As we grow older, we may naturally reach a point at which we, or our loved ones, can no longer fully support ourselves without additional help. At such a time, a difficult decision is faced regarding the best and most appropriate way to obtain the care needed in order to maintain a desirable quality of life.
Research by the charity Age UK reveals that the majority of people wish to remain in their own homes, living independently for as long as possible, yet many people still regard relocation to a residential nursing or care home as the only option for full time care in later years. Moving to the often unsettling and unfamiliar surroundings of a residential care home can be upsetting, depressing and even frightening.
Making care choices in a crisis
Unfortunately, many people purchase care in a crisis, brought about by a major change in their lives such as:
- Death of a spouse
- Change in circumstances of family carer
- Deterioration in health (progressive conditions, frailty)
- Acute incident/accident or hospital admission (fracture, stroke)
- Respite care to relieve a family care giver
- Re-ablement/Rehabilitation to aid recovery following acute event
However the problems of making a decision in a crisis is that such decisions are invariably hurried with little or no time allowed to review the various options available. There are issues around the personal wishes of the individual, their capacity to make a decision and whether such a decision is actually in their best interest. The consequences of getting it wrong can be long reaching and time consuming to change.
Other alternatives to care homes; Live-in Care
One care options, which is often not considered when care is needed, is live in care. There are, in fact, many benefits of staying in your own home with a live-in carer, such as:
- The ability to stay in your own home. It is often said that home is where the heart is, surrounded by our memories, belongings, beloved pets or gardens, and treasured possessions, relationships and community ties. This can be very beneficial as we age.
- One to one care, something more difficult to achieve in institutional settings, with personalised care
- Retaining independence and staying in control of your own personal lifestyle
- Avoiding a traumatic move at a time in life when change can be unsettling
- Couples can stay together as loving partners
- Continued participation in local activities, clubs and events
- Maintaining assets and capital appreciation
How to choose a good homecare provider
With live-in care at home, there are also many questions to ask as the standard and quality can vary greatly from company to company:
Fully managed service or introductions agency?
Some live-in care providers offer a fully managed service. They employ the carers and take full accountability for the service provided. There should be a care manager, regular reviews, an accessible complaints procedure and a quality assurance process.
Other live in care providers operate as an introductions agency. They introduce clients and carers, but do not manage the service. Instead, they take a commission and the client pays and manages the carer directly. There is no requirement to conduct background checks, provide training or undertake regular reviews. The client must manage any concerns they have with the carer directly.
Regulated or not?
All care providers are regulated and must be registered with the Care Quality Commission in England, the Care Inspectorate in Scotland and the Care and Social Services Inspectorate in Wales. However, care agencies that do not employ their staff, or offer a managed service, are not regulated. This means that these agencies are not externally regulated and do not have to meet the same quality standards. You can easily find out whether a provider is registered with the regulator by using the CQC, CI or CSSIW websites. If they are regulated, you can also access their latest inspection report.
Recruitment and training
- How does the provider recruit staff?
- What checks do they undertake?
- Do they interview all staff beforehand and how to they validate their skills and experience?
- How do they match carers with clients?
- What training does the care provider offer its staff?
- Does the care provider have the internal expertise needed to deliver specialist or complex care?
Unregulated agencies, who do not employ their staff, are not able to offer training. Even amongst regulated agencies, training standards can vary. All registered care providers should provide regular opportunities for learning and development for staff and should ensure that their workforce has the skills, knowledge and experience to deliver the service required.
Quality assurance and expertise
Home care involves carers working alone with vulnerable people. This comes with risks and any reputable care provider will have a rigorous quality assurance and risk management strategy in place.
- How does the provider monitor quality?
- What is the complaints policy?
- How often do they visit the clients and are these visits sometimes unannounced?
- What approach do they take to the handling of clients’ finances, for example if shopping is required?
- How well are staff trained, supervised and developed?
- Are they registered with external kite-mark organisations such as the UK Home Care Association?
- There are a number of industry quality awards and accolade programmes – is the provider an award winner?
Carer continuity, engagement and retention
Live in care is a demanding role for anyone and avoiding carer burn-out is critical for both safety and to ensure consistency of carer.
- What are the staff turnover rates and how does the care provider seek to retain good carers?
- What rota patterns does the provider operate and how are carer breaks handled?
- How does the provider look after its staff, ensuring that they feel valued for what they do?
- A motivated and engaged workforce is more likely to provide a high quality service and to stay with the client for the long term.
Number of carers
How a live in care package is staffed can vary from one provider to the next. Some providers will identify one live in carer who will remain in the house indefinitely until they choose to move on. This tends to occur more with agency models. Other providers may operate a rota where each carer works for a set period of time, for example 6 weeks, and then another carer will be provided to replace them at that point. The third option is that a team of two dedicated carers are identified from the outset, who will provide cover working shifts opposite one another. Having a sustainable staffing solution in place is very important if you are to ensure the long term continuity of the carers working with you.
In summary, whether considering residential or care at home, people should be encouraged to plan ahead as making informed choices early can reduce stress and improve outcomes later.
The Good Care Group is a national provider of professional, multi-award winning 24 hour live-in care services for people allowing them to continue to live safely and happily in their own home, maintaining dignity and independence, with tailored support as required. In addition to general care and support, they also have specialist services for complex conditions such as Dementia, Parkinson’s, MS and Stroke rehabilitation. As well as providing permanent care placements, The Good Care Group can also offer periods of short term respite care following hospital discharge, an emergency or if your primary family carer needs to take a break or holiday.