Looking for new care home and already feeling despondent...

[looviloo]

Hi, just to report that I've visited another two care homes. Both are modern, bright and airy with friendly staff and a homely feel. The main difference, again, was smell. One had a faint urine smell throughout and the other didn't. I hope you don't think I'm obsessive about this (if the place is right then the odd whiff wouldn't bother me at all) but this was just what I noticed.

I did feel I was being 'sold' one of them... there was a vacant room and they wanted to do dad's assessment within a couple of days. But I had to ring back and ask them to delay it a week and they were quite sniffy, impressing upon me that the room might not be available in a weeks time. Which of course is true, but dad's name is on the list and we're not in a huge hurry.

The manager of the second home was very helpful. She's arranging a visit from a nurse in one of their sister homes to see dad so we'll have a better understanding of his needs. I liked it there but given his recent deterioration I'm worried he'd have to move again sooner rather than later.

 

[DeMartin]

My dad was in a care home owned by a major chain, he started in the dementia unit, enjoyed trips out and activities but as his physical condition deteriorated he was moved to the upper level which had a very high staff to resident ratio. I was there one lunch time and noted 1:2 ratio, each carer sitting with two residents in the dining room, plus a couple taking meals to residents rooms. He never had to move, from been a walker of the halls to being Belfast it was always the same place. He had episodes of aggression and walking into other people’s rooms, and I believe picking up oddments like watches, glasses etc, but the home coped with al
There was a branch near me when I was hunting for mum, with the same concept, they had no vacancies when I urgently needed a place, but if mum ever has to move I’ll try ther.

 

[Amethyst59]

My recommendations would be

• No nasty smells. The occasional whiff is OK and mums care home did smell of disinfectant, but I could accept that!
• Friendly homely atmosphere - this is much more important that 5 star decor
• Good cheerful staff. The caring is the most important thing.
  
• Ask the manager what sort of behaviour they would not tolerate. Unfortunately, many care homes, even the ones that say that they specialise in dementia care, will not tolerate usual dementia symptoms like wandering at night, incontinence or any sort of aggression.
• Dont worry about large gardens and nice views. Mum very seldom went into her room (she was usually in the lounge) and when she was, she didnt care about the view. Her room overlooked the car park and she actually enjoyed watching everyone come and go. I really would not have believed that before she moved there.
• Home cooked food is nice as it usually means that they can adapt to residents needs
• Dont worry that many of the residents are much further along the dementia journey than your dad. If the care home will look after them right up to the end this is to be expected; if they all seem to be about your dads level then this probably means that fairly soon your dad would be asked to leave.

I’m just re reading your list, as I’m on the hunt. And the one we are due to visit on Monday (second visit for me, first for Msrtin) ticks a lot of boxes for me. I had been put off by a couple of things, but overall I think we’ll go see. I am thinking st the moment, that it is just for a few weeks, so Martin is settled while I have a REALLY good hunt round.

 

[looviloo]

My dad was in a care home owned by a major chain, he started in the dementia unit, enjoyed trips out and activities but as his physical condition deteriorated he was moved to the upper level which had a very high staff to resident ratio. I was there one lunch time and noted 1:2 ratio, each carer sitting with two residents in the dining room, plus a couple taking meals to residents rooms. He never had to move, from been a walker of the halls to being Belfast it was always the same place. He had episodes of aggression and walking into other people’s rooms, and I believe picking up oddments like watches, glasses etc, but the home coped with al
There was a branch near me when I was hunting for mum, with the same concept, they had no vacancies when I urgently needed a place, but if mum ever has to move I’ll try ther.

Thanks . You describe the kind of place I'm looking for, and although I've found one or two so far I'm struggling to know if dad would be at the upper or lower end of what they provide. We have two care homes coming to assess dad soon so hopefully that will help. I think if he does just about manage to move to the residential side then it won't be long before he needs the more intensive care. It good that you have a place in mind for your mum, and it will hopefully take some of the stress away when/if the time comes .

