After a stroke, some people may need support from staff 24 hours a day, and may want to consider moving to a care home.
For many people, the thought of moving into a care home could feel scary or worrying. In particular, you may worry about losing your independence. We hope the following information will reassure you and help you to make the right choice. If you need more support or someone to talk to, you can contact our Stroke Helpline on 0303 3033 100.
The information on this page can be accessed in the following formats:
- Download this information as a pdf or large print Word document.
- Order a printed copy from our shop.
- To request a braille copy, email firstname.lastname@example.org
On this page
Types of care provided
Some care homes mainly provide personal care such as help with dressing and washing. They will be more suitable for people who have some mobility and independence. These are usually referred to as residential homes.
Some homes will provide personal care and nursing care (care that needs to be carried out or supervised by a qualified nurse). In homes that provide this level of care, a nurse will be on call 24 hours a day. You may need to live in a care home that provides nursing care if you are unable to leave your bed or require regular medical attention. Some homes that are registered to provide nursing care will accept people who might need this type of care in the future. These are usually called nursing homes.
Some homes specialise in caring for people with particular medical conditions. Often, they will list several conditions which may include stroke, or physical disability and sensory impairment. People with dementia (which can happen alongside stroke) may need a home that can provide specialist dementia care. Sometimes these are called EMI (elderly mentally infirm) homes. Your age may affect your choice of where to live. Some care homes specifically provide support for younger adults.
How to find a care home
When choosing a care home it's a good idea to do plenty of research and find out as much as possible. You may want to get support from your family with the decision. With a close friend or relative, you may decide to visit each home you are considering to see what it is like first-hand before making a choice. Social services often provides a list of care homes in your area. The organisations listed at the end of this guide can also help.
Every person's situation is different. It may help if you take a list of questions with you on your visits. See the 'choosing a care home checklist' below for some questions and things to think about when deciding on a care home.
Who decides where I live?
If social services carry out an assessment and suggest you move into a care home, you can choose not to go, provided you have the ability to make the decision, known as mental capacity. If your local authority is covering all or part of your care home fees, you can have a say about the home you live in, providing your choice of care home:
- Suits your assessed needs.
- Has a place available.
- Can agree the support to be provided with your local authority.
- Costs no more than the amount the local authority would usually pay.
If you need to go into a care home but have difficulty expressing your own views, friends and family may be involved in discussions. You may find support from an independent advocacy scheme helpful. An advocate is someone who can support you, represent your interests and take action on your behalf. If you'd like to find an advocate, talking to Adult Services at your local authority may be a good place to start.
You may already have appointed someone you trust (such as a family member or close friend) to make decisions about your health and welfare or your finances by giving them power of attorney. A power of attorney is a legal agreement to allow someone to act on your behalf. A husband or wife does not automatically have the right to handle their spouse's affairs, such as a bank account. Even if you are married or in a civil partnership, you may need to give your partner power of attorney to allow them the authority to act on your behalf if necessary.
What if the care home does not have a place?
If your preferred home does not have a place, you may need to go on a waiting list. While you wait, you may need to go into another home or arrange for services in your own home. Any temporary care home should still meet your needs. The local authority should explain how the waiting list works and keep you informed of any progress.
What if I want to live in a different area?
If you pay for your care home place yourself, you can decide where you live. Otherwise, if you wish to live in a care home in another area of the country, the responsibility for paying for your accommodation will remain with the local authority where you currently live.
Paying for care
How much will I pay for a care home?
The cost of a place in a care home tends to vary from one area to another and will be affected by the facilities, support and level of care offered. Most people have to contribute towards their fees.
In Scotland, the social work department will automatically contribute to part of your care home fees if you are over 65 and their assessment shows you need personal care (or both personal and nursing care). If you are under 65, they will pay towards the fees if you have been assessed as needing nursing care. They will then carry out a financial assessment to see how much you can afford to pay towards any remaining costs.
In the rest of the UK, your local council will carry out a financial assessment to decide if you should contribute and if so, how much. All local councils should follow the government's rules set out in the Care Act 2014 when deciding how much you will need to pay.
