About care homes and nursing homes

Short video - 5 steps to follow when choosing a care home

• Have you considered all the benefits and drawbacks of home care versus a care home? 

• Have you thought through all the financial implications of moving to a care home: - How much will it cost? How will you pay? Will you have to sell your home? What will happen if your money runs out?

• Did you know you might be able to have your home adapted to make it easier to get around?

• Are you in a position to consider downsizing? This could release equity making it easier to afford some help with housework and maintenance.

• Have you investigated all the support options available to help you look after yourself as well as your house, garden and pets? See our Managing at home information section.

• Have you explored what equipment is available which may help you to manage daily tasks?

• Have you considered all the 'telecare' technology you can have installed in your home to keep you safe? There are pendant alarms, falls detectors, motion sensors and much more.

• Have you found out what support is available for specific conditions and disabilities?

• Have you researched other residential options where care is available?  Extra care housing is becoming a popular alternative to a care home. You rent or buy your own apartment or bungalow but have access to communal facilities and social activities, if you want to join in. There is 24/7 care available on-site.

• Have you considered employing a Personal Assistant?

• Have you searched our Community Directory for local support groups and services?

If you, or the person you care for, is no longer able to live at home and to stay safe - even with the help of family, friends and paid carers - it may be time to think about a care home. 

This can often be a very difficult decision, especially for relatives. But it is important to remember that you are acting in the best interests of the person you support.

There can also be many positives to living in a care home or nursing home. A care home will have staff who can provide continuous, 24-hour support. A care home with nursing will also have a registered nurse on site 24 hours a day. There are also important social benefits of living in a care home. Residents can meet one another, and join in group activities.

You can contact your local adult social care department for further advice. They can carry out a care needs assessment and will be able to advise you if residential care is the most suitable option.

• What type of care do you need - e.g. for old age, physical disability, dementia, learning disability? Focus on homes that are registered for these specific needs.
• Will you need nursing care - now or in the future? Some residential care homes offer nursing care and some do not, so it is important to understand whether you need this. Talk to your doctor or hospital consultant for professional advice if you think you may need nursing care. 

2. Inspection reports 
All care homes and nursing homes must be registered with the Care Quality Commission (CQC) who regulate and inspect them. Before arranging to visit any homes, search for the home on the CQC website. Check that they are still registered with CQC and to read their latest inspection report. The care homes listed in our Marketplace directory link to the latest reports for each home.

3. Long and short-stay care
As well as providing residential care, some homes offer short-term stays for convalescence care, or to give you or your carer a break. Residential care can often last a long time so you need to bear in mind the implications of any move including its financial impact at the beginning.

You may want to think about looking for homes that offer both personal and nursing care. That way you could stay in the same home if you need nursing care in the future.

4. Where you live
Choosing a care home in the area you currently live in would mean that you would still be able to see your friends and keep your doctor. If your family live in another area, you might want to move to a home nearer to them.

5. The size of the home and facilities and services offered
Care homes vary greatly in their size. Some have as many as 100 people with many facilities and activities while others are more like a small family home with just one or two residents. There are also some homes that are willing to accommodate couples in their double rooms.

6. Pets
You may have a pet that you would like to take with you. You need to check whether this would be possible. If not, ask if the home will allow others to bring pets in to visit you. If you cannot keep your pet with you, you might ask a family member, neighbour or friend to help.
Other sources of help:
RSPCA 
Dogs Trust 
The Cinnamon Trust

Help to find the right home
If you would like some help in finding the right care home for you, you could use a free care brokerage organisation such as CHS Healthcare.There are other organisations who are able to provide independent advice and help to source the right care. They will usually charge a fee for this service; always ask for details of fees up front.

1. Before you visit, speak to the manager and check: 

• they offer the kind of care you want
• they are registered to provide the type of care you need
• what their charges are and what they cover
• they have the kind of room you are looking for
• whether they have a vacancy
• whether they are happy to arrange a trial period

Arrange to visit the home. This will give you a chance to meet the staff and residents and talk to them about the home. It is essential that you are happy in the home you choose to live in. If you are not physically well enough to visit the home you should ask someone who knows what you want to visit on your behalf.