I’m just re reading your list, as I’m on the hunt. And the one we are due to visit on Monday (second visit for me, first for Msrtin) ticks a lot of boxes for me. I had been put off by a couple of things, but overall I think we’ll go see. I am thinking st the moment, that it is just for a few weeks, so Martin is settled while I have a REALLY good hunt round.

The lists here have helped me too! As for the point about 'nasty smells'... I've realised that only a limited number of incontinence pads are provided on the NHS, which may be insufficient for some people. If the home (or relatives) can't supplement with extra pads then maybe the residents can't be changed as often as required. It's a horrible thought.

Good luck with your visit to a care home on Monday, and with your subsequent hunt round. I've found out they vary a lot so unfortunately there's no substitute for visiting .

 

[Amethyst59]

I’ve just been to one in our home town. Five minutes walk from me...and I love it. And I nearry didn’t go and see it at all. I am taking Martin to see it this afternoon. The one we have an appointment at on. Monday. I have two reservations about that one...maybe three actually...but none about the one we are seeing today.

 

[looviloo]

I’ve just been to one in our home town. Five minutes walk from me...and I love it. And I nearry didn’t go and see it at all. I am taking Martin to see it this afternoon. The one we have an appointment at on. Monday. I have two reservations about that one...maybe three actually...but none about the one we are seeing today.

I'm just catching up... Amethyst, has it progressed with the care home you've found that you love? So glad you found it!

Well, dad was assessed last week by one of the homes I found (EMI residential). They also have a 'sister' nursing home that belongs to the same group, but they were happy that dad would fit into the residential side for now. I like it a lot and have visited twice at different times - no smell!!! My main concern however is regards to staffing ratios. It's 1:6. The residential home that dad lives in at the moment (not EMI) is approximately 1:4. I'm worried because dad's needs are increasing and he needs help with feeding. How will they manage this? He's also a high falls risk.

I'm afraid I'm becoming even more of a worry wart, to the point where it's affecting my health. I really want this move to be the right one because to move him again would be too distressing for everyone involved. Dad's health is also declining again at the moment, so that's another concern.

Opinions on the staff ratio, please? Most of the homes I've seen during my hunt for a new (EMI) home are about 1:5 or 1:6. His current home seems to be an exception in our area, even though it's not EMI :-/.

 

[canary]

I think the thing that concerns me is where they say "they were happy that dad would fit into the residential side for now." (my bold).
I would worry that this means that you will have to move him again quite soon.

 

[Amethyst59]

Martin is in the one near to my house. So far, I’m really pleased with it. It does smell a little bit, unfortunately just as you walk in, but the rest of the home is really fresh and lovely. I can’t decide if it’s a wee or a food smell!! But...the care is so lovely and personal. Lots of local people work there.
As far as your situation goes...I don’t think a further move would be the end of the world. I think to find a home that will last from giving a quite low level of support to go through to possible violent behaviour would be impossible,to find. I’m hoping that if ever I have to move Martin, he will not be aware of his surroundings.
The staff ratios where Martin is, vary. Sometimes I seem to be tripping over staff...once, I had to hunt for someone. It doesn’t worry me, because Martin can cope if he has to. If he were more vulnerable, I’d worry more. But, to be fair, the evening I had to hunt for a member of staff, they WERE with more needy residents.

 

[Rolypoly]

Just read through this thread which has proved very interesting and informative. Sorry, I can’t offer any help as I haven’t started looking at care homes yet even though it’s at the back of my mind to do so. Like you, my mind goes blank so writing questions or points down is a good thing to do. There are just so many factors to think about and we don’t want to get it wrong because of the effect in our pwd. Maybe I’ll just see if @canary is free when I go looking!

 

[Amethyst59]

@Grannie G gave me really good advice...she said to look at care and Not decor. @nitram was amazing too, really helpful behind the scenes!!

