Choosing a care home frequently asked questions
Things to consider when choosing a residential care home which is right for you.
We try to support people to live independently in their own homes by helping with everyday needs. It may eventually get to the stage when this is no longer possible. If this happens, we can help you find and arrange care in a residential or nursing home that suits you.
Sometimes an illness or an accident can affect your ability to manage in your own home, and a move to a care home may seem like the best solution. Or you may be feeling increasingly frail and finding it difficult to do things for yourself. But there may be other options that you can consider too, such as care at home or extra care housing. Or perhaps a temporary stay in a care home while you convalesce would be best for you. You can discuss all these options with Social Services.
We can provide you with a list of care home in the area and details of where to get further information.
You can also ask us to carry out an assessment of your needs. Even if you are not eligible for financial assistance, you may find an assessment useful. This will involve a social worker or care manager coming to visit you and asking you about the things you find difficult to manage in your own home. The assessment will enable us to identify the needs you have.
Following an assessment, if we agree with you that a move to a care home is the best way of meeting your needs, we can tell you which homes will be able to meet those particular needs.
Depending on how much money you have, you may be able to get help from us towards the cost of the fees. This can be complicated, we have more information on our paying for residential care page which explains the rules and processes for financial assistance.
Care home residents who receive Social Services funding will normally have to pay something towards the cost, but we will never ask you to pay more than you can afford to pay.
To get assistance from Social Services you, a friend or a relative can contact us through the Common Access Point for Health and Social Care (CAP).
If you are a patient in hospital, speak to the social work team based there or to the hospital staff.
All residential care homes offer personal care for people who are no longer able to live at home, even with some support. The help which staff at a care home could give would depend on your individual needs. It might include getting in and out of bed, help with bathing, dressing or using the toilet and help with meals. The home should also provide a feeling of security, companionship and a range of social activities.
Homes may, in addition, be registered to provide specific care needs, for example, for dementia or a physical disability.
Some homes also offer nursing care in addition to personal care. This means that regular care is provided at the home by a registered nurse or doctor.
What kind of home is best for you will depend on how much care you need. The assessment by the social worker will help you work out what is right for you. You may also want to think or talk about your likely needs in the future. For example, if you go to a home which does not offer nursing care, you would have to move if your care needs changed in the future and nursing care was required.
Homes may be run by Social Services, by specialist companies or by private individuals, but all will be registered by Care Inspectorate Wales (CIW).
You can choose to go to any home which can meet your assessed needs and which can offer you a place. The homes available locally will be given to you by Social Services.
However, you do have the right to choose any home in the country as long as that home can meet your care needs and it satisfies the standards set by the government. If Social Services is contributing to your fees then the costs of care must not be greater than Social Services is able to pay.
You may choose to go to a more expensive home than Social Services would normally pay for, but if you do you would have to find someone to pay the difference in costs on your behalf (you are not allowed to pay the difference yourself). This is known as a third party agreement and your care manager / social worker will be able to help you with these arrangements.
As well as operating its own care homes, Social Services has contracts in place with independent-sector care homes to provide care home accommodation on behalf of the council. If Social Services is providing assistance with your care home fees, you would be expected to choose a home which is on our approved list. In order to be included on the list the home agrees to meet a number of standards. These relate to areas such as how you are cared for, how staff are trained and managed, financial arrangement and the condition of the premises.
Social Services has monitoring procedures in place for accommodation it purchases on behalf of the council, and works with the independent sector care homes to maintain and improve standards. In addition the Care Inspectorate Wales (CIW) regularly inspects every home to ensure that its standards are being met. After CIW inspections take place a report is written about the home. This is a public document. You can ask the care home to show you a copy of its last CIW report or you can contact the Care Inspectorate Wales (CIW) and ask for a copy of the report, or you can get a copy from their website.
Each home must by law produce a service users' guide which includes a statement of the service provided. This will tell you what you can expect from a home and what to do if you have a complaint.
You can also ask to see a copy of the most recent inspection report from the CIW (as mentioned above).
Before you move in, a written contract should be made with the home. If you are paying the fees yourself, the contract will be between you and the home. If Social Services is contributing to the fees they will make the contract with the home (called the placement agreement), but you should also receive a copy.
Yes, if possible you should visit any home before making a decision to move there. The staff at the home will expect this. You may wish to visit more than one home, and you may like to take a friend, relative or someone else who has an interest in your care with you. You may like to ask if you can visit at a meal time and eat with the residents. In some cases it may be possible to have a trial stay.
