How to choose a care home

If you are funding your own later life care then you have lots of options when it comes to choosing the best care home.

How many care homes are there in the UK?

Before you start to identify potential care homes, you need to know how to start narrowing the field. There are over 17,000 care homes in the UK - including homes for Adults with Learning Difficulties (ALD) - so it's a good idea to be clear on the 'must haves' before you start a detailed search for a care home or you could waste time, and risk becoming despondent.

The Autumna website does not include ALD listings but concentrates solely on later life care in all its forms - not just care homes, but home care and live-in care services and also retirement housing and assisted living.

A lot of people use our short form to narrow their search for later life care. It only takes a minute to complete, after which the Autumna team can send you a filtered shortlist of providers in your area, offering the care you need at a price that fits your budget.

Read on for our step-by-step guide and useful information on planning for you future.

Do you have a Lasting Power of Attorney (LPA) in place?

If you do not have a Lasting Power of Attorney (LPA) in place then it should be considered. An LPA allows nominated family members to act on your behalf should you become incapacitated in any way.

You’ll need to talk to a solicitor specialising in family law as a Lasting Power of Attorney is a legal document. You will find more on this in the section headed 'Legal Advice' or by calling our trusted partners, Law and Life on 0800 999 4437.

What medical conditions do you need to consider – now and in the future?

Your family will need to know about any existing medical condition/s and the long-term prognosis so that you can all plan your on-going care needs effectively. That may mean a joint consultation with your GP so that you are all clear on the current situation and the future prognosis – and so that the GP has a record of who to speak to at any point.

You will swiftly discover that there are many different categories of care home provision - it is therefore important to look at those that can cater for your likely long-term needs and not just for now. If you have a degenerative condition, your needs will change. 

How many different types of care home are there?

Residential care homes come in all shapes and forms but the two main categories are those that provide just residential care and those that provide nursing care.

Some residential care homes will also provide dementia care and some nursing homes will also provide dementia care. Most homes will also provide respite care - a short stay of around two to four weeks - which is a great way for prospective residents to 'try before they buy.'

How much money do you need for a care home and how long will it last?

In England, anyone with assets in excess of £23,250, including their home as long as their spouse is no longer resident, will have to fund their own care.

Residential care for self-funders typically costs from £750 - £1200 per week – but can be more for homes that are more like 5* hotels – or where 24-hour one-on-one nursing support is required.

Knowing how much money will be available, how to release funds, and how long it will last, is vital before you start the search for a care home.

It may at first look as though the sums won’t add up, but rest assured, there are various financial management schemes available geared specifically to the ongoing release of funds to cover long-term care needs.

We advise that you contact a registered Independent Financial Adviser (IFA), someone who has the SOLLA (Society of Later Life Advisers) accreditation. They will be able to provide initial guidance and tailored advice should you need it. 

You can find more useful information in the section headed Paying for Care on this site, or get in touch with our trusted partner, Schroders Personal Wealth who will be able to advise you.

Where does the care home need to be located?

If you and your family have never discussed the possibility that you may one day live in a care home, there may be a lot of ground to cover quite quickly. It’s not unusual to be opposed to the idea initially, and to want to stay in your own home.

It’s important to be realistic about location and environment. Someone who has enjoyed the silence of the countryside may not want to move to the centre of a busy town, however, perhaps most importantly, the chosen care home should be near enough for family and friends to visit.

What other questions should you ask yourself before you get started on a care home search?

