Residential / Nursing care

Choosing a residential or nursing Home

Residential care homes aim to provide the care and attention you would receive at home from a caring relative. Residential home staff help with personal care, such as getting up, washing, dressing and going to the toilet. Each residential home generally offers care to people with a similar condition or problem such as those with a physical disability, a learning disability, mental health problems, or to older people with physical disabilities or mental health problems. Meals are provided and there are often outings and other activities. Residential homes do not, however, provide care for people who require nursing support.

Nursing homes also offer care to people with a similar condition or problem but specialise in providing nursing care for persons suffering from sickness, injury or infirmity - the kind of care that requires the skills of a qualified nurse. Nursing homes are required by law to have a qualified nurse on duty 24 hours a day.

Care homes registered as both residential and nursing homes are known as 'dual registration'. Some people may choose such a home so that if their condition deteriorates they do not need to change homes.

This also enables a couple with differing needs to stay together in the same home. Both residential and nursing care homes are registered and inspected by the Care Quality Commission (CQC) who can provide you with their inspection reports.

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Care Quality Commission offices are:

CQC South West
Newcastle Upon Tyne
Telephone 03000 616161

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What to look for in a care home

You need to be sure that the home meets all your needs and will be somewhere that you will enjoy living. Think very carefully about what you require. Questions you may wish to ask could include ...

  • What personal possessions can I bring to the home?
  • Are special diets catered for?
  • What about meal times?
  • What about social activities and outings?
  • Can I have family and friends to stay?
  • What about medical support?
  • What about religious worship?
  • Are residents encouraged to use local community facilities or services?

This list is not comprehensive, you must ask questions about what is important for you. Read our Factsheet 10a - Is a care home right for me? image - PDF icon (84KB - pdf help) for more information.

All homes should have a brochure, ask the home for a copy and read it carefully.

Help from Adult & Community Services

Moving into a care home is a big life change. It is important that you feel that it is the right thing to do. Adult & Community Services can help you choose the right home by giving you lists of homes in Devon and advice on the admission process.

Whether you intend to pay your own home fees, or you think that you may require financial support from Adult & Community Services - please note that you must meet our eligibility criteria for support. Please see  Social Care for Adults Explained (Leaflet 1) and contact us before choosing a home.

If you need help with paying fees for the home, and we agree that a care home place is best for you, you have a legal right to choose any home provided that:

  • a place is available
  • we agree that the home is suitable for your care needs
  • we can agree a contract with the owner of the home
  • the home does not cost more than we usually pay for the care you need, or if it does, someone can pay the difference.

Adult & Community Services staff can help you choose a residential or nursing home. They will help you complete the contract for your admission. However, you may have to wait until we can agree your choice of home. If this happens, we will ensure that you are looked after until we can do so.

Also read our Factsheet 10b - Choosing a care home - what should I ask? image - PDF icon (84KB - pdf help) for more information.

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How much will my stay cost?

The weekly charge for your accommodation will be determined by an assessment based on the financial details you gave to your care manager. Adult & Community Services will decide how much you have to pay by carrying out a financial assessment that is based on rules agreed by government. If you are going to live in a nursing home some of the costs may be met by the NHS.

Funded Nursing Home Care

Please note that people who need care in a nursing home can have the costs of the Registered Nurse input to their care met by the National Health Service (NHS). If Adult & Community Services are helping to pay your fees, we will arrange for an NHS nursing assessment to take place. If you are going to pay your own fees, you should ask for an assessment of your nursing needs. Information on how to do this is contained in the leaflet on NHS Funded Nursing Care in Nursing Homes.

Sometimes, the exact amount you are required to pay is still being worked out (or assessed) when you move into the home. Your care manager will explain what happens in this situation.

Please note that the value of your house (the one that you were occupying before your admission to residential care) will be excluded from the financial assessment for up to the first 12 weeks of your stay.

If you have less than the capital threshold set by the government, including the value of your home [see Charges and Benefits] you may be entitled to government help and should apply for Income Support. Your Care Manager can tell you how to apply.

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Payment arrangements

If you have adequate funds you may go into the home as a self-funding private client, you are still advised to seek advice. You may also enter the home on aa Adult & Community Services contract.

How to pay?

There are two ways that you can pay for residential or nursing home care. The usual way is to pay Adult & Community Services who will bill you every four weeks or you can pay by Direct Debit. If you prefer, and the home agrees, you can pay the home directly every week.

Topping-up payments

Someone such as a friend, relative (other than husband or wife) or charity can top-up your care home fees to enable you to stay in a home that is more expensive than we would consider reasonable. Unfortunately you are not allowed to top-up your care home fees from your own capital, unless you are subject to a 12 week property disregard or you have a Deferred Payment Agreement. For more information about Deferred Payments, talk to your Care Manager.

When someone agrees to top-up fees, they become responsible for these payments. If they stop for any reason then you may have to move to a less expensive home (unless the home agrees to accept less or someone else agrees to pay). If you have to move to another home, we will give you as much support as possible.

See Factsheet 2b - Charges for Residential and Nursing Care image - PDF icon (87KB - pdf help) for more information.

Paying for extras and your personal expense allowance

Your fee covers accommodation, heating, lighting, food and all your basic requirements. Your personal expense allowance is for spending on daily items such as toiletries, clothes, birthday presents, leisure activities and outings.

If you are in doubt about whether an item is covered by the weekly fees, and you are not happy with the answer you get in the home, please contact your care manager.

If you do not receive the personal expense allowance directly, then the person receiving it on your behalf must keep a full record of the money paid.

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Privately funded residents

If you have in excess of the capital threshold in assets (including money in the bank, building society, pensions, shares, insurance policies and the value of your house in most cases), you will have to pay the full cost of your stay in the home, except for the costs of Registered Nursing Care agreed by the NHS.

It is important to take professional advice, as there are various types of insurance schemes available to help you pay for your stay in the care home. These organisations will also help ensure you receive all your entitlements to any state benefits.

Useful contacts:

or ask your own professional adviser, or check in the Yellow Pages.