To arrange a visit you should normally contact the home direct, but if you have difficulty with this your care manager will assist you.
For most people and their families, it will be important that the home seems to be well run, welcoming and comfortable with clear arrangements in place to help new arrivals settle in as quickly and easily as possible.
When you visit the home take a good look around. Talk to staff and other residents, and don't be afraid to ask questions. You are about to make a big decision; a good home will understand this and will be happy to tell you anything you want to know.
The staff who look after you are a very important element of the care home experience. If they are positive, friendly, welcoming and respectful to residents, this is also likely to mean that they will provide a good quality of care to residents.
Help to settle in
You should expect to have a key worker. A key workers is a member of staff who takes a special interest in you and helps you to settle in to the home. They will show you around and introduce you to other residents and staff. Your key worker will help you in making decisions about how you want to live in your new home. For example, finding out what time you prefer to get up, what social activities you would like to take part in and what food you like. They will also want to get to know you better, and find out about your past and the things that have made you the person you are today.
Your key worker will also be a help to your family and friends as they adjust to your new home and will keep them informed as you settle in.
Staff at the home should consult and involve you about a range of things. Most importantly they should talk to you regularly about the care you require and check that your needs are being met.
Other ways that homes involve residents are:
- Through residents' groups who get involved in organising social activities.
- Organising regular residents' meetings to consult with residents about any changes that may happen in the home.
- Ensuring that, as well as the official complaints procedure, there are less formal ways of making comments or suggestions.
- Involving the families of residents in the running of the home.
It is important for you to maintain as much independence as possible.
Consider how easy it would be for you to get around the home on your own. Look at things like lifts, steps, handrails, grab rails in bathrooms and how the emergency call system operates. If you have visual or hearing difficulties, does the home have any facilities to help with these? If you use a wheelchair, what is the access like? Remember that your needs may change over time.
Talk to other residents
When you visit the home it's a good idea to chat to other people who are living there. Are they positive about the experience?
These could be people you'll spend a lot of time with in the future. Are there other residents from the same sort of background as you? Are the activities that take place at the home things you'd enjoy?
Before you visit a home it is a good idea to write down a list of the questions you would like to ask. Some common questions often asked include:
- Are there any extra charges I would be expected to pay?
- Can I keep my existing GP?
- Can I keep and administer my own medication?
- Can the home meet my dietary needs?
- Is there a smoking policy?
- Does the home cater for my language and cultural needs, for example, are there Welsh speaking staff?
- Is there public transport to the home?
- What links are there with the local community?
- Can the home cater for my religious needs?
- How will I get to know what activities or outings are happening?
- Can I bring my own furniture or equipment into the home?
- If I bring my own TV will I be able to get cable / satellite channels?
- How can I keep valuable items secure?
- Can I adjust the temperature in my room?
- Can I bring my pet?
- Is there a garden or an area to sit outside?
- Are there any restrictions on visiting times?
- Can I take visitors to my room?
- What are the arrangements for making or receiving telephone calls?
- Can I get access to the Internet or to email?
Fees will vary from one home to another, and may also depend on your assessed needs.
The home fees should include the services which are provided for everyone living there. These would include meals and hot drinks, laundry, heating and cleaning. Your contract should confirm what the fees are and what is included.
You may be expected to pay extra for optional items such as hairdressing, toiletries, newspapers, telephone calls, dry cleaning, chiropody, physiotherapy, outings or other leisure activities.
Some homes provide rooms with different levels of facilities. You may have to pay extra if your room has, for example, its own bathroom, a private telephone or even a better view than other rooms in the home.
The home should provide information in writing about the fees it would charge you before you make your final decision about the home.
Costs of nursing care
If you are assessed by a registered nurse as needing nursing care, that part of your care should be provided by the NHS. This means that you will not have to pay the part of your fees which covers your nursing care yourself, even if you are paying for your own personal care.
If you have complex health needs and need regular supervision from NHS staff you may be eligible to have all your care costs met by the NHS. This is referred to as 'continuing NHS care'.
At the time you move into a care home, that home will make an undertaking that it can meet your needs. However, sometimes a person's care needs change over time, and may become more complex. This may mean that the home you are living in is not appropriately registered or skilled to provide adequately for your increased needs. If this happens the home has a duty to advise you of this and ask that you make alternative arrangements for your care. Support is available from Social Services where this situation arises.
If you have to move to another care home, and your care is paid for in full or in part by the council, the care home will normally have to give you at least 28 days notice that you will need to move to another care home.