Residential care homes

chucknorris

Hi everyone,

It's my first day of posting here (on this board). I couldn't find an exact appropriate board to post this on, but thought this might be the better one to do so.

My wife and I are in the VERY EARLY stages of exploring the possibility of eventually starting up a residential care home. The reasons for this are quite extensive:

1. We both feel it could be possibly be a rewarding experience
2. I am early retired (now 52) and my wife is anticipating retiring in about 4 years (at 45) and we both would like to start up a business together that would be both rewarding and of course profitable.
3. We both have elederly parents and if they needed to go into a care home we would like to ensure we have max control to enjoy it as much as possible.
4. We both have run our separate businesses for years (on top of our professional careers) and are no strangers to the business world and feel we have the ability to adapt our skills to most business situations, particularly if highly motivated.

As I said this is the very beginning of my research, so far I am picking up on the fact that new entrants into this field seem to be flourishing and expanding, yet some established companies seem to be struggling. It is obviously very important for me to establish if this is true, and why? I am aware recently there has been more leglisation and wondered is it because the existing businesses had a business model which is struggling to adapt, whereas newer entrants into this filed have built their business model around the new rules.

I think some of the avenues I have to find out is:

1. What is the most effiecient size (within what would be our budget) in terms of numbers of beds provided to staffing levels.

2. What effect does the geographic location have (in terms of fees for that area compared to the building cost).

3. Where to pitch in the market, top or above middle( we would not be bale to afford the very top and would not touch anything which would not provide customers with excellent conditions.

I would be interested to learn of anyone's experience of residential care homes whether it is negative or positive (we are not currently considering nursing or specialist care homes, simply residential care homes for the elderely but without the need for full time nursing care).

missile

I would suggest that like any business research is the key to success, i.e. work smarter not harder. Have you considered taking a job in a care home so that you can find out what it is really like and learn the ropes.

I would suggest that many of the older businesses found it too expensive and lacked the capital to improve their facilities to meet the changes in regulation.

Errata

Few residential homes are residential only, and the ones that are, are moving to dual registration residential/nursing.
Many care homes are going out of business because they are unable to meet current accommodation standards.
The direction of travel on care for older people is to enable people to stay in their own homes with necessary support from care and nursing workers. This means the need for care homes in the future may decrease significantly with only the people in need of very intensive nursing care moving into a care home.

Can't help you out further without knowing what your experience in running an establishment for a number of people is and what your budget is. Off the top of my head I would say business experience is useful but nursing experience is vital.

chucknorris

missile wrote: »

I would suggest that like any business research is the key to success, i.e. work smarter not harder. Have you considered taking a job in a care home so that you can find out what it is really like and learn the ropes.

I would suggest that many of the older businesses found it too expensive and lacked the capital to improve their facilities to meet the changes in regulation.

Thanks.

Yes I have, when we have gone much much further with the 'desk top' research and it still looks feasible, I would defintiely get a job in a care home (I may have to seriously downgrade my qualifications to be taken seriously).

chucknorris

Errata wrote: »

Few residential homes are residential only, and the ones that are, are moving to dual registration residential/nursing.
Many care homes are going out of business because they are unable to meet current accommodation standards.
The direction of travel on care for older people is to enable people to stay in their own homes with necessary support from care and nursing workers. This means the need for care homes in the future may decrease significantly with only the people in need of very intensive nursing care moving into a care home.

Can't help you out further without knowing what your experience in running an establishment for a number of people is and what your budget is. Off the top of my head I would say business experience is useful but nursing experience is vital.

Thanks, I said to my wife yesterday, that the newer entrants to the market appear to offer (as you say) multi purpose homes (ie not only just care only but also nursing and dementia). However at this early stage I would still like to focus on merely a residential only (rather than nursing) home although as I have said to my wife we may need to reconsider this either on day one or at least be aware that later diversification may be necessary, to reach the full potential. We do not come from nursing/medical backgrounds (I'm a chartered surveyor and my wife an actuary) so we don't bring any specific professional skills with us, although we may quickly realize that it would be better to hire in those skills rather than do without and risk running a business below it's full potential.

As regards to budget I think we would like to start off small but try and leave room for future expansion. So probably approx 1-1.5m initially. Especially as we wouldn't want to borrow too much, that could be done later if/when the business flourishes and proves expansion is feasible/warranted.

I am aware and accept your point regarding the 'stay at home care' however I suspect that the ever growing older population will offset this, You were right to point it out though and it is a point that I picked up on yesterday.

margaretclare

All I can say to this is: if you have no experience in the healthcare field you need to consult someone who has.

Think: good-quality B&B. That means: an en suite bathroom with every room. Single rooms or double for a couple. Apart from couples, no sharing. Disabled facilities i.e. grab-rails everywhere and alarm cords reaching to floor. Maybe walk-in showers rather than baths. No steps. You may have to call the paramedics and get someone taken to hospital by stretcher, so steps are a no-no. A lift.

Just a few thoughts, off the top of my head.

