Choosing a care home
Once you’ve decided that residential care might be necessary, you’ll want to start exploring care homes near you to work out where you will be happiest and most comfortable. This decision, whether it’s for yourself or a loved one, can seem daunting. But there are several steps you can take to make the process a little easier.
- Find out more: Care homes and nursing homes: what’s the difference?
1. Get a needs assessment
Before you begin exploring local care homes, make sure that you (or the person you’re caring for) gets a free needs assessment from the local council’s adult social-care department. This is especially vital if you might need financial help from the local authority, as councils will only fund care when someone has been assessed as needing it.
Even if you think you will end up paying for your own care, it’s still worth getting a needs assessment. It provides a professional assessment of the type of care and support that’s needed, which will help you to choose a suitable care home. It might also highlight other care options that you might not have considered.
2. Make a care home shortlist
Think about what’s important to you
This might involve location, facilities or specialist care for a specific health problem such as dementia. What do you consider essential, and what is desirable? You might want to include other close family members or friends when talking about care options, too.
Additional questions are bound to come up once you start looking for the right home, but you can use this conversation as a starting point.
Our downloadable checklist of questions to ask a care home is also a great way to start thinking about your priorities when choosing a home.
Find care homes near you
Use our care services directory to find suitable care homes in your chosen area. You can filter your search for residential homes or nursing homes, as well as looking for homes that offer more specialist support, such as for those with dementia or physical disabilities.
Ask friends and family for recommendations
Does anyone you know have a relative or friend who is already in a care home, or has recently lived in one? A recommendation from a happy resident is worth its weight in gold.
3. Read the care home inspection reports
In the UK, there are four watchdogs responsible for inspecting and reporting on care providers. The reports are publicly available, and give valuable insight into how well a home is managed and the level of care it offers.
In England and Scotland, the care regulators also give care providers a quality rating. The regulators in Northern Ireland and Wales don’t rate the providers they inspect, but you can read the inspection reports.
You can also use the reports to see whether:
- points raised by inspectors have been addressed, or whether they reappear on subsequent reports
- high staff turnover is mentioned, which could indicate unsettled, unhappy staff
- inspections have occurred frequently, which might be a sign of problems.
Find out more about the regulators and their reports in our article about quality and regulation of care providers.
4. Contact suitable care homes
Contact your shortlisted care homes and talk specifics from the first phone call. Talk directly with the care home's manager about how the home can meet your needs. Ask the home to be upfront about the fees, too, even if it's reluctant. This will help you to avoid wasted visits. The home will want to know if you are self-funding, local-authority funded or a mixture. It could be that you don’t know this yet, in which case explain the situation.
Also enquire about availability of places. Finding out about cost and room availability will help you to eliminate any homes that aren’t suitable, either because they're out of your price range or are lacking spaces.
Ask the home to send you written details of costs, together with a brochure. When arranging a visit, check who you’ll be meeting (this should preferably be the care home manager) and confirm the appointment before you set off.
5. Visit the care homes
It’s important to visit all the homes on your shortlist to get as much information as you can.
Now is the time to consider what’s important, ranging from practical issues such as the social activities on offer, through to questions about the care home contract, your potential room, and what else happens in and around the home. See our checklist for some useful questions to consider.
If possible, visit the care home with a family member or friend. If you’re unable to visit in person, ask a representative from the home to come to you to assess your needs face to face.
Use your senses
As well as arming yourself with your list of questions, use all your senses to help inform you: what you see, hear, smell and feel on a visit is as important as what you’re told.
- See Does the seating layout encourage people to socialise? Do residents look happy, well cared for and relaxed rather than slumped asleep? Look for signs of activity and things to do. This can mean a more able resident doing washing-up, newspapers in easy reach or personal photos and ornaments scattered around, as much as planned activity.
- Hear Listen for laughter and chatter. Do staff sit and chat with residents in a way that you and the residents like? Do staff sound like they’re working in the residents’ home, rather than residents living in a workplace? Warning sounds to listen out for include shouting and the persistent ringing of unanswered call bells.
- Smell Is there a smell of fresh air, rather than air freshener masking unpleasant smells?
- Feel Do you feel positive as you leave?
Make a surprise visit or two
After you or your loved one has chosen the care home you think will be suitable, visit without notice to see what the home’s really like. For example, are sandwiches being served for supper rather than the tempting menu displayed, and is everyone in bed by 7pm?
During an unannounced visit, you can see how the staff interact with the residents, how many people are around and what activities are going on.
Do be aware that during the coronavirus pandemic, it might not be possible to visit a care home in person. Many care home providers have made alternative arrangements to help prospective residents to see their facilities, such as video tours.
Consider arranging a trial stay
If you want to see what living in a care home is like, it might be possible to arrange a trial stay. If you’re interested in this, ask if it’s possible when you visit.
If you usually care for someone who might need to move into a care home, you might be able to arrange a short-term stay as respite care, so you can take a break. This could be a good opportunity to see what it’s like to be in a care home, even if it’s only for a week or two.
6. Pay attention to care home fees, additional costs and other contract terms
On our checklist, there are some key questions around fees, additional costs and other contract terms, which are very important to address before signing up with a care home.
See our advice on care home contracts for more detailed information about what to look for.
If your care is being paid for by the local authority and a care home suggests that a top-up fee could be paid (maybe to help cover the cost of the room, or for a room with a better view), explain that you’ll talk to the local authority about this. Third-party top-up fees should always be a voluntary payment and the contract for this should be between the person paying the top-up and the local authority, not the care home.
NHS-funded Nursing Care (FNC) is another area that our research at Which? has shown is potentially being exploited by care homes. If an older person is eligible for a nursing care contribution, it’s paid directly to the care home by the NHS. So if you or the person you're caring for is going to be a self-funder, check with the care home that the fee it's quoting includes nursing costs. If FNC is then awarded, this amount should be deducted from the bill.
Choosing care that meets your cultural needs
When choosing a care home, you may want to ensure that the home can provide care that’s appropriate for your personal heritage or identity. We have some useful guidance and suggestions for people considering culturally appropriate care options.
We look at the the pros and cons of moving into a care home, and what to consider before making the decision.
Read about residential care homes and nursing homes, and the different services they provide.
We explain what should be in a good care home contract, who is involved and how to spot any potential problems.