Choosing the right residential care home

Lanie

Registered User
Aug 31, 2008
293
0
Surrey
Does any one have some advice on what to look for in selecting a residential home. Perhaps tips on what to look for.

Any advice appreciated

Lanie
 

christine_batch

Registered User
Jul 31, 2007
3,387
0
Buckinghamshire
Dear Lanie,

Your Local Authority should have a directory of all Nursing Homes/Care Homes in your area.

Asking you local Alzheimer's Branch is another path to try.

Good luck
Christine
 

noelphobic

Registered User
Feb 24, 2006
3,452
0
Liverpool
This link will take you to the CSCI website, where you will find reviews of all care homes

http://www.csci.org.uk/registeredservicesdirectory/rsquicksearch.asp

I always advise that if you go to visit a home you go unannounced. If they have a problem with you just turning up on the doorstep then I would say there is potentially a problem with the home - unless you turn up in the middle of the night of course! Write a list of questions before you go and write down the answers that they give you.

I hope this is of some help.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
81,451
0
Kent
Dear Lanie

This was posted by a TP member TinaT. Ken is her husband. I found it so useful I saved it and hope she won`t mind if I copy it for you.

When I go to any care establishment, I look at the layout of the place. I have to bear in mind that Ken's particular form of dementia means that he needs to wander around constantly. If the home has only one room where residents are expected to sit around - then that is immediately crossed off my list. Again to refer to the number of public rooms, is there another room that Ken could go to if he didn't like a particular resident, or to get away from a particularly noisy, disruptive resident. Is there a separate dining room which can be used for other activities during the day? He needs a corridor, preferably with some seating somewhere along the corridor and more than one room to wander in and out of. I look at the garden area - is it easily accessible? How is the garden layout? Will Ken be able to wander around the garden on safe, well laid paths? Is there seating and any shade for very hot days?

Then I try to check (without asking) how many residents there are and how many staff I can see on duty and how the staff interract with the residents. I ask can I come and have a meal with the residents as I think it is important to see how the staff deal with mealtimes. Do the staff take time and patience with the reluctant eaters? Are special diets observed? Is there a choice of a cooked meal / sandwich type food? I also ask how many night staff do they have. I try to observe how the staff interrract with residents and how long have the staff worked at the care home? How do the staff interract with each other - do they work as a team? I chat to any staff I meet and try to find this out without appearing to be too inquisitive. Have any staff been on a recent 'refresher' type course? If they do not want to chat with me or appear distant with me, then this care establishment is also crossed off my list.

I look at the residents themselves, how they are dressed, are residents wearing glasses, are the ladies wearing any bits and pieces of jewellery - a sign for me of good care is that residents still seem to have their own, individual personality, reflected in how they are dressed.

I look at what facilities the care home provides for recreational activities. Do the activities which are on the notice board actually take place? Where do most activities take place? Who organises them? Are there any outside groups which come into the home? How many TV's, DVD players, Radios? Again this supposes that there are enough rooms for residents to have a choice of whether to listen to a radio or watch tv. I sit and watch TV for a while to see if the programmes being shown are relevant to the age group of the residents. Is there a 'smoking room' and has it got proper ventillation? Is there a whiteboard where today's date is displayed, what the weather is like and what activity will take place today and is this in a prominent place and used by staff to help residents to know what today's date is.

Are the toilets clean? Are they well positioned and are there signs informing residents that they are toilets. Above all else, does the place smell clean??? Residential homes do have their own particular smell and I am not asking for pristine, Febreeze smells to gently waft around. But essentially there is a difference between an acceptable 'institutional' smell and a downright offensive, unbearable smell.


None of the above are unattainable dreams - all of the above are concerned with the quality of life which we would expect for our loved ones.


I hope you find it helpful.

Love xx
 

Lanie

Registered User
Aug 31, 2008
293
0
Surrey
Hi

Thank you for your responses especially the one from Sylvia. It certainly makes you think. I suppose the advice is to know what you want and what you won't even consider before you go and you won't go far wrong in your choice.

Lanie
 

merlin

Registered User
Aug 2, 2006
139
0
Surrey
Hi Lanie

I can't add much to the Grannie G's advice except don't bother to ask all the standard questions about staff ratio's, nos of agency staff etc as the answers will be well rehearsed and meaningless.

