Care Home how much luxury is required?

The husband physically is finding it so hard to care for her now. She needs 24 hour supervision. He has to be in The same room with her at all times. It is very hard for him to deal with her double incontinence.

He has been really dedicated to her care and is thinking of letting her go one week each month for respite for him. He hopes this will give him the energy to carry on. He does not want to do this and has taken lot of persuading from his son and daughter. They are very worried about the stress he is under. He is unable to have a a live in carer. I don’t think he could stand another person in the flat with him.

He employs a carer 2 hours a day so that he can shop, have a bath, use the loo and get some fresh air.

Oh dear, a live-in carer does not sound very suitable then.

I think assessing the quality of the staff is the most important aspect of choosing a care home. You want staff who are caring and helpful.

My DM refused to use most of the extras at her care home - hairdressing, actvities, day trips out etc. However the home was the most caring and had lovely staff popping in and out and making mum (and us) cups of tea. She liked the food as well having survived a diet of ready meals when carers came 3 times/day - especially the home's dinner buffet although you had to watch out that she didn't put prawn sandwiches in her handbag "for later" and forget about them!

My experience of this is very recent and I would be very careful indeed. My mum’s home started at £1200 a week when she was first admitted nine years ago. The accommodation part of the cost went up every year by more than inflation, and the nursing care costs grew hugely as her needs increased. We ended up paying over £7000 per month by the time she died last week. In total we have spent over half a million pounds on Mums care. You cannot predict how long your relative will live or what their needs will be from one week to the next.

Mum was always clean, was fed well and enjoyed all the activities until she was unable to take part. Housing her there assuaged my guilt over not being able to care for her myself but I think it was an emotional decision and not necessarily the wisest one.

Unfortunately these homes are big business and their business is profit! ‘our’ home was not transparent about pricing because it seemed to think money was no object for people who wanted the best for their relative.

Before choosing ask really detailed questions about anything and everything that might concern you, read the homes CQC report.....add a pinch of salt and choose. Price is no indicator of quality.

I sincerely wish you luck!

I am sure that you will get lots of practical advice but in long experience of nursing and care homes I would ask you, which one has the more loving atmosphere and staff.

I regularly visit two local care homes. One has staff that are almost exclusively from overseas and the other has staff that are mostly British and from the local area. Both care homes are noted for the excellence of their staff; I believe the commonality is that the staff in both homes have been there (willingly) for donkey's years.

Yes please don’t knock a care home out because of overseas workers my Dad had carers come into the home they were nearly all overseas workers he was unsure at first because he worried they wouldn’t understand him or he them, but they were all wonderful, without exception He loved them all so much, and near the end of his life he was so close to a young Portuguese man who used to go over and above his work load Some of them came to Dads funeral They really did come from the four corners but enriched Dad with their chat and care
I cannot visualise £1600 a WEEK, how the other half live eh
Money and posh spas and stuff don’t make a good care home The love and efficiency of the staff and the well run care is all that is important most elderly don’t need hotel style meals they want something as close to their home cooking as possible they don’t need all these extras cleanliness, good quality care and love is all they need

^ if dad has to go into a care home they could sell their flat^
Is the flat part of Buckingham Palace ? To pay two lots of luxury fees of £80,000 each is £160,000 a year !!!! What size flat will pay for more than a couple of years at most

A 2/3 bedroom flat in a decent part of London would bring in about £15,000,000 Bluebell

Thank you so much for continuing to add to this thread. I was asked for my advice and I think my conclusion is this. When a person enters a care home and is mentally aware of the surroundings, the extra luxuries, if affordable, are worth the money. In this case she has no awareness of who or where she is.

They have visited the homes and have been invited to lunch at both of them. As he is holding off as long as he can, I think I will suggest that they all visit individually. Make their observations about how staff interact and make the decision when they are all more used to the idea. Emotions a so raw at the moment, that it is hard to see clearly. I would also suggest they ask what experience they have with residents who have lost the power to communicate.

I do know that sometimes even her husband gets very frustrated, even heartbroken at not being able to understand all of her needs.

I will also mention what has been said about them hiking the fees.

I was a social worker for 30 years, some of that time working with elderly people. The absolute best home in our area was scruffy and chaotic but everyone loved it.

Both my parents, at different times, were in a superficially "down market"home where they were cared for with great love and dedication in a homely atmosphere. They both died there with a carer by their side holding their hand while we tried to get there as speedily as possible.

It is the little things that matter and you can spot these as you go round:
- do they knock on the residents' doors when they are showing you round?
- do they greet the residents as they go round?
- do the staff greet you and seem relaxed?
- does the place smell strongly of disinfectant - or worse.
- are the rooms personalised?
- what is your personal response to the manager? - do you warm to him/her?

These judgements are always very hard, as sometimes it is something intangible (that the CQC cannot measure) that singles out good from bad.

But, if money is no object, then that can be removed from the equation and the decision made on other things that are truly the most important.

My thought would be , to the person choosing the care home, go with your gut.
Its very rarely wrong.

@oldbatty you have hit the nail right on the head. If he was making the decision alone he would have gone with the lower priced home. He thinks the care offered in each is equal. His wealth was acquired by shrewd business sense and being ‘careful’ with his money. However, he brought the children into the decision making, which is where he now has a dilemma. The daughter has enjoyed a higher standard of living than the son as the mother was indulgent towards her. The son has worked hard for what he has and is, I think, more prudent.

