Care Homes

seven-day-weekend

I have read several threads lately about care homes and two recurrent themes seem to be prevalent.

1. If an elderly person has to go into a home fully paid for by the State as they have no assets, then they will only get very basic care, whereas if they pay for themselves they will get top-class care.

2. That in any home, everybody gets the same level of care regardless of how they are funded.

These two things appear mutually exclusive to me. How can they both be true?

Could someone explain please, so that it makes sense to me?

PasturesNew

I'm working through this minefield of clouds and mist at the moment... once the money runs out it seems to be a question of whether the person can stay in the chosen home, whether the Council and the home will allow that to happen if you top up the fees between funding and the actual bill. I'm hearing a couple of different things:

[1] Yes, the person can stay here, yes we're on the approved list, you simply top up the difference. If you can't top it up they have to move out to wherever accepts Council funded people.
[2] No, we are not on the approved list, they'll have to move out regardless of whether you would be prepared to top it up.

Maybe your question/the answer depends on what care is provided in the first instance, then whether [1] or [2] apply thereafter.

seven-day-weekend

I suppose the self-funding person will have more choice of homes in the first place, won't they? There are probably homes that don't take State-funded people at all.

pelirocco

seven-day-weekend wrote: »

I suppose the self-funding person will have more choice of homes in the first place, won't they? There are probably homes that don't take State-funded people at all.

Exactly


The difference in care homes is staggering

seven-day-weekend

pelirocco wrote: »

Exactly


The difference in care homes is staggering

Could you give me examples of 'the difference', please?

soolin

seven-day-weekend wrote: »

Could you give me examples of 'the difference', please?

I won't give all the background for this as ti would take too long, but due to a mix up the SS thought my dad was state funded and attempted to move him out of a pyschiatric hospital to a fully funded dementia home. That home had a 1* rating and was on a warning that they were going to be closed due to elder abuse and an unsuitable venue. It was on a very busy main road and although the outer doors were locked the staff were all temps and around 80% of the time the outer doors were open and the residents could get out onto a busy road.

There were insufficient disabled access bathrooms and insuffcieint staff to be able to fully bathe the residents, ao on my visit many were in a state that I thought was disresepectful. When I asked about the comments in the report about lack of hygiene I was told that yes they couldn't bathe all the residents as the hoists etc rarely worked and they had no one trained to use them anyway- so they did the best they could with a wash down in a chair.

Special diets (ie gluten free or those for religious requirements) could be catered for but staff needed support from family to ensure the diet was correct as the staff were again untrained.

Rooms upstairs where stair gates were left open, or were low enough to easily topple over (I suspect baby gates were being used rather than proper gates for dementia patients.) They also had shared rooms which I was very surprised at. Oh and shared clothes (although I was sssured that was accdiental as many patients had no relatives to sew in name tags and it was easier just to pool clothes- even underwear)

When I went to look at a private funded place there were several suitable bathing rooms per floor and staff with the training and knowledge to use them. It was a pleasure going to see my dad all bundled up in pjamas and a dressing gown smelling of baby soap and powder and looking happy and clean. There were fully trained cooks and they were very careful to make notes of what dad liked and disliked- even phoning me once as he wouldn't eat to ask if there was anything they could tempt him with.

Double security doors, even relatives couldn't access the outer doors without a member of staff. Everything was completely safe and very regularly they had walk rounds wher erelatives could attend and mention any trip hazards or other htings they might have missed.

Exercise classes were a hoot- many dementia patients can become quite stubborn so although many joined in with simple actions from their chairs it was very often just me and the instructor waving our arms along to the music. Sing alongs went the same way- it is very surreal to be sitting in a comfy chair at 2 o clock in the afternoon singing 'daisy daisy' on a karaoke machine!

I was very pleased that dad had funds to enable me to choose the home I wanted- it also meant that instead of being put in a home in his area I could move him to my area wher ehe was just round the corner.

soolin

Sorry I rambled a bit there.

However, always check out the star rating of any care home you visit and actually read the reports online, see if there is anything you are not happy with.

http://www.cqc.org.uk/registeredservicesdirectory/rsquicksearch.asp

Errata

seven-day-weekend wrote: »

I have read several threads lately about care homes and two recurrent themes seem to be prevalent.

1. If an elderly person has to go into a home fully paid for by the State as they have no assets, then they will only get very basic care, whereas if they pay for themselves they will get top-class care.
The standard of care will be the same in all care homes which have both state funded and self funded residents, and the majority do. The reason is that it's too much faff for the staff to amend the standard of care they give according to which resident they are at that moment giving care to. And also because the hands-on staff won't know which residents self fund and which don't.

2. That in any home, everybody gets the same level of care regardless of how they are funded.

These two things appear mutually exclusive to me. How can they both be true?

Could someone explain please, so that it makes sense to me?

The only differences will be homes with high fees which enable them to provide a first class environment, lots of activities, trips, etc, supported bathing every day if wanted, better food. Of course, LA's won't meet the total cost of a place in such a home, but it's possible relatives could top-up to meet the shortfall if they wanted to.
Having said all that, residential care is a bit like education. Good education can be delivered in a tent, bad education can be delivered in a very expensive boarding school.
Good residential care depends on the calibre of the staff and the manager's skills and leadership qualities. That doesn't come cheap, is reflected in the fees which enable the business - and care homes are a business - to maximise profit.

soolin

To pick up on Errata's point staff are almost the most important thing in the care home, especially for dementia residents. The real difference between some of the completely council funded ones we saw and the private ones was the staff.

The council ones tended to use either poor staff or temps who had no involvement with the residents. They came, they did their job and they moved on. They tended not to be able to keep staff as the homes were poor and paid basic wages to keep costs low.

Most of the private homes I saw had staff who had been there for years. My dad used to cry if I took him out in my car as he loved his care assistant and thought i was taking him away . They bough tlittle gifts for dad, I often saw him with a little dish of washed grapes that no other resident had- because dad had said he liked them.

Ther ewer elots of little extras the staff did, I would often see a resident given extra custard and less pudding as that is what they liked- or something nice cooked because the person said they remembered having it as a child.

pineapple

I used to be a registered homes inspector and encountered good and bad in both private and council. Though of course as always more money brings more choice. And a home with a higher income should in theory have higher standards. I say in theory because I still remember us closing down one particularly posh home due to abuse of residents! And a private home near me was closed down a year or so back. But really you only had to visit, to sense that all was not right.
If you are choosing a home for your or yours, you should always visit first to pick up on any vibes and talk to existing residents.
That said there is a happy medium between 'council' and 'private' - such as the bigger voluntary organisations like Anchor. The home my Dad was in had a mix of privately funded and council funded and they all got the same care.

seven-day-weekend

Thanks all for your informative posts.

My son's girlfriend works in a care home as a cleaner. She has been trained to NVQ Level 2 in Cleaning Services. I would imagine that if they take the trouble to train the cleaners, then they will also train the carers. The staff all appear to stay, there are no temps afaik.This is a private home but I have no idea whether they take state funded residents or not.

However, this appears to be the kind of home one would choose.