Home Care v Care Home: What’s the Right Option for You?

Are you approaching a time where you need to make a decision about the kind of care you’ll need, and where you want to receive it?

Many people find it very difficult to choose whether to go into a care home or receive care in the home, and that’s because there’s an awful lot to consider from a financial, practical and emotional perspective.

It’s likely that neither a care home or receiving care in your home is going to be an entirely perfect solution, but aim to be as objective as you possibly can be and think about which option provides you with the highest quality of care at the best possible price by weighing up the pros and cons below.

A care home

A care home is a place where you will be able to live on a full-time basis. Often, your partner can live there too, and you’ll have all your needs met by a team of trained staff.

There are two main types of care home: the first is a home that provides nursing care and assistance with personal care. The second is a home that provides nursing care with registered nurses and experienced care assistants.

The option you choose will largely depend on the level of support and assistance you require, and the amount of money you have to pay for your residency in the home. On average, a residential care home can cost around £28,500 a year, or as much as £37,500 if nursing is required.

There are lots of good things about going into a care home, such as having trained staff on hand at all times, not needing to worry about chores or maintaining a house, as well as having company and lots of opportunism for social interaction. However, there are some downsides too, such as losing some of your independence and needing to move all your belongings into a room. You can read more about the pros and cons of moving into a care home here, as well as the pros and cons of receiving care in your home too.


Home care

Home care means that you’ll continue to live in your home (or a family member’s home), supported by registered care workers who visit you regularly to help with your personal care, meal preparation, personal care and other tasks. For instance, some care packages will include cleaning, chores, ‘meals on wheels’ and anything else you’d like to do yourself but may need support with.

Carers will cost around £15 an hour, so expect to pay £11,000 a year for carers to assist you for 14 hours a week, or as much as £30,000 a year if you’d like a carer to help you full-time during the day.

The best thing about home care is that you’ll be able to stay in your home and retain some of your independence. You’ll also be able to continue a way of life that feels familiar to you, and you’ll be in full control of the level and frequency of care you receive.

However, there are also some downsides too. The first downside is that you’re still at risk if you remain in your own home (despite alarm systems and regular visits from carers), and you may not be getting the full level of support you really need without even realising it. Another big concern is that you may suffer with loneliness and isolation – something that’s a challenge for many elderly people at the moment. You may also need to make modifications to your home in order for you continue living there, which can be an expensive and stressful undertaking.

Other things you should consider

As well as the financial implications and the pros and cons of each option, here are a few other things you should consider:

Are younger family members willing and able to provide any level of care if you were to stay in your home?

  • How do you feel about coping through the night if you can only afford to pay for a carer to visit you in your home throughout the day?
  • Would you enjoy making friends with staff and other residents in a care home?
  • Do you already suffer with loneliness and isolation?
  • How do your partner’s needs fit with your own? Can you find a solution that best serves you both?

What’s the right option for you?

Carefully weigh up the pros and cons of each and see which option appears to be the best choice for you. While you may be determined to stay in your home and retain your independence, or are fixed on the idea of moving into a home, try to be objective: evaluate if the arrangement is really working for you, and be prepared to change your plans if your health or financial situation suddenly changes too.

Growing numbers of NHS patients waiting too long for A&E and cancer treatment

A series of crucial targets were missed in November including waiting time for urgent cancer treatment and ambulances

Denis Campbell and Haroon Siddique writing for The Guardian (14/01/2016):
Growing numbers of patients are waiting longer than they should for A&E care, urgent cancer treatment or a blue light ambulance, prompting warnings that the NHS will struggle to cope this winter.

The latest NHS performance data shows it missed a whole series of key waiting-time targets in November, forcing around 200,000 patients to endure delays.

Experts said the figures were “particularly worrying” and that hospitals missing targets is now so routine that it has “become the norm” in the NHS.

There is concern that, with performance so poor despite mild weather and little flu around so far, hospitals may struggle if a blast of really cold weather brings an influx of seriously ill patients, many of whom need to be admitted at a time when beds are already scarce.

“These new figures are particularly worrying given that they only cover November, when the weather was exceptionally mild and winter had not even begun properly,” said Nigel Edwards, chief executive of the Nuffield Trust, a leading health thinktank. “The fact that there have been such dips in performance so early in the season does not leave the health service in a good position to cope with the rest of winter.”


In all, 157,101 people waited more than four hours to be treated in hospital A&E units that month, which meant the NHS only treated 87.1% of such patients within that time – well below its target of 95%. That is more than three times the 45,838 who waited more than four hours in the same month in 2010.

Similarly, 34,057 patients were stuck on a trolley for more than four hours in A&E in November as they waited for a hospital bed – almost five times higher than the equivalent figure back in 2010. However, only 32 waited more than 12 hours.

November also saw the largest ever number of patients occupying a hospital bed despite being fit to leave – 3,671. The NHS lost a total of 100,515 hospital bed days because of such patients – what it calls delayed transfers of care – almost double the number recorded in 2010. Of those, 26,794 were because the patient was waiting for their local council to arrange a package of care to allow them to be discharged safely.

“The issue of delayed transfers is fast becoming the biggest problem many NHS trusts are facing,” said Edwards.

In another sign of serious strain on the NHS, more than 3.5 million patients are now waiting for a planned operation in England – the highest number since 2008.

Some 7,664 people with suspected cancer did not see a consultant within two weeks of an urgent referral by their GP, as they should have, though overall the NHS met its 93% target on that measure.

Similarly, 536 patients had to wait more than the one month expected to have their first treatment for cancer. Again, though, hospitals met the target overall, treating 97.7% of patients (23,420) on time.

But the NHS failed to treat 85% of cancer patients within two months of being referred by their GP, scoring 83.5%. That meant that 1,926 people had to wait longer than they should have, although 11,643 were treated on time.

Labour said the figures proved that “the NHS has gone backwards” under the health secretary, Jeremy Hunt. Heidi Alexander, Labour’s health spokesman, said: “There is a crisis in A&E, elderly patients are stuck in hospital because of a lack of care in the community and thousands of people are waiting more than 18 weeks for operations. The reality is that this dramatic deterioration in patient care is a direct consequence of this government’s policies. They cut older people’s care in the home, meaning hospitals have become dangerously full, and cuts to nurse training places have forced hospitals to drain resources hiring expensive agency staff.”

Dr Jennifer Dixon, chief executive of the Health Foundation thinktank, said: “These latest figures from November show health services are struggling to deliver the basics, even before colder weather and any upsurge in flu.”

Richard Barker, NHS England’s interim national director of commissioning operations, stressed that frontline staff had treated record numbers of patients in November. Year-on-year demand has gone up 6.8% for diagnostic tests such as CT and MRI scans and 4.1% for consultant-led treatment while emergency admissions are also up by 1.9%, putting even greater pressure on the availability of beds.

The NHS knows it needs to do more to improve its record on cancer treatment waiting times, NHS England said.

“Bluntly – Our NHS is irreparable and Social Care is becoming so”