get very poor care.

Thank you so much again for these responses. I’m going to make sure I save this thread carefully.

I also really appreciate that everyone has really read and understood my thread. Thanks again ❤️

This site has care home reviews. Also when you go to look around see if there are any cards from the family of previous residents on display. If there are, ask if you can read them. They will only be from families who are happy with the care their relative received but the more of them there are the more reassured you will be. And chat to the staff to see how long they have been there and ask a few questions about anything you notice or things that are important to your relative whether it’s the food, activities, trips out, watching tv in bed at night etc. What they tell you can help create an impression of how the home operates.
https://www.carehome.co.uk/

I have two parents in the same care home. I would visit as many as you can and ask locally for personal recommendations. Check that where you choose will fund them if they run out of money and have to be council funded as moving can be very difficult with elderly people. They have separate needs and also have seperate rooms so that they don’t disturb each other but spend all day together in the lounges.

PIL moved into a care home together in 2022. It was a 2 room suite so they had a bedroom and a sitting room.

DH looked at a lot of care homes and what stood out was the difference between homes that accept council-funded residents and those that don’t. The care home that he chose was lovely, like a 5* hotel and the staff were amazing. It was about £120 a week more than one that was like an NHS ward with lino floors and battered wipeable plastic chairs. With the nicer one you aren’t subsidising council-funded residents.

None of us know how long we’re going to live, but according to statistics people live for 12 months - 2 years on average in a care home. And PIL were the same. Unfortunately, once the falls started they went downhill quickly despite excellent care.

The home had a dementia floor which meant that they didn’t have to move at all later stage, which I think was very important.

DH and I could visit whenever we wanted so it was easy to get a feel for the care given. We couldn’t have asked for more. It was definitely worth the extra cost for somewhere so lovely. No guilt for us either!

The most expensive doesn’t necessarily mean the best
from having to find care homes for my mum twice (1st one couldn’t cope with her needs after she fell & stopped walking) I found visiting them to get a feel is key, if you like one, visit another time, preferably at a different time to get context.
My Mum has dementia & has been in a care home for about 6yrs now
her current home isn’t the fanciest but the care staff are very kind to her, she has a nice room, they can cope with her needs and it’s very close so I can visit whenever I need. She’s at a stage where activities don’t bother her too much (end stage) but they do make sure she always has music, they bring visiting animals into see her & spend one to one time socialising with her - consider what your parents will actually use & their key priorities not just what they offer.

Care home was a good move for mum, the controlled environment was helpful with her dementia allowing her to walk (when she could) without getting lost, socialising etc

Two websites https://www.carehome.co.uk and https://www.cqc.org.uk. These give you a good overview. Don't automatically rule out a home based on one rating.

Ideally at 90 & 91 you want one move - look for a home that will cater for advanced and complex dementia and end of life. Good homes have separate areas for physically disabled vs dementia as dementia develops the home has security measures to prevent wandering. Any move can see a deterioration and a second move is undesirable.
Location - either near where they currently live so they can keep up with friends etc. or near to you to reduce your travel.
Visit and spend time listening to what is going on I.e. how do staff ( all staff not just carers) interact with residents. Think would you want to live there!
Consider the size of home I.e. number of residents, remember they will be living and eating with the same people 24/7/365.

Think about a locking cabinet in their room for toiletries, valuables etc.

If your parents agree Contact their GP and get a PeACE plan in place so everyone is clear about end of life wishes.

WRT finances work out their income, if relevant add in Attendance Allowance which they maybe entitled to. Work out savings once house is sold and do some calculations. if the costs are £90k a year each and they each have an income of £20k you need £70k x 2 I.e. £140k. If they have savings of £250k with interest it’s only going to cover 2 years. If they have £500k

Also think about what the financial position of the surviving spouse is (unlikely to die on the same day) I.e. do they inherit widows/er pensions etc. You may find quite a disparity in income.

Edited to add also look at staffing ratios.

AgedUK has an excellent section on finances and care homes. They also have advisers to answer specific questions.

www.ageuk.org.uk/information-advice/care/paying-for-care/

Thank you again everyone! Yes the site care home.co.uk was the one I was looking at @Kirschcherriesand @Choux

Would agree with the above. One point to remember with finances is that if you sell the home it frees up not only the sale proceeds but also removes costs with upkeep (Council Tax, insurance, energy, maintenance and repairs) plus the cost of food, tv licence, gardeners, laundry and cleaning as these are included in the care home fees. You do still have to pay for toiletries, hair cuts, newspapers and trips out. Remember to include any income they receive - pensions, interest etc. in the calculations.

Re things to look for:

• visit without an appointment- you’ll see the home on a normal day, not nicely presented just for you. Around lunch time is a good time to visit.
• does it smell nice?
• are call alarms answered quickly?
• do they offer you a drink and biscuit?
• are there activities happening? Is there a weekly calendar on notice boards? are many residents joining in?
• are there many residents moving around independently? What’s their body language like? Are they chatty?
• if you need to drive to the home, how much parking is there? (I would also add - choose somewhere close to where you live. Their friends will only visit occasionally- you’ll be there much more frequently!)

The point about making sure you don’t have to move them again, is very important. So choose somewhere that offers a range of care levels. My DF should have gone into a home sooner as he was quite poorly. We had discussed care homes with him and the conversations were all very reasonable until it came to actually doing something about it and then he dug his heels in.

When he eventually agreed to ‘try one for a month’ he didn’t settle well, wouldn’t leave his room. He was embarrassed in case he had a heart attack or some other event in front of people - we hadn’t realised just how strongly he felt about this as he was a very social person usually.

In the 4 weeks Dad was in a nursing home, either me or my DSis (or both) ended up almost daily at the care home. He called us constantly complaining about pain, breathlessness, not being given unlimited access to his drugs (he was on a lot and he hated no longer having control of them - another battle before as he was making mistakes and reason for him needing more care) or just something he wasn’t happy about. Mostly he was fine, but was very anxious and wanted reassurance we would come and hadn’t abandoned him.

The care home changed his GP (they used a specialist elderly GP care hub) and there were some mistakes with doses which didn’t help in the early days. He had complex medical needs and we’d had a running battle between different consultants for months, so this wasn’t the care home or GPs fault as medical advice from the hospital was often conflicted. Unfortunately he had increasing health events that required ambulances to hospital in those final weeks. Being in a care home did help reduce our stress in reaching him quickly as we knew he was being looked after, but in the last week, we had 3 blue light events. He died of kidney failure after a final heart attack in hospital.

We looked at a lot of care homes for both FiL and DM (both with dementia). In their cases we were looking for cosy and homely, with cheerful looking staff. Certainly didn’t need the smart decor and ‘frills’ offered by the more expensive homes.

I’d just add that the ‘plushest’ and very expensive home chosen by an aunt of dh for a month’s stay while her helper was away, certainly did not live up to the hype! The staff were surly and miserable, and not at all welcoming when I visited her twice - She absolutely hated it and couldn’t wait to get home.

Yet on the surface it looked brilliant - seafront setting, 5* decor, etc.

I certainly wouldn’t think that the most expensive must = the best. One or two we looked at for DM were a wee bit shabby around the edges, but the atmosphere was warm and homely, with cheerful, friendly staff. These things are IMO so much more important.

Thank you that is very useful information.