Flossie, I would not completely dismiss the idea of 24 hour care at home. At the moment, your friend only has 2 hours respite - absolutely not enough for someone of his age.
24 hour care could be suitable, if the layout and space of their home would permit it. It just might be the stepping stone he needs. Of course, it may be too intrusive and upsetting for him.
I'd like to add that I understand the daughter - if she has been somewhat indulged by her mother, she may wish to 'pay back' by seeing her mother being cared for the in the way she thinks would be best. If they were close, she may well have a good sense of what her mother would have liked. And at least she is not thinking about her inheritance!
On everything else I think you have very good advice from gransnetters.

I’ve been a live in carer periodically for a few years. I’m self employed and the client pays me £81 per day plus the recruitment agency. In total this would amount to approximately no more than £35,000 a year. And without boasting too much this client receives the very best in care living an independent lifestyle. She is indeed a happy 98 year old who continues to enjoy life. Granted she continues to live in her own home with costs associated with various everyday living needs but she can afford it. May I ask what more could a person need. Granted this is not for everyone especially where degenerated health care needs require specialised care. Good luck to all searching for utopia.

I think the main things to look for when choosing a care home are these:

staff to resident ratio - how many carers will be on duty during the day? During the night?

Have they all completed relevant training, and is it up-to-date? Moving & Handling, Health & Safety, etc.

Is there a qualified nurse on duty or on call?

How EXPERIENCED are the staff?

Is laundry done separately for each resident? (Some places do everyone's laundry together!)

The daughter is mistaken if she thinks higher price = better resident experience. That may be true of hotels but it doesn't correlate in care homes.

My mother - having lived with me for 9 years - kept wanting to go 'home' to S Wales 4 hours drive away. She had this idea that all her old friends would be there and would come and visit her - apart from one they were all dead! We did our best and researched all the local ones. We ended up with a fully funded one where the Manager had known my sister and the staff were lovely. The nursing sister was from Guyana and the rest of the staff were a mix of local/ overseas. She loved them all. Money is no indicator.

Having looked at so many care homes, when choosing for two relatives (both with dementia) I think cosy and homely with a warm, welcoming atmosphere, are the most important factors. If someone is going to use extra facilities, well and good, but if they aren't, they're not important.

Might add that the most 'luxurious' care home I ever visited - where an aunt of dh's (no dementia) stayed for a month while her helper was away, had a horrible atmosphere - staff were surly and miserable, and the aunt hated it, she couldn't wait to leave.

Having looked at so many, I think you just know when one feels right. And I particularly remember one where the public areas were very 'stylish', in a 'Homes and Gardens' fashion, but although they were quite willing to take my mother, the rest of it was totally unsuitable for anyone with dementia - it was a converted hotel, with a maze of narrow corridors, etc.
IMO the 'stylishness' was there very largely to impress the relatives who were choosing.

Would just add, re laundry, how on earth is a care home with more than a very few residents expected to do their laundry separately?
They can't, and this is why all clothing inc. underwear will almost always need to be very securely labelled - I used good old Cash's woven name tapes. And unless you are prepared to take it away and do it yourself, forget anything that needs hand washing, dry cleaning or can't go in a tumble dryer.

I'm just thinking that for anyone who is considering starting some sort of business, surely they could do a lot worse than to consider opening one of these care homes?

I had no idea how expensive they are. £1,600 PER WEEK??? How on earth can they justify that amount ?

Obviously there are many overheads, staff wages etc but it sounds to me to be an extremely lucrative business to be in.

Its long been a pipe dream of mine to open a small home, and to make it great for the residents, the staff, and me!
Well, I can dream.

Of course care home fees can vary a lot, often according to where you live, but personally, to be strictly fair, when looking at average rates, I don't think they are necessarily so excessive when the daily cost is compared to one night in a reasonable hotel or B and B locally.

Instead of just B and B it's normal for care homes to include,
All meals, snacks and drinks
All laundry (often a lot)
Help if (as so often) needed with washing, dressing, 'toileting' as they like to call it, and maybe with eating and drinking, too.
Not to mention very high levels of heating in most care homes during the colder months.
Plus of course someone on hand 24/7 for anyone needing assistance in the night, or anyone like my mother (with dementia) who frequently wandered around half the night. There was always someone there to reassure, maybe make her a cup of tea.
And often various activities as well.

Just saying. Should add that neither I nor any of my or dh's family have any financial interest in any care home!

Yes but when you think that a small home with, say only 5 residents could still bring in over £400,000 p.a. That's a hell of a lot.

Carers' wages are notoriously low aren't they, and a lot of these homes don't employ medically qualified staff, so their wages bill wouldn't be too much.

Ok, I realise that there are many other expenses involved, but with an income of £400,000 in my example, that's still a tidy profit.

I would give it some serious thought MissAdvnture !
You could drum up some business on here, couldn't you?!!

I'm sure I could, even though I feel like booking myself a space lately..

Obviously there are many overheads, staff wages etc but it sounds to me to be an extremely lucrative business to be in.

Its not unless its part of a chain where lots of services are centralised. That's why so many independent care homes are closing down and nobody is willing to take them over. The money is in the chains which are part of investment portfolios. The small homes can't keep their heads above water.