What does a financial assessment involve?
A social worker or care manager usually carries out the financial assessment after your health and social care needs have been reviewed. They will look at your ability to pay for your care, taking into account your income, savings, property, any benefits you receive, and any financial assets you have such as stocks or shares. There are rules about what will be counted in the assessment and some income will be disregarded. The social worker will usually ask to look at financial documents, such as bank statements, records of savings, or details of pension schemes. They will ask about your outgoings, such as how much you pay for your mortgage, rent, insurance or bills. You can ask questions and have someone else there to help you.
Unless you are able to cover the whole cost of a care home yourself, the council will tell you how much they can pay per week for a home that meets your assessed needs. They should also give you a list of homes in your local area which can meet your needs.
If the council is covering the entire cost and there are no places in a suitable care home at the right price, the council should increase the amount they will pay.
Even if you are going to pay your own fees, it is a good idea to have an assessment. Social services can advise you of the costs so you can plan for these.
Will I have to sell my home?
You will not necessarily have to sell your home to pay for a care home. If you are only staying in a care home for a temporary period, the value of your home will be ignored. Different councils work out the cost of temporary stays differently.
The value of your home will not be taken into account if one of the following people is going to continue living in your house:
- Your husband, wife, civil partner or other partner you live with.
- A relative who is 60 or over, or a younger relative who is eligible to claim disability benefits.
- A child (under 16) whose welfare you are responsible for.
- An ex-partner if they are a single parent.
If you need the funds from the sale of your home to pay for your care, the council will pay for your care home fees for up to 12 weeks while the sale goes through. You will not be expected to pay this money back to the council.
It may be possible to defer payment of your fees until after your death, when the council will be able to recover the money from your estate. Contact your local authority to find out if you are eligible.
As it can be a very complex process to arrange funding for a care home, it is a good idea to seek individual advice and support. Organisations such as Independent Age offer information and a helpline, and Age UK can provide detailed information about care home costs.
What if I want to live in a more expensive care home?
If your chosen care home costs more per week than the council is willing to pay, in some areas a family member or friend can choose to enter a contract to pay the difference. This is called a 'third-party top-up'. You are not normally allowed to pay the top-up fees yourself. The main exceptions include if you have a deferred payment arrangement with the council, or you are in a 12-week property disregard period.
What about my partner's money and assets?
The financial assessment only looks at the assets of the person who needs care. But if you share assets such as savings or shares, you'll each be assumed to own 50%. For example, if you have a joint bank account with your partner, half of the balance will be considered your capital. Jointly owned property is treated differently because it is usually unlikely that someone would buy just your share. There are rules to stop you moving money out of your home to purposely avoid it being included in a financial assessment.
Paying for nursing care
If you are eligible for NHS continuing healthcare, the NHS will fund the full costs of your care.
If you are not eligible for NHS continuing healthcare but you have nursing care needs, you may be eligible for free nursing care. This means that the NHS will make a payment to the care home to cover the nursing care costs.
If you move into a care home permanently and you are completely self-funding, you may still be able to claim benefits such as Attendance Allowance. The council will expect you to do this if they are paying for your care. For more information about what you may be able to claim, visit our benefits and financial assistance webpage.
How are care homes regulated?
There are independent regulators to make sure care homes meet set standards. Social care services, including care homes, are regulated by:
- The Care Quality Commission (CQC) in England.
- The Regulation and Quality Improvement Authority (RQIA) in Northern Ireland.
- The Care Inspectorate in Scotland.
- The Care Inspectorate in Wales.
These bodies produce inspection reports on homes that you can read. These will tell you how the home you are considering was rated in terms of quality, what residents say about it and whether there are any areas for improvement.
If services are not meeting standards, regulators can issue notices requiring them to make changes within a set period of time, issue penalties and restrict the services they can offer.
How do I make a complaint about a care home?