 

[Norfolk Cherry]

I am looking now. I accidently turned up half an hour early to one home and was asked to sit in the waiting area where I was witness to the monthly residents meeting. It was very informative! By listening to their complaints and the managers responses to them, I formed a good impression of how things were approached.

 

[Sirena]

My main concern however is regards to staffing ratios. It's 1:6. The residential home that dad lives in at the moment (not EMI) is approximately 1:4. I'm worried because dad's needs are increasing and he needs help with feeding. How will they manage this? He's also a high falls risk.

Opinions on the staff ratio, please? Most of the homes I've seen during my hunt for a new (EMI) home are about 1:5 or 1:6. His current home seems to be an exception in our area, even though it's not EMI :-/.

I agree with Canary that the 'for now' is a bit concerning. What impression did you have of the other residents? Did they seem to include those at a later stage with higher care needs, or were those residents moved on?

When my mother moved to her dementia care home in February she was relatively easy care but she has since deteriorated (poor communication skills, can't use cutlery, can't wash herself, is a falls risk, and is approaching incontinence). I knew they would be able to cope with deterioration though because there are other residents who are clearly late stage and need a lot of support.

 

[love.dad.but..]

At dad's dementia NH staff ratio was 32 residents..2 nurses..6 carers plus 2 activity co ordinators each day. 1 nurse 3 carers at night. Sounds very reasonable however even with effectively 1:4 day there were times when care staff weren't very visible and most probably because a lot of residents required double handed personal care whether mobile or as quite a few were...bed bound.

I too would be concerned about the 'for now' comment. I particularly wanted to find somewhere that could take dad through to end of life and deal with his challenges at time of admission and anything likely to come.

 

[Amethyst59]

I think it was really good advice I had, to make sure there were other residents who needed much more support than my husband. That way, you know what can be coped with.

 

[Angela57]

When my dad went into his home he started off on the residential side, until his deterioration meant that he needed to be in the EMI nursing part, but he only had to move to a different room on a different floor of the building. It's far better than having to move homes in my opinion and dad didn't get stressed at all.

Ang

 

[looviloo]

I think the thing that concerns me is where they say "they were happy that dad would fit into the residential side for now." (my bold).
I would worry that this means that you will have to move him again quite soon.

I paraphrased what they said, but essentially that's what they meant. And it rang alarm bells for me too, canary. I just haven't known which way to turn recently, and since it is the nicest home I've seen so far I hoped it might be enough. But I'm having second thoughts. Many thanks for your support x

Martin is in the one near to my house. So far, I’m really pleased with it. It does smell a little bit, unfortunately just as you walk in, but the rest of the home is really fresh and lovely. I can’t decide if it’s a wee or a food smell!! But...the care is so lovely and personal. Lots of local people work there.
As far as your situation goes...I don’t think a further move would be the end of the world. I think to find a home that will last from giving a quite low level of support to go through to possible violent behaviour would be impossible,to find. I’m hoping that if ever I have to move Martin, he will not be aware of his surroundings.
The staff ratios where Martin is, vary. Sometimes I seem to be tripping over staff...once, I had to hunt for someone. It doesn’t worry me, because Martin can cope if he has to. If he were more vulnerable, I’d worry more. But, to be fair, the evening I had to hunt for a member of staff, they WERE with more needy residents.

Aww, it sounds great Amethyst, just what you and Martin need. I'm very pleased for you because I imagine it's a relief, and the care sounds lovely. As for dad he's quite far along his dementia journey and I'm afraid that yet another move in the future could actually (dare I say it) kill him. I'm actually worried that this next move might cause a terminal decline. It's so unpredictable though.

Just read through this thread which has proved very interesting and informative. Sorry, I can’t offer any help as I haven’t started looking at care homes yet even though it’s at the back of my mind to do so. Like you, my mind goes blank so writing questions or points down is a good thing to do. There are just so many factors to think about and we don’t want to get it wrong because of the effect in our pwd. Maybe I’ll just see if @canary is free when I go looking!

