Q: What types of care homes are there?

A: There are primarily two types of care homes. Those which provide mainly personal care (previously called residential homes) and those which also provide nursing care (many care homes may have facilities for both types or resident).

People who can no longer cope with their day-to-day activities alone in their own home, even with a carer or outside help, need the support offered and personnel care of a Care Home. This includes accommodation, personal care (such as help with bathing and dressing) and meals.

People whose infirmity, illness or injury require nursing care on a regular basis, which cannot be provided for them at home by the District Nursing Services, also need a Care Home (these used to be called Nursing Homes). This sort of care, the law says, can only be provided by a Registered Nurse or under the direct supervision of a Registered Nurse.

Nursing care generally requires higher fees than personal care because of this care being assessed, supervised and evaluated by a Registered Nurse, on top of the personal care, accommodation and meals. In England nursing care is “free” and in Scotland both personal and nursing care is “free”.

Q: How is care monitored?

A: Each potential resident undergoes an assessment of their needs and from that, a Care Plan is developed. The Care Plan ensures that:

• Your needs are identified by careful assessment, with your own involvement or that of your nominated relative/friend.
• The Care Plan will describe those identified needs and the way in which our staff will meet them.
• You or your nominated relative/friend can choose to be involved in the ongoing care planning process.
• Care Plans are reviewed periodically and also when your needs change.

At Canterbury Care, we firmly believe that you, and if you wish, your family, should play an integral part in the care planning process, we also have a comprehensive quality assurance programme designed to ensure that the needs of residents’ are paramount.

Q: How do I choose a care home?

A: Choosing a care home for yourself or for someone else is a difficult decision as you are selecting a home that has to meet a person's individual and care needs. Often decisions are made in a hurry when there is a crisis or difficulties have arisen, the best advice is to visit a few homes and ask lots of questions and keep an open mind. Good care homes will be happy for you to visit anytime and will not pressure you in any way.

Q: When should I start thinking about care homes?

A: Many people have to make a decision about a care home in a crisis, perhaps after a fall or illness, or the death of a carer. Looking back, they often wish they had longer to look around. So if you think yourself or a relative might need a care home in the future, it’s a good idea to do some planning now, so that you know what to do should the need arise.

Q: Where do I start?

A: To decide which homes to visit, it may be useful to speak to:

• Friends and relatives, for their recommendations.
• Your family doctor (GP), your solicitor, pharmacist, bank manager or Citizens Advice Bureau.
• If the potential resident is in hospital, most hospitals have discharge liaison staff or social workers.
• Your local Social Services department, which should be able to provide a list of registered homes in your area.

Choosing care for a relative can be a difficult and emotional decision. The Relatives’ and Residents’ Association can offer advice and support (020 7359 8136)

You may also find it useful to look at inspection reports for individual homes which are produced independently by:

• The Scottish Commission for the Regulation of Care (for care homes in Scotland)
• The Care Quality Commission (for care homes in England)
• The Care & Social Services Inspectorate for Wales (for care homes in Wales)

Q: Ask questions.

A: In many ways, choosing a care home is like choosing any other place to live – within a few seconds you know whether it ‘feels right’. Ask yourself an important question – do these people and this home care about what they are doing? Remember happy staff usually means a happy home.

Do not be afraid to ask questions and to talk to staff and most importantly resident’s and their families, ask to see copies of the home's independent inspection reports and a document called the “statement of purpose” this document will detail all the things the home can do for you.

If you feel uncomfortable or daunted, take a friend or a professional advisor to visit with you and always ask for evidence to back up assertions.

Q: What is the first step?

A: If you will be paying all of the care home’s fees, you can contact homes directly yourself. Once you have found a home you like, the home will make an assessment of your needs, so that they can be sure they can offer you the right kind of care.

If you will be asking the local authority to help with all or part of the fees, you should first speak to your GP and your local Social Services department. They will carry out an assessment of your needs, and produce a report called a Care Plan that outlines the care, including any nursing care, they think you need.

Q: Can I choose the home I want?

A: Many people think that care homes in the independent sector are only for the wealthy. You may be surprised to know that the majority of care homes in the UK are owned by the independent sector and that 70 per cent of residents have their fees paid partly or wholly by their local authority.

If you are paying all of the fees yourself, you can choose whichever home you find suitable for your needs in your price range.

If your local authority is assisting with funding, it doesn’t mean you have to choose one of their homes. You can request any home that accepts residents funded by the local authority. However, the local authority will want to be sure that the home is suitable for your needs and doesn’t cost more than it would usually pay for that type of care. If you want a more expensive home than the authority is willing to pay for, you are allowed to ‘top up’ their contribution from another source.

Q: Paying for Care – where can I get more advice?

A: Paying for care is a complex subject, and everyone’s situation is different. You should seek advice about your own case. Among the organisations offering specialist advice are:

• Charities such as Age UK (0800 169 6565) and Counsel and Care (0845 300 7585)
• Your local Social Services department
• The Benefits Agency (0800 88 22 00)
• The Nursing Homes Fees Agency (0800 99 88 33)
• Independent financial advisers (ring 0117 971 1177 for the names of local IFA’s)
• Citizens advice bureau
• Insurers who specialist in care fees planning

Q: Insurance policies to pay for care.

A: Immediate care insurance may be suitable if you are currently considering moving into a care home. It involves paying a single large sum at the time you decide you need care. The cost is based on how long the insurer thinks you’ll need care for, and the level of care you need. While the cost can seem a large amount, it should provide a fixed payment for as long as you need care, and can protect the rest of your assets.

The payments are tax-free if they are generally made directly to a care home and are portable if you decide to move to a different home.

Long-term care insurance, where you pay premiums over a long period before you actually need care, is no longer widely available. If you have already taken out one of these policies it should still be honoured. All policies are slightly different. We suggest you speak to an independent financial adviser who specialises in care fees planning. Among the questions to ask are:

• What are the benefits and for how long will I receive them?
• What is the maximum amount the insurer will pay out per month?
• Should I take out capital protection so that the balance of any lump sum is returned to my estate?
• Are the benefits paid to me so that I can arrange my own care, or paid directly to the care home?
• Are the benefits protected against inflation?