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What is the difference between council-owned care homes and privately owned care homes?

There remains a small number of local authority owned and run care homes alongside the much larger private care home sector. Families facing the challenge of finding the right care often ask what is the difference between the two and what are their relative advantages and disadvantages.

Some of the families we speak to have a perception that council-owned homes will be more closely regulated and therefore better run. While it may be true that homes within local authority ownership are governed by a greater number of rules and regulations, this does not necessarily equate to the home being better run for the residents.

Privately run homes are also regulated, facing inspections from the Care Quality Commission. At least as importantly, the owner of a small, privately-run care home will have a great personal stake in the quality and reputation of their business and this will serve to regulate standards

Of course, perceptions about the differences between private and council-owned will vary according to your personal experience. Some people will see private as a better and more aspirational care option than local authority. It is not possible to apply a broad distinction – some private homes will provide good care at a lower cost and a homely, ‘down-to-earth’ ethos. Major private homes groups, by contrast, do market themselves along the same lines as private healthcare, with an emphasis upon the quality of the facilities and types of activities offered. This will suit some people, but it is very worthwhile asking about staff to resident ratios and use of agency nursing staff in all homes ‘ including the higher end facilities.

There is also the issue of the longer term viability of homes, a concern which applies to both council owned and privately owned homes. During the past decade, councils across the UK have embarked on a widespread programme of care home closures. The rationale behind this has been efficiency – it is simply much cheaper for a local authority to pay a private care home to provide care than to provide that care themselves in a council run home. So if you are considering a council run care home for your family member, you are entitled to ask your local authority for assurance about the long term viability of that home.

Of course, the long term viability of a care home is not guaranteed within the private sector either, as the Southern Cross example has shown so emphatically. However, one of the best markers for the long term future of a care home is its reputation; the reputation not only conveyed through the regulatory mechanics of inspections and reports, but also the reputation known to people working in the area, such as Carehome Selection advisers.

They will have found people places in all the good homes and followed up placements with contact for months, sometimes years after that. Like a parent who has already been through your local school system, they know the reality behind glossy brochures and guided tours; understanding the ethos and values of each home.

For those going into privately run care homes with part or full local authority funding, there is another check in place. Your local authority Social Workers who manage placements and funding of people within care homes are regularly in touch with the homes and will become aware of any complaints or issues that are raised. They will place a ‘hold’ on any further placements there until the issues are resolved. This is a sanction which is still applied when required.

But what about self-funders? They are outside this system and so would not ordinarily have any means of accessing this important information – that a home they are considering is not able to take local authority funded placements because of an ongoing issue. This does place self-funders – already disadvantaged by lack of support – at a real disadvantage. Because Carehome Selection works so closely with many local authorities and hospitals, we generally know when there are issues regarding a particular home and can share this knowledge with self-funders.

Looking ahead to the future, it is likely that there will be further closures of council run care homes. Local authorities are now concentrating upon specialist care, such as homes for people with dementia. But even these homes normally provide interim care, before a permanent placement within the private sector is found.

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