Yes! We all need canary with us! I did write a little list on my latest visit, and just blurted out all my questions and came across as quite emotional, which made me feel embarrassed... didn't help that the lady I was speaking to was very self-contained and matter-of-fact!

I agree with Canary that the 'for now' is a bit concerning. What impression did you have of the other residents? Did they seem to include those at a later stage with higher care needs, or were those residents moved on?

When my mother moved to her dementia care home in February she was relatively easy care but she has since deteriorated (poor communication skills, can't use cutlery, can't wash herself, is a falls risk, and is approaching incontinence). I knew they would be able to cope with deterioration though because there are other residents who are clearly late stage and need a lot of support.

I've visited the care home again last week, and have decided that they must have seen dad on a very good day, because I honestly think he would be one of the most poorly there. I told the person in charge my concerns and she is going to suggest that the manager does a second assessment (the manager is away at the moment). To be honest, I think I've decided it isn't the right place after all... I'm still very uncomfortable with the staffing ratio, and feel that the care dad gets in his current home is better. So why move him to a place where his care might be worse?!

At dad's dementia NH staff ratio was 32 residents..2 nurses..6 carers plus 2 activity co ordinators each day. 1 nurse 3 carers at night. Sounds very reasonable however even with effectively 1:4 day there were times when care staff weren't very visible and most probably because a lot of residents required double handed personal care whether mobile or as quite a few were...bed bound.

I too would be concerned about the 'for now' comment. I particularly wanted to find somewhere that could take dad through to end of life and deal with his challenges at time of admission and anything likely to come.

I've decided to look at nursing homes now, in the hope that the staffing ratio will be higher and that dad can stay there till the end of his life. Thanks for your experience, it really helps.

When my dad went into his home he started off on the residential side, until his deterioration meant that he needed to be in the EMI nursing part, but he only had to move to a different room on a different floor of the building. It's far better than having to move homes in my opinion and dad didn't get stressed at all.
Ang

This would be ideal for dad - somewhere that combined residential and nursing on the same site. We have one place a bit like this nearby but I visited and wasn't struck with it unfortunately. But maybe I need to take another look. There don't seem to be many of them around, and even places that describe themselves as nursing vary a lot in my experience.

-

Thanks everyone, for your input. I spoke to an advisor on the Dementia Helpline yesterday and she suggested that the care worker was wrong in her assessment of dad, and that he really needs somewhere that can provide nursing care. So I've gone back to square one and searched on the Alzheimers website (https://www.alzheimers.org.uk/find-support-near-you) for care homes within a 15 mile radius of me and found about 30 that provide nursing care. Half of them are rated 'inadequate' or 'requires improvement' by the CQC. And another 4 or 5 are not suitable for other reasons. Which leaves me with approximately 10 to consider. I've seen two of them already and have reservations about them, but it's a start. I have plans to see more next week.

What I find most upsetting is how complicated it all is, and how much the care homes vary even when they say they offer the same service. My own health hasn't been too good recently either, which hasn't helped. Keep your fingers crossed we find what we need very soon. And good luck to anyone else in a similar situation.

 

[Angela57]

I do hope you find a suitable home for your dad very soon. When you do, it will give you peace of mind.

Ang

 

[love.dad.but..]

No one home answers everything for everyone but decide in terms of care what your priority criteria are as you know best how your dad is and what needs he has now and likely to have although it isn't an exact science and what you can compromise on now and in the future. Make a shortlist and then read again through everyone's suggestions of what to look for and what to ask. All fingers crossed

 

[Amethyst59]

Fingers are crossed for you here in Kent too.

 

[canary]

since it is the nicest home I've seen so far I hoped it might be enough

Im not quite sure what you mean by "the nicest", but if you are thinking about it looking nice, well decorated, bright, airy etc then please try and look beyond the decor and superficial stuff. The caring is the most important aspect. The care home mum was in was really quite scruffy (I initially discounted it because of that), but the caring was wonderful, it had a nice homely atmosphere and mum was happy there.