How to start a care home from scratch.

dipcho2002 · 20 August 2018 at 11:08PM

Hi,

I've been wanting to start a care home for some time and have been doing research with little success.
I have no clue on where exactly to start. I have called up my local council for information and they suggested to contact CQC. I understand this however they don't have much information except about registration.

I want to start a care home from the absolute beginning meaning buying the building, recruiting manager and staff.
I want to know who to contact to start off as well as how I would be able to get elderly people into my care home. Also, how I would get paid.

I have the funds (approx 55,000) but I would want to know what the minimum requirement would be as an estimate.

I do have experience in the health sector but not in the care home aspect.

I'd be very grateful for detailed answers especially from those who have experience with adult care homes.

Thanks.

elsien · 20 August 2018 at 11:26PM

If you know so little about it, why do you want to do it? What's the motivation? Because this is people's lives you are talking about. The care homes I have been in run by people just in it for the money tend to be dreadful places. The two worst ones that I wouldn't put any relative of mine anywhere near even in a dire emergency were owned by doctors.

So, client group - residential care, residential with nursing, nursing care, EMI unit? All older people or younger people with dementia, or physical health needs, or a learning disability, or autism or nursing needs, or a combination of the above? How many people do you want to support and is it financially viable?

Are you looking for self funders who pay their own fees or are you looking for people who may be funded by the local authority or by CHC? Have you done any research at all into what the local authority in your area will pay for people to live there?
Have you considered what qualities your staff will need?
Have you looked at the CQC standards and understand what you will need to achieve so as not to get closed down? Do you know what qualifications your manager will need? What equipment you will need for the client group you are aiming for? What other services you might need to buy in?
Have you looked at what staffing levels you need according to the client group, as above? And how you will recruit them in a sector which pays close to minimum wage in most places for unsocial hours and working all year round.
Do you know what you need in terms of accessibility, suitability of building, what facilities and adaptations will be required, planning permission and how likely the neighbours are to complain? What you will include in the fees and what you will charge extra for?

Do you know how many care homes are closing because the LA rates do not cover costs? A 120 bed home in my area was closed recently after being put into special measures because the owner wasn't prepared to fund what actually needed doing to make it a half decent place.

And you only have 55K. Have you done any business plan or research at all? 10 seconds worth of googling found more information than you seem to have at the moment.

(Ex-manager of small group home for people with learning disabilities.)

daisy_jean · 20 August 2018 at 11:55PM

I don't know much about care homes or setting them up. I work in childcare, which to some extent will have similar safeguarding aspects and DBS set ups for staff.

We are a small nursery. Well, relatively small. We have a workforce of 15-17 girls. Pay varies from minimum to decent, obviously dependent on qualifications and experience. Our payroll per month currently comes in at almost £18,000 pcm (part time and full time)

You need to look at ratios and funding. Because if funding in care is the same as childcare, it doesn't cover half of what it needs too (thinking 30hr funding here - laughable!).

So a 55K layout is not going to go far. To get a building, kit it out sufficiently and staff it with GOOD qualified staff. It'll last maybe a month, if that.

I don't wanna knock an idea that someone has, please just be realistic. I was lucky, my Nana lived in a care home that treated her with respect and dignity. Not all do.

soolin · 21 August 2018 at 8:22AM

As above I think you are several years and several hundred thousand pounds away from being able to realise this dream. Firstly the money, even a modest home is going to need equipment that meets the needs and safety requirements of your residents - have you any idea of the costs of specialist beds, bathing facilities with hoists , adapted toilet areas etc? Obviously different types of resident of have different needs so your first action would be to research which group you would be aiming at.

You would need professional advice as well at least with your business plan, that won't come cheap, plus you'll need someone with qualifications on your board or staff somewhere , depending on type of home, again not cheap. Insurance, staff training, recruitment costs. That's all before you even try and get a loan , a suitable building could cost you quite a lot of money, and then you would need to adapt it which could cost even more. I suspect £55k would barely cover start up costs with registration, professional advice, training and other statutory requirements.

How about working in a care home for a while, it's difficult for them to get staff and most locally to me advertise all the time, so take a few !!!!!! a week, see how it's done and maybe talk to the managers, owners, residents etc. Get a feel for it.

Lastly as above the funding is going to be an issue, I live in a London Borough and have experience in this regard in this Borough and another and due to funding shortfalls have seen the scandal of people being moved out of London to 'cheaper' places where owners can try and cut costs and still not lose too much.

My dad was in a home, it was very basic but he loved it and they were very kind to him, that closed (after he had died) purely because they were making a loss month on month and couldn't afford to keep going.

Wizzbang · 21 August 2018 at 10:04AM

dipcho2002 wrote: »

Hi,

I've been wanting to start a care home for some time and have been doing research with little success.
I have no clue on where exactly to start. I have called up my local council for information and they suggested to contact CQC. I understand this however they don't have much information except about registration.

I want to start a care home from the absolute beginning meaning buying the building, recruiting manager and staff.
I want to know who to contact to start off as well as how I would be able to get elderly people into my care home. Also, how I would get paid.

I have the funds (approx 55,000) but I would want to know what the minimum requirement would be as an estimate.

I do have experience in the health sector but not in the care home aspect.

I'd be very grateful for detailed answers especially from those who have experience with adult care homes.

Thanks.

As a health professional, your whole post concerns me to the deepest part of my being. You obviously know nothing about care or care homes. For starters, you'd need to know what sector (learning disabilities, children, adults, elderly etc) you wish to provide care for and what kind of care (residential home, nursing home, supported living etc).

I cannot for the life of me understand why you think you could start up a business like that with a mere £55,000. You state you want to the buy the building!!! Exactly what you think you could buy with that - a static caravan, I should think. You're obviously assuming that the rates people pay you will cover it all, hardly likely - especially at the outset. Care homes tend to be million pound properties, even multi-million pound properties due to the size required even for a small home with say 10 residents. I should think your manager would eat up almost the entirety of that sum in their annual wage alone, let alone the nurses salaries and other qualified staff, before you've even paid the care assistants etc.

Just a few of the things you would need to consider, not a comprehensive list for sure - insurances (employer, building, public liability, contents and so on), the home meeting the minimum sizes laid down by the council, CQC etc, staff recruitment, training, wages, sickness, accountants, all the different registration costs for health professionals, the home manager, the home and so on. The home needs to be fitted out with a catering kitchen and all the associated equipment. Every room would need hospital beds, all sorts of medical equipment - again not cheap at all. Staff need food hygiene training. You'd need lawyers involved in order to work through the various contracts you'd need between clients, staff and the local authority. Hardly cheap, any of it. And that's barely a fraction of what's required.

And then you state you wonder how you get paid - do you know nothing about running any kind of business? What role exactly do you hold in health and social care?! A care assistant? Hardly preparation for running a home. I hope you steer well clear, for the sake of all those elderly people you want 'to get in your home'.

lincroft1710 · 21 August 2018 at 5:09PM

Don't bother ploughing through the previous 4 replies (excellent though they are), I'll summarise in 4/5 words:

It's a complete non-starter.

How to start a care home from scratch.

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