Residential care homes

ukmaggie45

There's an interesting article on dementia care in The Independent today.

With the increase in need for help for dementia patients this might be a way to go? The system they use, the SPECAL method (Specialised Early Care for Alzheimer's), sounds wonderful to me. Both my parents ended up in Nursing Homes with dementia (Dad with vascular dementia, and we think maybe Mum had Altzheimers - she was very aggressive and unkind), and I would have been really happy if something like this had been available to them. I so much regret I kept trying to bring my Mum back to reality. I suspect this approach is very expensive to implement though.

Errata

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.

Broadly speaking, people were not moved for this reason which is why LA's prefer dual registration.
TBH in your shoes I would stop thinking about a care home as some kind of 'residential hotel' and start thinking of it as a cross between a nursing home and a cottage hospital.
I have experience of care homes from both sides of the fence, and if I was going to start some kind of residential business I'd be thinking of a small hotel/B&B before I ever thought about a care home. Why ? Because I could turn my hand to all of the jobs needed to be done in a small hotel and wouldn't have a cat in hell's chance of being able to do that in a care home.

ETA have a read through the standards, bear in mind they will have been enhanced since these docs were published and also that these are MINIMUM standards
http://www.dhcarenetworks.org.uk/dignityincare/Topics/Browse/DignityServiceSettings/DignityResidentialCare/?parent=3623&child=3554

missile

ukmaggie45 wrote: »

we think maybe Mum had Altzheimers - she was very aggressive and unkind.

I think my ex-mother in law was born with that :rotfl:

ukmaggie45

missile wrote: »

I think my ex-mother in law was born with that :rotfl:

LOL missile, I know what you mean! :rotfl: Mum was rather like that. I am very fortunate with my mother in law, she's lovely, a real friend. :j And I say that sincerely, not tongue in cheek or anything. She really is lovely.

Mojisola

ukmaggie45 wrote: »

There's an interesting article on dementia care in The Independent today.

Penny Garner is wonderful. The book mentioned at the bottom of the article -
Contented Dementia by Oliver James - is well worth a read. I use some of her techniques with my Mum and it has made her life much better.

Chuck - have a look at the book and learn more about dementia care. It's where the demand is going to be in the future and any well-run home will have a high occupancy rate.

Errata

Certainly Barchester's Tandridge Heights home delivers high quality dementia care, but that's reflected in the fees £650 - £1200 a week and its 75 bed capacity. The dementia care unit is 35 beds and I suspect the charge for those is at the upper end of the fees.
The home will also benefit from being part of a large group, which should mean better and cheaper training than a stand alone home could achieve.

mumps

chucknorris wrote: »

(I may have to seriously downgrade my qualifications to be taken seriously).

Why? People who work in care have a wide range of qualifications. I don't suppose your's would come as any surprise. My staff are an amazing groups of people with qualifications up to PhD level.

monkeyspanner

As people have mentioned the aim of social sevices is to keep people functioning in their own homes for as long as possible with at home daily care provision. This care is often unsatisfactory and as a result people are admitted to hospital after a crisis and from there go into a care home.

If you are looking at financial modelling I would recommend you look at the standard funding levels to which council social services are prepared to support residential/nursing care funding. This I believe is one of 4 bands for residential care and each council sets their own levels. Many care homes complain that these levels are inadequate to support the level of care required. From personal experience I know that the care home my MIL was in refuse to take any council supported residents below care level 3, except where relatives are prepared to make 3rd party top-up payments.

These factors combine to drive up the care requirements of most care homes to the higher levels of care need.

It may be worth you looking at areas where the council are prepared to offer better levels of subsidy. This may however mean you need to spend more on property.

I would certainly recommend that you have someone with nursing experience as you may find GP's reluctant to provide much support. It seems to be expected that care homes can stand on their own without the support an individual might expect.

You might like to look at a slightly different model of a residential facility similar to sheltered housing. Individual units with combined catering, entertainment, and care facilities. Methodist Housing Association do some very good facilities in this area which you could use as a model.

[Deleted User]

sadly like pubs res.care homes are closing daily,the standard of care/staff/accomodation/red tape required make them almost worthless,you would be better off investing your cash in a good b&b in a good year round tourist area i.e. NOT blackpool

foreign_correspondent

Errata wrote: »

Broadly speaking, people were not moved for this reason which is why LA's prefer dual registration.
TBH in your shoes I would stop thinking about a care home as some kind of 'residential hotel' and start thinking of it as a cross between a nursing home and a cottage hospital.
I have experience of care homes from both sides of the fence, and if I was going to start some kind of residential business I'd be thinking of a small hotel/B&B before I ever thought about a care home. Why ? Because I could turn my hand to all of the jobs needed to be done in a small hotel and wouldn't have a cat in hell's chance of being able to do that in a care home.

I agree - my gran is currently in respite in a very nice care home - it has the facilites you would expect in a decent hotel, i.e. nicely furnished rooms with patio doors leading out into a garden, ensuite bathroom, a nice TV lounge / dining room and she gets three good meals a day, her vegetarian diet is catered for and between meals tea and biscuits are offered.

But, the big difference is that on top of all that, it also has all the necessary equipment to ensure safety for the old and infirm, it has a high staffing ratio, staff are trained to deal with all aspects of care of the elderly, she gets help with her personal care, with washing, dressing, toiletting etc as needed, her laundry is done for her etc..

Even though care homes seem expensive, the full cost of her care is £390 per week, so £55 a day - not much more than full board in most hotels, even though the care offered is far more specialised and involved.

Staff will also require a great deal more ongoing training than hotel and catering staff - they need to know about legislation, health issues, (mental and physical) ethics, medications, safe practice, managing challenging and aggressive behaviour etc etc.. and because so many of these are statutory requirements, training is a commodity that does not come cheap.

There is also the risk factor - working with vulnerable people places a high level of responsibility on those entrusted with their care. Get things wrong (or employ staff who get things wrong) and you could find yourself in court. The duty of care that people working with, or caring for vulnerable people, have is massive, and the more vulnerable they are, the more the responsibility lies with the carers. As the owner of a unit, ultimately, if things go wrong, the buck stops with you. There are also a lot of areas where you need a good insight into the legislation - day to day decisions about care, and people's rights cannot be made without knowledge and experience - eg. when is stopping someone walking out of the front door reasonable, and when is it deprivation of liberty? When is encouraging someone who is reluctant to engage in personal care ok, and when is it abuse?

You really need to work with someone who is an expert in the field, who is well respected, and who has recent management experience.

Read as much as you can - I think care homes are now audited and assessed by the care quality commision (used to be CSCI)