Once you have identified where the care home needs to be (+/- 5 miles), the maximum amount it can cost and any medical conditions that you need to bear in mind, try and identify what else will help you to refine your search quickly. The following list should cover most things you need to be thinking about:

Choosing a care home - a list of considerations 

• What do I enjoy doing when I’m at home?
• Do I get fearful about anything when I’m alone?
• What do I hope will be the main benefit of living in a care home?
• Do I have any reservations about moving into a care home?
• Are we just looking for me – or my partner too?
• If so, do we want a double room? And a double bed?
• Do I prefer an open and airy living environment or one that’s more cosy?
• Would I prefer modern or traditional styling in the main?
• Do I like things to be very tidy – or a bit cluttered?
• Would I be happy with my room being upstairs or downstairs?
• Do I need a lift or a stair lift?
• Is an en-suite bathroom essential?
• Do I enjoy a bath, or prefer to shower?
• Are there any favourite pieces of furniture I’d like to take with me?
• When do I like to eat?
• What’s my favourite meal – breakfast, lunch, tea, dinner?
• Will I miss preparing my own meals?
• Do I enjoy a glass of wine?
• What do I hope the people looking after me will be like?
• Do I like to watch TV/listen to music in bed?
• What types of programmes do I particularly enjoy?
• Do I watch a lot of films?
• Do I like being outdoors?
• Will I miss gardening?
• Do I do any particular type of exercise regularly?
• What hobbies would I like to be able to continue?
• How often do I like to have my hair done?
• What other activities do I enjoy now?
• How much do I socialise?
• Have I typically been the life and soul of the party?
• Do I want a bit of independence – to go into town occasionally?
• What clothes do I like to wear?
• Do I want to take my pet/s into the home with me?
  

Of course, you could also get an expertly compiled shortlist sent to you from the Autumna advice line team, simply by filling in this quick and easy form.

From the information you give, Autumna will find an initial ‘long’ shortlist of potential care homes for you to look at. You’ll be able to review detailed information on each, comparing one with the other from the comfort of your own home, and then make direct contact with any that look promising.

Alternatively, if you have a more complex situation and needs, or you are feeling a little confused - perhaps overwhelmed - for a small fee, Autumna's team of care home experts can conduct the research on your behalf. They will make contact with all the homes that may be able to help you, and come back to your best options presented in a bespoke Care Home Report.

If this more personalised care home research service appeals to you, please get in touch on info@autumna.co.uk or by calling our team on: 01892 33 53 30.

Once you have done this, it’s a good idea to call those care homes that you are left with – it’s all part of the securing a vital ‘First Impression’.

What do you want to find out about a care home when you telephone them?

Some things to look out for from Autumna's years of experience in contacting care homes:

• How quickly the phone is answered?
• If there is a voicemail? How does it sound and what promise does it make to the caller?

• If you get through, what is the level of background noise from the care home?
• How instantly welcome are you made to feel?
• Is the person you speak to able to help you with your enquiry? –If not, can put you through to the right person?
• Do the staff seem efficient and well-organised?
• How interested are they in you?
• How willing do they seem to patiently listen to you and answer the questions you have?
• Are the questions they ask you designed to determine whether they can meet your needs?
• How you feel at the end of the call?

If you are planning to visit a care home with a view to moving in, it’s important that someone goes with you – ideally a close friend or relative who knows you well. Not only are two sets of eyes better than one, but you'll be able to discuss the pros and cons of the home with them afterwards.

Ask if you can take photographs - it should be fine if you don’t include residents in the pictures.

Over and above anything else, you need to be able to identify with ‘how it feels here’.

Top tips for a care home visit:

Since the pandemic most care homes will have restricted - by appointment only - visiting. Whereas we used to advise that any prospective resident should arrive unannounced, that is no longer the case and, unless you have pre-booked your visit, you are unlikely to get a 'show round'.

1. Weekday or weekend care home visits?

Bear in mind that Monday – Friday runs like a working week; weekends are slightly more relaxed and the care home manager may not be there. However, you will probably have the opportunity to meet more visitors which can be very useful.

2. On arrival at the care home, what do you find?

• How clear is the sign-posting?
• Is it easy to park?
• Are you able to park near to the main entrance?
• Is the front area well maintained and tidy?
• Are there clear entry instructions?

3. In the care home reception - what do you see?

• How tidy is it?
• Is it welcoming?
• What can you smell?
• What are the décor, flooring and furnishings like?
• How is it lit?
• Is it noticeably clean and fresh?
• Are their flowers?
• Is it JUST a Reception area, or does it double up as something else?
• Can you see beyond Reception – and if so – what do you see?
• Who is in the Reception area when you arrive?
• Who greets you and how?