Errata

HTH - you will find that the vast majority of older people who need to move into a care home do so because they can no longer manager their own homes because of a significant mental or/and physical health condition. For this reason most homes are dual registered and those that aren't are moving towards that. Two thirds of residents are funded by their LA who look more kindly on dual registered homes. Staff prefer to work in dual registered homes to maintain and develop their skills base. To give an example - there are 63 homes in my LA district of which only 3 are registered as residential only.
Pay attention to Saga Group's latest development, they are moving into home care not residential care, and consider the reasons why they would do that.
Many LA's are now developing intensively supported independent living purpose built accommodation as this is a more effective way across many domains of supporting people than a care home.
Consider why a care home is being sold. Owner's retirement/can't be brought up to current standards/LA doesn't like residential only homes and prefers not to license them/staff unable to obtain more than minimal qualification/poor local reputation/run of poor inspection reports/ & etc.
Care homes are regularly inspected with reports published on the inspecting bodys website (sorry, forgotten what its new name is), have a read through a sample so you understand what standards homes are expected to reach and where they fail.
Bear in mind a possible 10% unoccupancy rate, bear in mind staff go on sick leave/resign at the drop of a hat and use that to consider what Bank staff costs might be. Think about what new standards might be brought in eg Fire Service have recently developed new standards for care homes which have to be implemented even though a home's current system may have been satisfactory up to that point. Owners need to implement new standards to retain their license.
HTH

chucknorris

margaretclare wrote: »

All I can say to this is: if you have no experience in the healthcare field you need to consult someone who has.

Think: good-quality B&B. That means: an en suite bathroom with every room. Single rooms or double for a couple. Apart from couples, no sharing. Disabled facilities i.e. grab-rails everywhere and alarm cords reaching to floor. Maybe walk-in showers rather than baths. No steps. You may have to call the paramedics and get someone taken to hospital by stretcher, so steps are a no-no. A lift.

Just a few thoughts, off the top of my head.

Thanks, but I'm ok on the building side as I will probably get one of my ex colleagues (I'm a quantity surveyor) to get me an elemental cost analysis of a health care home that they have worked on.

It's more the financial feasability and business plan direction options that I am trying to discover more about. I certainly wouldn't want to operate anything less quality than all rooms have ensuites. I think it's unreasonable these days to expect people to have to share bathing/toilet facilities. I think you won't get anywhere unless you treat people with respect and make sure they get what they want.

chucknorris

Errata wrote: »

HTH - you will find that the vast majority of older people who need to move into a care home do so because they can no longer manager their own homes because of a significant mental or/and physical health condition. For this reason most homes are dual registered and those that aren't are moving towards that. Two thirds of residents are funded by their LA who look more kindly on dual registered homes. Staff prefer to work in dual registered homes to maintain and develop their skills base. To give an example - there are 63 homes in my LA district of which only 3 are registered as residential only.
Pay attention to Saga Group's latest development, they are moving into home care not residential care, and consider the reasons why they would do that.
Many LA's are now developing intensively supported independent living purpose built accommodation as this is a more effective way across many domains of supporting people than a care home.
Consider why a care home is being sold. Owner's retirement/can't be brought up to current standards/LA doesn't like residential only homes and prefers not to license them/staff unable to obtain more than minimal qualification/poor local reputation/run of poor inspection reports/ & etc.
Care homes are regularly inspected with reports published on the inspecting bodys website (sorry, forgotten what its new name is), have a read through a sample so you understand what standards homes are expected to reach and where they fail.
Bear in mind a possible 10% unoccupancy rate, bear in mind staff go on sick leave/resign at the drop of a hat and use that to consider what Bank staff costs might be. Think about what new standards might be brought in eg Fire Service have recently developed new standards for care homes which have to be implemented even though a home's current system may have been satisfactory up to that point. Owners need to implement new standards to retain their license.
HTH

Yes all good points, I hadn't considered that staff would want a dual registered home, and you wouldn't get anywhere without the better staff. I will talk this over with my wife as I have now arrived where I thought I would eventually (after seeing all the newer homes seem to cater for this), ie forget about exclusive residential care and explore and find out if we want to go down the avenue of a dual registered home.

A good point also about the LA leaning towards dual registered homes.

Something else I thought of too was that if you had someone in as a care only patient, you would not lose them if they developed the need for nursing care.

chucknorris

Thanks for everyone contributions, it has been very helpful so far

Mojisola

Did you watch "Can Gerry Robinson Fix Dementia Care?"

That was worth viewing to see how not to run a home.

I would definitely get a job in several homes. The standards can vary enormously. You could also visit a few to see if they are suitable for "an older relative".

I've had to do this for real and you very quickly get a feel for the ones you wouldn't put a dog in, let alone a relative, despite the what the reports say.

You will get an understanding of how you want your home to be.

I think the secret is in the staff. Most carehome staff are poorly trained and poorly paid. Recruit the right people, provide on-going training and pay them well so they stay with you.