If you have any concerns or are not happy about your care or treatment in a care home, it can help to initially raise your concerns with a member of staff in the care home. A friend or relative could do this on your behalf. You should never be disadvantaged because of any concerns you or someone you know has raised.
All social care providers are required by law to have a complaints procedure and all residents should be provided with information explaining how they can make a complaint. If you are not given this information you can ask for it. If you make a complaint following this procedure and you are not happy with the response, you can contact your local council, if they are funding your care.
If you are still not happy after this or if you fund your own care, you can contact the Local Government Ombudsman. This is an independent body that can review complaints. If the NHS is funding your care you will have access to their complaints procedure.
Choosing a care home checklist
You could take this list of questions with you when you visit a home. You can download the checklist and print a copy.
Location - Where is the home? You might feel happier moving somewhere near to your friends and family. However, narrowing your search to a very limited area can mean you don't have much choice.
Accommodation - What is the accommodation like? Are the rooms shared or single? What facilities are available? Your room should include a lockable place to put personal items like money.
Fees - How much does it cost? What is the weekly fee? How often does the home increase its fees and will you be able to afford any increases? How much do you pay if you go into hospital or away on holiday? Do they charge for extras, such as a TV in your room?
Care - What care provision is offered? If you need more care in the future, will the home be able to meet your needs?
Cleanliness - What about hygiene? Does the home smell clean and fresh?
Belongings - Are you allowed to bring personal possessions or furniture with you?
Privacy - Are residents given privacy? For example, do staff knock before entering rooms?
Access - How accessible is it? If you use a wheelchair, are door frames and corridors wide enough? Are there ramps and lifts?
Equipment - Is appropriate equipment provided such as handrails and adjustable beds?
Comfort - Is it a place where you will feel comfortable and safe?
Diet - What kind of food is provided? Are meal times fixed and if so, what are the times? Can residents prepare their own food? Does the home cater for special diets?
Shared space - Look at the living areas. Are there areas where residents can socialise, sit quietly, see visitors, or sit outside?
Activities - What kinds of activities can residents take part in? Are books and newspapers available? Are outings arranged? Will you be able to continue a current hobby? Can residents go out alone, for example to the shops or to a stroke club? Do they get involved with the local community?
Beliefs - Can your religious beliefs or cultural needs be accommodated? Some homes have a place of worship. Are staff interested in learning about your background and culture? Can they speak your language?
Atmosphere - Is there a positive atmosphere you would feel comfortable in? Watch and talk to the residents and staff to see how friendly and happy they are.
Support - Will you get personalised support? Does the home pay attention to each resident's individual needs or expect all residents to follow a certain routine?
Independence - Is maintaining as much independence as possible encouraged? Do staff support residents to do things for themselves?
Visitors - What are the visiting hours? Can your family and friends join you for a meal or stay overnight?
Staff - Are staff friendly and supportive? Do they treat residents with respect? Do they spend time talking to residents? What is the staff to resident ratio?
Stroke knowledge - Do they understand the effects of stroke? What qualifications and level of training do they have?
Communication support - Do you have difficulty with communication? Do the staff understand this and know how to support you? Do they have the skills to support you with any hidden effects of your stroke, such as personality changes, memory problems and tiredness? Access to GP - Which health services are available? What happens if a resident is unwell? What doctors can they see? Who administers medicine?
Community Services - What about community services? Do community physiotherapists, speech therapists and occupational therapists visit? How do residents access other services such as chiropodists or dentists
Decision making - How are decisions made? Is there a residents' association to give people a say about things that affect them?
Information - What information is available? All care homes are required to produce a 'statement of purpose'. This document tells you about the home's aims and objectives and the services they provide.
Trial stays - Do they offer trial stays? Find out if you can have a trial stay to decide if the home is right for you.
Complaints - What is the complaints procedure?
Pets - Can you take your pet with you? Some care homes do not allow pets, so you may need a relative to take over their care. Alternatively, the Cinnamon Trust is a charity that can provide long-term care for a pet when their owner has had to go into a care home that cannot accommodate pets.