What standard should a commissioned care home be working to?

Let's start by explaining what a commissioned care home is before we go any further. This is a care home which the local authority use to provide care for elderly and vulnerable individuals who cannot afford to meet the cost of their care privately. These are circumstances where an individual has less than £23,250 and probably less than £14,250 of capital savings and are reliant on their state pension, pension credit or a very small private pension. The cost of the care is paid for by the local authority direct to the care home and no payment to a care home is required by the recipient of the care.


When an individual is referred to the social services department of a local authority they must first have a needs assessment. Once a care home need has been identified a financial assessment is undertaken to assess contribution towards care charges. If someone falls within the categories above the local authority will then commission a care home provider to meet the needs of that individual. The purpose of the commissioned service is to provide accommodation, care support and stimulation for those, for whatever reason, for whom it is no longer appropriate to live in their homes whether it be for the short or long term.


Aside from living up to the criteria established by the local authority commissioning the care the home must be compliant with Care Quality Commission standards.


The Care Act 2014 sets out key principles, including promoting individual well-being and preventing needs for care and support which local authorities must consider when making care decisions and these are to be implemented by the homes used to provide the service.


All homes are required to complete and maintain a care and support plan which documents their needs and wants and health related issues. An individual must be allowed to maintain and maximise their ability and potential in respect of physical, spiritual, intellectual, emotional and social ability. Most importantly individuals are entitled to receive care and respect whilst in the care home.


Each home must provide a resident with a single room (unless specifically requested otherwise) access to a toilet and washing facilities preferably in their room (but not necessarily), personal care, medical support, supervision, stimulation and food!


Any request to move into a commissioned care home must involve an admissions assessment by the care home seeking to house the individual needing care. A move into a commissioned home cannot take place without such an assessment. If the move is to be directly from hospital must include an admissions assessment within 48 hours with the home advising the local authority within a further 48 hours if the placement can continue.


Help must be given to the resident to continue with activities and social interaction. This does not have to be confined to the care home but can be outside the home. It goes without saying the care home must be a safe and clean environment for those living in the home. this includes cleaning of the home, laundry services, bed making, hazard identification and making sure equipment is maintained and regularly services. A full kitchen service must be provided with three meals a day and access to food outside of mealtimes. Meals should have nutritional value and be appropriate for the individual eating them, taking into account allergies, culture and preferences. Records must be kept of how residents' money is managed and safeguarding put in place to prevent abuse. Staff must be suitably trained to look after the individuals in the home and training must be maintained but most of all they must treat the individual with dignity and respect throughout their stay and particularly when end of life care is required.


A care home commissioned by the local authority should not be providing services at a different level to a home which is privately funded. If you are told your family requires care charges to be met by the local authority you are allowed to visit the homes they are recommending and make observations and reports to the local authority. Do not be pressured into taking a home because you are told that this is the only one available or the hospital bed is required. That is not how you would book a hotel, let alone pick your home for the future. There is no rush!



Remember, when thinking about suitability you need to consider whether the home is a home which is caring, kind and comforting. It is the care which is important. It doesn't matter whether the home is in pristine condition with new everything and gleaming. It doesn't mean the care they provide is good.


Check the care home website, check the Care Quality Commission reports, speak to the residents, speak to their families, visit at tea time and see how you are welcomed. Would you want to live in that home? If the answer is yes, then you have found the right place!

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