4. On the tour, what do you notice?

• Were you invited to have a tour?
• Were you asked what you wanted to see?
• Did you feel the tour was thorough?
• Were you happy with the answers to the questions you asked?
• Did you feel that residents’ privacy was respected during the tour, eg: did your guide knock gently on the door, was the resident's permission obtained to let you see their room?
• Were you introduced to residents and encouraged to ask them questions?
  

What questions should you ask when you visit a care home? The Autumna checklist.

Much of this information can be obtained from the online profile of the care home on Autumna, however whilst you are there, it's always useful to seek confirmation.

A. Staff

1. Who manages the care home on a daily basis?
2. When is the manager on duty and who deputises when they are absent?
3. How many staff are there in total?
4. How many management staff, carers and ancillary staff are employed by the care home?
5. What is the ratio of staff to residents? (Note: this will vary depending on the type of care provided).
6. Will there be profiles available of the staff who will be caring for me/my relative?
7. What are the staff retention figures?
8. Is the care home fully staffed currently?
9. What is the absence rate?
10. What is the shift pattern?
11. How many staff are available during the night?
12. Are there any medical staff on call during the night?

B. Residents’ Rooms

1. How many floors are there in the care home?
2. Can I specify the floor and type of room I would like?
3. Are all rooms the same size with the same facilities?
4. Are there any double rooms or suites?
5. Do any rooms have a kitchenette?
6. Are there any apartments within the care home/complex?
7. What is the view like from the bedroom window?
8. Do the windows have safety catches – how far do they open?
9. Does every room have en-suite shower and/or bath facilities?
10. Does every room have a telephone point?
11. Is there wi-fi throughout the care home?
12. Does each room have a television?
13. Is there fitted furniture in each room?
14. Can a resident bring their own furniture if they wish?
15. Are there bedside lamps and an overhead light?
16. Are all furnishing fabrics flame retardant?

C. Communal Areas

1. How many lounges are there?
2. Is there a ‘quiet lounge’ without a television?
3. Is there a library/reading and writing area?
4. What facilities are there for activities – art room, exercise room etc.?
5. Is there a hairdressing/barber facility in the care home?
6. Are there any treatment rooms – eg: for massage, beauty treatments?
7. How many wheelchair-accessible downstairs toilets are there within easy walking distance of the communal lounges?
8. Is there an area where teas and coffees are available all day?
9. Are there dedicated areas for smokers/vapers?

D. Food and mealtimes in the care home

Autumna has recently introduced CHOICE Dining which is the first ever food accreditation in care homes across the UK. Look for the CHOICE Dining badge on any care home profile on Autumna to find out exactly what standard of food is on offer.

1. Is all food prepared using fresh ingredients? Is it… cooked on the premises, delivered ready to eat or supplied frozen, for thawing and re-heating?
2. Does the care homecater for special diets – Vegetarian, Vegan, Kosher?
3. Do the care home cater for individuals with specific nutrition needs?
4. What times are meals served in the care home?
5. Does the home have a dedicated dining room?
6. What range of refreshments are available outside normal meal times?
7. Can residents eat in their rooms if they prefer?
8. Can residents order in their own food or can visitors bring food with them when they visit?
9. Does the care home have the facilities for residents to prepare their own drinks and snacks?
10. Can the care home provide food for residents’ guests and visitors?

E. Organised activities at the care home

1. What activities are available to residents?
2. Is there a full time Activities Manager?
3. Is there an activities programme in place?
4. Does the home lean towards particular types of activity – eg: art; ceramics, etc
5. Do residents play board/card games?
6. Can residents choose what they want to do?
7. Are there any outdoor activities in the care home gardens/grounds?
8. Are any external trips organised – to exhibitions, musicals, plays etc.?
9. Do people come in to give talks and demonstrations?
10. Are there any clubs run at the care home that non-residents participate in?
11. Are books available – is there a reading area?
12. Are newspapers delivered?

