Choosing a care home as an attorney

The order to do it in

1. Ask the local authority for a needs assessment, and a carer's assessment if relevant.
2. Explore care at home first — the least restrictive option is part of the legal test.
3. Get a financial assessment; the money and the care decision are separate but linked.
4. Visit shortlisted homes, and take the donor if at all possible.
5. Record your decision, your reasons and who you consulted.

Best interests in practice

• Consider the donor's past wishes, religion, culture, language and relationships.
• Proximity to the people who visit usually matters more than the décor.
• Check the CQC report and ask about staff turnover.
• A trial period is a legitimate way to test a decision.

A worked example

Consider Sheila, whose son David is her registered health and welfare attorney. After a needs assessment confirms Sheila can no longer be safely supported at home, David shortlists three homes within easy travelling distance of the family, checks each one's latest CQC report, and visits twice — once announced, once not. He takes Sheila to see his preferred choice on a good afternoon, and although she cannot express a reasoned preference, she visibly relaxes in the garden there rather than the day room at the alternative. David records that observation, along with the CQC ratings and the staff turnover figures he was given, as the reasoning behind his best-interests decision. That written note is exactly what protects him if anyone later questions the choice.

If the family disagrees

Siblings often disagree about the right home, sometimes because they are weighing convenience for themselves rather than the donor's interests, and sometimes for entirely legitimate reasons. As attorney, you are required to consult family who take an interest, but the decision, and the responsibility for it, is legally yours if you are the sole or lead health and welfare attorney. Keeping a written record of who you spoke to and what they said protects you if a disagreement escalates later.

Paying for the place you choose

Choosing the home and paying for it are legally separate acts, carried out under different forms of LPA. Once you and the property and financial affairs attorney have agreed on a home, that attorney arranges the financial assessment, checks for any local authority contribution, and manages the ongoing fees — see LPA and care home fees for how that side of the process works, and ask whether an NHS Continuing Healthcare assessment should happen before you commit to a placement, since continuing healthcare can fund the whole package where the donor is eligible.

Common questions

Read next

• What can a health and welfare attorney actually decide?
• LPAs and care home fees
• NHS Continuing Healthcare and your LPA