When choosing a care home, meeting the needs of the individual is crucial. Angela Faherty explains what clients should be looking for when making their decision
As the ageing population increases, so will the number of people requiring care. The 2001 Census showed over the age of 85, only 26% of men and 22% of women considered themselves to be 'in good health.' With this in mind, it is likely as the population grows older, demand for professional care is also likely to increase.
Choosing a care home is not a decision to be taken lightly. There are many factors to take into consideration and it is therefore best to start thinking about the need for professional care at retirement age.
As many people may be fit and well on retirement, choosing the care home they want to enter, should they need it later in life, is not necessary at this stage. Making the choice at this point is somewhat premature as circumstances may change if the person actually enters the home. Similarly, the home may no longer exist, or the person needing care may have moved away from the area.
While selecting the actual care home should be postponed until nearer the required time, it is imperative financial planning is undertaken as soon as possible. The run up to retirement is a good time to start to consider the financial implications of entering a care home, says Nicky Cave, care fees adviser at Millfield Care Partnership.
Every penny counts
"Just after retirement is the ideal time to consider the need for care later in life, certainly from a financial planning perspective. At this stage a person should be thinking about where the funding will come from should they ever need to enter a care home later.
"If they have to pay for the care out of their own pocket, then they need to consider how they will do this, how much it will cost and assess all the financial options before making the decision," she says.
For those with assets below £19,500, the care home costs will be funded, in the main, by the State. This also means the State essentially makes the majority of the decisions regarding the type of home it will pay for an individual to enter. Should the person requiring care wish to enter a more expensive home, they are not allowed to pay the top-up fees. Instead, a third party, such as a son or daughter, must pay the additional costs.
At a time when house prices are going through the roof and more people have assets greater than this threshold, it is anticipated most people requiring care both now and in the future will have to self-fund. While this will provide greater choice for the person requiring a care home place, the problem is how to choose the right one.
"It is important to choose a home that can provide the care you need," says Philip Spiers, partner at the Nursing Home Fees Agency.
"It is vital to look at the options and assess what suits your individual requirements, especially as this is the place that will eventually become your home."
Care homes are generally divided into those with nursing care and those without nursing staff. Individuals requiring personal care only, such as assistance with washing, dressing and feeding will find care home costs are generally less than those care homes offering nursing assistance. Some offer mixed dependency, which prevents the need to move between homes if an individual's care needs alter at any stage.
Little extras
As well as ensuring all care needs are addressed, social factors should also be considered when choosing a care home. Location, atmosphere and the type of room and social activities available should also play a significant role in influencing the decision. Does the individual want to live in the locality or community they are used to, or move closer to certain family members? Will the individual have their own room, or will they be required to share? Are the people living in the home happy and relaxed?
"It is also important to know what is and is not provided by the care home," says Chris Ellicott, technical support manager at Age Concern Financial Partnerships.
"Simple things such as whether the home provides a daily newspaper may also need to be considered. If the person requiring care has to pay for it, this is an extra cost for them. It may not amount to much on its own, but these things can mount up."
Cave agrees that individuals paying for their care home place should consider all the things they would do at home and whether these activities can be maintained.
"For people used to activities such as playing cards and doing crosswords, having an in-house activities co-ordinator is important as they will want to maintain the same level of mental stimulation as they always have done," says Cave.
Perhaps the most influential factor when choosing a care home is the cost. Table one shows the average care home costs throughout the UK. These vary greatly between different parts of the country. Typically, a care home in the South East of England, for example, will be greater than in the North. However, these figures represent the national average and costs can be much lower or significantly higher.
"Region by region there are significant variations in costs," says Ellicott. "By and large the pattern is much the same as the pattern in house prices - more expensive in the South, less so in the North. But there can also be huge differences in a local area. I found one nursing home in Tunbridge Wells at £475 a week, and another at £916 a week," says Ellicott.
There are a number of reasons for the variations in care home costs at both a local and regional level. First, property value plays a significant part in dictating the cost of a care home place. Costs are relative to the price of properties and the higher the monthly outgoings on the property itself, the higher the cost of a place in a care home is likely to be.
Room with a view
In addition to the property costs - the standard of accommodation, the facilities on offer, the quality of meals, location and even the view will also influence the price. Newer purpose-built homes with lifts and with the layout and rooms planned for convenience are likely to have cost more to purchase and equip appropriately, compared with an old converted Victorian residence. Therefore, a place in one of these homes is also likely to cost more.
One of the major factors affecting price is supply and demand. Areas where there is a higher concentration of elderly people, such as in the South of England, will find that costs are higher compared to other parts of the country where some care home places remain vacant. As a result, costs are fractionally lower in an attempt to remain competitive.
With the ageing population increasing year on year, it is likely that supply and demand will continue to remain affect care home costs throughout the UK. Especially when the number of places are continuing to dwindle. Figures from Laing & Buisson's Elderly People Market Survey 2003 showed 13,400 elderly care places were lost in the 15 months leading up to 1 April 2003. This does not bode well for the future of care home provision.
"The continuing decline in care home capacity is particularly worrying due to evidence that demand for care homes has stabilised and the prospect of increasing demand from 2005. Without new investment in care home capacity, consumer choice is threatened," says William Laing, director at Laing & Buisson.
For those approaching retirement, the financial implications of entering a care home later in life should be considered as soon as possible. While prices vary throughout the country, costs remain relatively high and are likely to continue to rise, as supply cannot meet demand. Being financially prepared is imperative.
However, other factors such as the social environment and the location of the care home are equally important and should be thoroughly examined before a final decision is made. At the end of the day, the main issue is to ensure all the individual's care needs are met.
COVER notes
• The best time to think about the financial implications of entering a care home is at retirement age.
• It is important to choose a home that can provide the care you need.
• Property costs, the standard of accommodation, available facilities and location are all influencing factors in the price of a care home place.
