A Guide for Families and Friends

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What is a residential service or care home?

The term care home refers to any establishment that provides accommodation and care twenty four hours a day. Services that provide a nursing element are called Nursing homes. All care homes must be registered with the Care Quality Commission (CQC) as ‘service providers’. The CQC is responsible for registering and regularly inspecting all services and ensuring that standards are maintained and the service delivers quality care. Services may be privately owned, run by a company or they may be run by the local authority. 

Where to look for a service?

  • The Care Quality Commission website lists all care homes in each area. You can also see the latest inspection report for each home here.
  • Social workers at your Local Authority may be able to provide you with a list of service in your area
  • Learning Disability charities or organisation may have a list or know service that might be able to help you
  • Many websites offer a search facility so you can see all homes within a specified mile radius of your home address; a simple internet search will highlight these websites for you. You will then be able to contact different providers direct

The Funding Process

Obtaining funding for a residential service can be a complex process. Your social worker will work with the relevant health and social care professionals to take your case to a panel meeting. They will keep you informed during the process until a decision is made.

Dual Funding

It is possible to get a contribution from both health and social care; the social care aspect would be funded by your local council and the health side will be funded by your local Clinical Commissioning Group (CCG) or the NHS Trust. The source of the funding will be determined by an assessment completed by professional from the Local Authority and the CCG or Trust.

If you have already identified a service you think may be suitable for your family member, then you will need to discuss your ideas with your Social Worker or Care Manager. Alternatively, your Social Worker may present you with a number of suitable services so you can choose which one you prefer. You may wish to visit all of the services on the list or you may just want to visit one or two. Your social worker will be able to help you to arrange visits to the service.

Assessment

One you and your social worker are in agreement, your social worker will contact the service provider to make an official referral. The service provider will then arrange to meet your family member and carry out an assessment. You may wish to be present during the assessment or you may speak with the assessor separately if you wish. During the assessment, the professional will talk to your family member about their general mental and physical health, their ambitions and goals for the future and any issues that may affect them in day to day life. The service provider will then write up their findings in an assessment report and put together a proposal which covers how they would meet your family member’s needs. 

Visits

If you have not already done so, you may be invited to visit the service provider, have a look at the bedrooms and meet some of the staff; this is a useful opportunity for you to ask questions and find out more about life there. You might want to use our CHECK LIST of things to consider as a guide to help you when you visit.

Panel meetings

The assessment report will then be sent to your Social Worker who will discuss the findings with you. If you are happy, the proposal will then be sent to a panel meeting where panel members decide if they are able to fund the cost of the care. Sometimes, the panel may ask the provider for further information so it may be some time before a final decision is made. Sometimes you or your family member may be required to make a personal contribution towards the cost of your care; if this is the case, your Social Worker will discuss this with you.

Funding confirmation 

If funding is approved, the service provider will work with you, your family member and your social worker to organise a transition period where your relative can get to know staff, the service itself and what to expect when they move in. 

If funding is not approved, there may be several reasons why; you should speak with your Social Worker to discuss alternative options.

Things to consider when choosing a service:

Recent Inspection Reports

Check the most recent inspection report to see how well the service is performing and if there are any concerns. Service Providers are now required to display the results of their most recent inspection in the service – if they don’t, ask them why. Alternatively, you can search for the service on the Care Quality Commission’s (CQC) website www.cqc.org.uk 

Service location

Should the service be near or far away from where your family member is at the moment? Staying close to family and friends may mean it will be easier to your family member to stay in touch. You may also want to consider the community facilities that are close to the service; are there shops, cafes, sports facilities or colleges nearby? Is there a lot to do in the local area? Are there good transport links that can help your family member get around and visit neighbouring towns and cities?

Size of the service

Depending on your family member’s individual needs, you will need to think about the size of the service and how many other people your family member would want to live with. Smaller services are often quieter and provide a more homely atmosphere where as larger ones may have lots going on at the same time and feel busier.

The bedroom

Some services may allow the service user to choose their own room and many will let them personalise their room with posters, photographs and other personal items that will help them feel at home. If you have any specific items that your family member would want to take to the service or any items of furniture, you should check to ensure the bedroom is big enough for these. You may also want to check that the service provides private ensuite shower rooms and toilets. 

Food and Drinks

Every service should offer a choice of healthy, nutritious meals. Where appropriate, service users should be encouraged to prepare and cook their own meals and be involved in the planning and shopping. Service users should have access to special food items or diets if they require it.

Activities

If your family member has a particular interest or hobby you need to consider whether or not the service can help them continue with the activity. Some services have activity timetables where the individual can join in activities with other service users and others give the service user the opportunity to choose what they want to do and then provide staff to help.

Service staff

You may want to meet staff members at your chosen service before your family member moves in. Services should work in a person-centred culture where service users value their relationships with the staff team. Staff should provide care that is kind and compassionate. Each individual should receive care from someone who understand their history, their goals and their ambitions. 

If the service is a specialist provider, staff should receive specialist training. For example, if the service provides specialist care for service users with Autism, staff should have received training regarding that diagnosis and specific needs of this service user group. Staff should keep their knowledge and training up to date and be well informed on new approaches in working with service users within their specialism. 

The service should be well supported by a strong senior management team that has experience in the sector. The senior management team should be visible and accessible and on hand to support staff as well as families and carers. Staff should feel confident and able to question practice and report any concerns to the senior management team. 


Checklist

Location

  • Are family and friends close by?
  • How far is it to local amenities such shops, cafes, sports facilities etc
  • Is there enough to do in the local area?
  • Are there local colleges nearby?
  • Are there good transport links?
  • Is the service easily accessible for visitors?

Service facilities and appearance

  • Is there a garden area with seating?
  • Is the communal space large enough for all service users
  • Are the grounds and the building well maintained?
  • Is the interior clean and tidy?
  • Does the service have internet access?
  • Do the bedrooms have ensuite shower or bathrooms?
  • Does the service feel welcoming and homely?
  • Is the service accessible for wheelchair users?

Service ethos/philosophy/outcomes

  • What outcomes does the service aim for?
  • How does the service promote social inclusion?
  • Will service users be able to fully participate in the community?
  • Does the service provide care that is person centred and tailored to each individual?
  • How does the service encourage service users to become more independent? 

Specialist input

  • Is there any specialist input in addition to the input of the staff team? 
  • How do staff manage challenging behaviour?
  • Are there are specialist therapies available? 

Staffing

  • What is the ratio of staff to service users?
  • Are the staff awake at night or does the service use sleep-in staff?
  • Are there additional staff available if a service user needs one-to-one support?
  • What sort of training do staff undertake?

Visiting

  • What are the visiting arrangements?
  • Can visitors visit at any time or do they need to make an appointment?
  • Is there parking available for visitors?
  • What is the communication process for visitors? Is there a specific email address or telephone number?
  • How can relatives get involved with the service user’s care?

Day to day life

  • Can service users cook their own meals?
  • Can service users get involved with the running of the household?
  • Can service users go to bed and get up at a time they choose?
  • Is there somewhere service users can use the telephone?
  • Can service users help with the day-to-day running of the household?
  • Can service users have pets at the service?
  • Can the service help to meet any specific religious, spiritual or cultural needs?
  • How often can service users access the community?
  • Will service users get the opportunity to go on a holiday?
  • Are there opportunities for service users to develop new skills and/or take part in community based projects?