You will have a lot to think about on your first visit. Your first impressions of staff and residents are important. You'll also want to note the physical features of the building, details of the rooms, arrangements about personal possessions and day-to-day life as well as financial matters. It is a good idea to think of all the questions you may have before you go and to take them with you when you visit.

• The Alzheimer’s Society includes a useful list of things to think about in their information about selecting a care home.
• There is a Care home checklist available which you can print out.

You should make sure that before you move into a home you are given a contract or resident's agreement. This should be signed by you or your representative and by the home owner or manager, or his or her representative.

The contract should confirm exactly what you will be paying each week and what that charge covers. For example, it might tell you that laundry for bedding and clothes is included, but that any dry cleaning would be charged extra. You need to be clear about all extra charges before you move in, and how and when the price you pay will be reviewed. You should always ask to see a copy of the home's standard contract/agreement when you visit, and discuss how and when the price you pay will be reviewed.

The contract should also tell you:

• when you should pay your fees or other costs - for example, monthly in advance or after you have received an invoice
• how you can pay the fees – for example, by standing order
• what happens if you have to go into hospital
• when and how the contract/agreement can be ended
• what you should do if you have complaints about the home or about the way you are treated.

If you are planning to give up your home and move into a care home, don't make a hasty decision. When you have found what you think is the right home for you, arrange to spend a trial period there for a few weeks before you make your final decision.
Even if you go into a home in an emergency, you should still think about your first four weeks as a trial period. You should not arrange to sell or give up the tenancy on your existing home until after the trial period and when you are sure that you have found the right care home for you.

Once you have moved into a care home, it can take a while to settle in as this will have been a major change in your life. It will take some time for you, the staff and other residents to get to know each other and for you to get used to new routines and activities.  You will also need to know what you should be able to expect from the care home and what to do if you are worried about your or someone else's safety.

If you are unsure or worried about anything, try to talk to a member of staff about your concerns. If you are a relative or friend of someone living in a care home and have concerns about the care they are receiving, try talking to the manager or whoever is in charge. All care providers must have procedures for handling complaints. See CQC information about making a complaint.

If you are worried about someone’s safety, make your concerns known to a person in authority that you feel comfortable talking to.

If you have concerns or want to report abuse contact your adult social care department or the police on 101.  In an emergency, or if you or someone else is in immediate danger, phone 999.

Hampshire Safeguarding Adults Board (HSAB) has information about Safeguarding Adults in Hampshire, including advice, leaflets and policy documents.

The Care Quality Commission (CQC) monitors, inspects and regulates health and social care services, protecting people’s health, wellbeing and human rights, and enabling them to live free from harm, abuse and neglect.

Your rights explained.

If your council has agreed to fund you in a care home, you are free to choose a home anywhere in England, Wales, or Scotland. For example, you may wish to move to be near your family or back to the area where you were brought up. If you move to another area, you will need to arrange for a cross-border placement with the council. If a council is paying your fees, and you move to a different area, you will always be paid for by the council that originally assessed your needs.

The Care Act ensures that people receive proper 'continuity of care' when they move from one place to another. This "continuity" means that a person receiving care and support in one area will continue to receive care on the day of their arrival in the new area. 

If you want to move to another area, you (or someone on your behalf) must tell the council where you plan to live in future (known as the "second council") about your intentions.

After the second council has been informed, and is satisfied that the intention to move is genuine, it must then inform the council where you are currently living, or which is responsible for paying towards your care and support at the current time (known as the "first council").

Your local council is only obliged to pay enough to cover the cost of the care you need in the area you require. It is therefore important to find out the cost of care homes in that area. You could also find out how much the local council in that area pays for places which it is funding. 

Care homes will sometimes charge a different rate if a person is being paid for by the council compared with a person who is paying his/her own fees. Therefore, when you are looking for a care home place, it is important to tell the care home that your fees will be the responsibility of your local council.

First Stop provides a telephone advice line for older people, their families and carers about housing and care options for later life: 0800 377 7070.

It is very important that you consider all the financial aspects of moving into a care home, whether you are funding the costs yourself or you are eligible for funding from the NHS or your local authority. We strongly advise you to read our Paying for care information.