F. Outdoor Space

1. Does the care home have a garden – and is it visible and accessible from the communal rooms?
2. Is there a kitchen garden?
3. Is there any other outside space for residents?
4. Who maintains the garden – are residents encouraged to take part if they want to?

G. Medical and Wellbeing Services

1. Is there a GP assigned to the care home and all its residents?
2. If so, does that person visit regularly as a matter of course, or just when called?
3. Can a new resident retain their existing GP if they are still living within the relevant catchment area?
4. Does the home arrange for dentists, opticians and chiropodists to visit regularly?
5. Are there hair dressing facilities for men and women within the care home?
6. Are there any therapy rooms for beauty and medical treatments, eg: massage, manicure, pedicure?
7. Can residents continue to visit the therapists they have always used if they prefer?

H. Safe Mobility

1. Are there hand rails near doorways, steps, stairs, along corridors, in toilets?
2. Is there at least one lift that will accommodate two wheelchairs at once?
3. Is there a stairlift in operation?
4. Do all the toilets – including any visitor facilities – provide for wheelchair access?
5. What are the floor coverings throughout the building (trip hazards?)
6. Can wheelchairs go everywhere, including outside?
7. Can residents bring their own mobility vehicle? If so, will it be maintained?
8. What safety provisions are outside to protect residents with compromised mobility?
9. Is the garden/outside space safe and accessible for residents with dementia?
10. Is there direct access from the garden to the drive and parking areas?

I. Security

1. Is there a burglar alarm fitted to the care home?
2. Are there window locks?
3. Is there CCTV in the common areas and the grounds?
4. Is a resident’s room accessible by anyone passing by – or just staff?
5. Is there somewhere secure for residents to store valuables, including paperwork?

J. Language, Religion, Culture

1. What languages are spoken fluently in the care home by care home staff?
2. What languages are spoken amongst residents and their families?
3. How are different religious beliefs catered for in the care home?
4. What efforts are made to ensure people of varying cultural backgrounds feel respected and included?

K. Guests

1. Can guests visit at any time?
2. Can residents invite family and friends for lunch/supper? Weekdays? Weekends?
3. Are there any events that are open to family and friends?
4. Can relatives get involved helping with activities and events?
5. Can guests stay overnight (if they have a long way to travel)?
   

L. Fees

1. What are the weekly fees for the type of care needed?
2. Is payment made on a monthly basis by standing order?
3. What items/services are ‘extras’ and is there a price list for those?
4. How and when are extras invoiced?
5. Do I need to pay a deposit in addition to the first month’s fees?
6. When is the initial deposit returned?
7. What notice period do you require of a resident who is moving elsewhere?

M. Availability

1. What is the room availability and is there a waiting list?
2. How far ahead can I put my name on the waiting list?
3. Will I have to pay a deposit at that point?
4. Would I have to take a room as soon as it becomes available?

N. Legalities

The care home is obliged to provide a brochure which should clearly set out the following:

• Its aims and objectives
• The facilities offered
• The terms and conditions of residents’ contracts of occupancy

Once you have ticked off everything on your check list, reflect, and ask yourself:

• Did the person showing me round seem proud of the care home? 
• Did he/she seem popular with staff and residents? 
• Were other staff welcoming and willing to talk?  
• Was I encouraged to talk to other people?
• Were staff actively involved and engaged with residents – above just ‘doing the job’? 
• Was there a cheerful, lively atmosphere in the public rooms? Were people talking, sitting together, doing things together? 
• How was the furniture arranged – sociable clusters or chairs lined up around the wall?
  
• Did I see enough of the care home and its grounds to give me a clear picture of the environment and facilities?
• Do I think I could be happy there?

Make sure you satisfy yourself that the reality matches the marketing message.

And before you sign any agreement:

• Read and understand the contract
• Let your solicitor know what you are intending to do
• Speak to your financial adviser