Questions to ask a prospective care home

[Gem101]

Hi
I visited a couple of nursing homes today and have one I feel may be suitable for my aunt. Obviously I was being shown round and taking in the usual we do this / that. Although the reviews of the home are good the cqc rating is RI from 12 months ago.
I'm planning to go back tomorrow morning for a second look round but has anyone got any experience of what things I should ask to get a better idea.
I'm being pushed to make a decision as otherwise we may end up with an interim bed place and having to move her again.

 

[Beate]

I thought there was a factsheet for selecting a care home somewhere but I can't find it so maybe I dreamt it.

The important thing is not to be blinded by five star hotel places with sensory gardens etc - if your loved one needs nursing care they usually won't appreciate them anyway. If the place exudes a homely feeling with friendly staff and no urine smells, it doesn't matter how threadbare the carpet is.

I don't know your aunt but I would ask about staff ratio and also which behaviour they would not tolerate. Some places say they are dementia friendly but in reality only take "well-behaved" clients.

What is the deal with sudden hospital admissions - would someone from the home accompany her if you couldn't? Most places don't offer that or charge extra.

If she is self-funded it might be prudent to ask what will happen once the money runs out - would she be allowed to stay being LA-funded? Some places only take privately funded people. Don't get pushed into paying a top-up of any kind - you can't be forced.

 

[karaokePete]

Here's a link to the Booklet to which @Beate made reference. Just click the 2nd line to read and/or print it

Selecting and moving into a care home (690)
PDF printable version

 

[Sirena]

I would base the questions around a conversation about your relative's needs - explain what behaviours she exhibits and what her needs are, ask how they would deal with it. See if you like the answers. I am not sure how useful it is to ask about staff ratios. What really matters is how staff interact with the residents and how effectively they spend their time. If there is no smell of wee, the residents look content (within reason), and you have a 'good feeling' about the place that also counts for a lot.

 

[ChocolateBrownie]

Personally, I think staff ratios are important - especially if PWD also needs 2 people for transfers - it makes a big difference how long they have to wait for attention.

 

[Beate]

Plus the answers can be quite revealing. In one care home they wouldn't tell me, just kept repeating that they are within the legal requirements or something. Basically, as little staff as they can get away with!

 

[Kevinl]

The only people that can tell you anything is other visitors and you don't usually get to speak to them but they're the only people who can tell you what it's really like.
My wife's in an EMI nursing home which takes people with "challenging" behaviour so we have a lot of people who've come from other homes and it's surprising how many of the relatives say how much better it is than the last place they were in previously.
The other people I like to talk to are the agency staff, some I've talked to have worked at over 30 different homes so they know a lot about what other homes are like and some places I thought would be good aren't in their opinion.
I honestly don't know how anyone's able to make an informed decision based on a short visit, homes can go from an ocean of calm to a sea of storms in minutes sometimes, I know I see it just about everyday.
K

 

[canary]

homes can go from an ocean of calm to a sea of storms in minutes sometimes, I know I see it just about everyday.

Yes, thats quite true, but it can be revealing to see how the staff deal with it all. How soon do they arrive, can they defuse the situation, how quickly is it calmed down, is peace restored, how do the staff react afterwards (are they angry, philosophical, etc)?
I remember a situation at mums home when it was almost literally zimmer frames at dawn. Two residents started a fight using their zimmer frames and one of the frames got thrown (no-one was injured). The staff swooped in, separated them out without raising their voices, took them off in opposite directions with some excuse or another and then tea was brought out for all the other residents in the area. All was peace again. There was no blame or anger from the staff- just a few rolled eyes and discussions on how to avoid it starting again.

 

[Sirena]

Personally, I think staff ratios are important - especially if PWD also needs 2 people for transfers - it makes a big difference how long they have to wait for attention.

In theory yes, but you have to know what answer you are looking for, otherwise it will be meaningless. I did not ask the question when my mother went into a care home a year ago, it just never occurred to me - and if they had told me, I wouldn't have known if it was good or bad. The important thing is that I could see residents were content and not kept waiting for attention, in the main lounge there are always 4 carers tending to needs, and other carers in different parts of the building, so (as you say) if someone needs hoisting there are two available.

The ratio may be a good starting point but on its own won't tell you what you want to know. There is also the issue that however many staff you have, they need to be doing the right things - actually giving the residents the help they need.

But once you've asked all the questions you have to use your instinct. Does the place feel welcoming, is there is a good atmosphere, do staff and residents seem happy/content?

 

[Quizbunny]

I would ask what their staff turnover was like. When mum moved into her CH all of the staff had been there for years and were very happy. A few years later the CH was sold and the new manager was all about rules and signs stuck on walls telling the staff what they couldn’t do. Within six months all but one had left, and the atmosphere was dreadful.

 

[Canadian Joanne]

I agree with @Quizbunny the staff turnover is very important. There wasn't too much turnover at my mother's home, so the staff learned the residents' little quirks and idiosyncrasies and were able to cope with them.

 

[Mistie]

Staff turnover and how many Managers a home has had recently. Read the CQC report, especially if they had RI so that you can ask what measures they have in place, and timescales, to bring them up to Good. What activities - not the plan, what actually happens. Are activities/ stimulation taken to people who are unable to go to the lounge. Are they over 7 days - do residents have a say in what's planned. Are there residents/relatives meetings - ask to see the last minutes - in a good home they will be out on a notice board. Smell and ambiance. Is there are carer in the lounge interacting with the residents. Are there places that people can 'walk' with things to do/ places to sit along the way. Is the general environment dementia friendly - colours/lighting/flooring/rails - all things that aid and encourage mobility and independence. Is visiting unrestricted - can you share meals. If your relative needs hoisting - look at the equipment. Are there individual slings, are the frames visibly clean - use your antennae and don't feel awkward at looking/ listening and asking. Absorb - form more questions and go back again. It's often something that we have to do in haste so forward planning, horrid as it is, can help at a crisis time. Become familiar with the homes near you and do stand outside and talk to relatives. Homes like schools can change but you'll get a good idea. Do not be overly impressed with the sales pitch or the brochure - what can you see, hear and smell!