I had some difficulties in toilet care and finally decreed that my wife should have her pad changed more often so check on toilet care/frequency.

I also had problems with getting her to be allowed to stay up in the evening rather than be put to bed early and thus spend over 12 hrs in bed, so check on bed time routine.

One other point, ask what happens at shift changeover. I found that there was no carer coverage from about 7.30 to 8.30 which is in my view essential I won that battle as well.

Hope it helps and is not too late

Merlin
 

Debby Short

Registered User
May 29, 2008
38
0
Near Heathrow Airport
Hi Lanie

The post from Grannie G is the one that I sent my sister when she, and my Dad, were looking at a home for my mum.

My Sister asked all of these questions, and spoke to nearly every single member of staff, all of whom were happy to stop and talk. Even some of the residents visitors talked to my sister and my dad.

The staff were extremely honest, talkin about how things go missing, but that once a month they have a 'purgh' and give everyone back their own belonging. I have come to realise this has to be expected.

Mum has now been in the home for nearly 3 weeks, it is a lovely place and she appears very happy.

Please don't be afraid to ask as meny questions as you can think off, my sister actually wrote them down and took them with her.

Good luck with funding the right place

Debby
xx
 

Lanie

Registered User
Aug 31, 2008
293
0
Surrey
Hi

I have now been informed that my Mum needs a nursing home. It's all so difficult the care manager has referred us to a home and I rang on Friday only to find that its not a Nursing home and after seeing my Mum's assessment they couldn't help they were sorry.
I have rang the care manager to ask about nursing homes in the area, I'm still waiting for a return call. I don't want to go and look at homes due to the fact my mum will be self fuding for approximately 18-24 months then she'll have to be funded by social services, I don't want to look at homes only to find that social services won't fund the home later and she has to be moved. I would rather just see the ones they will fund. I've spent time looking for NH homes on the internet and requesting brochures purely because I feel in limbo and its something I can do.

Do other people find care managers useful, it seems that when I ring he does something, but nothing happens unless I'm pushing for it. This is the second referral the first was to a day centre only to be told they can't Alzheimers patients. Surely care managers should have some understanding of local homes or do I have to find them and then ask if they will fund them. Why is everything so difficult?

Lanie
 

TinaT

Registered User
Sep 27, 2006
7,097
0
Costa Blanca Spain
Dear Lanie,

I'm not sure what a care manager is? Do you also have a social worker? Or are they one and the same thing in your area?

The first thing I would do is phone social services and establish what is the maximum amount per week they are allowed to pay? Or there may be someone here on TP who knows a website which will give this information.

Then I would contact as many Nursing Homes as I could and ask them what is their weekly rate? Once you have this information you may be able to then go ahead and inspect some homes with a clearer idea of what is available to you.

I was lucky. The specialist Dementia Care Home my husband is at is run by the Local Authority and it is excellent with good care, well run and with the amount of space which I felt neccessary for the comfort of my husband.

This particular home was the cheapest I looked at so please don't think that cheaper fees equal poorer care. You will have to be the judge and I know that you have some clear ideas of what you need to see.

Good luck and 'nil desperandum' - good care is out there but it may take a little searching on your part.

xxTinaT
 

DianeB

Registered User
May 29, 2008
765
0
nottinghamshire
Excellent post Grannie.

May I just say that I also looked on the csci site before we found Mums home and I only wanted the best and therefore only ticked the 3 star ratings. We went to see one home that had been rated excellent and was shocked and dismayed by the home its standards and the smell was gagging, further more they stored all the lifting equipment in the toilets so they were cuttlered and posed a safety hazard!!! How on earth it got 3 star ratings is beyond me. The one we have found is a 2 star rating and far far exceeds the top one we went to. I have gone through Grannies list and there is only one thing that they have not got and that is somewhere to sit in the corridoors ....although I could be wrong and will have a peep when I go.
I again spoke to every member of staff and there was no questions they didn't answer. The home does not have any nasty smells either.
When we went to view, we went with the fact if it were us in Mums situation would we like to stay there, given the same situations.
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
there is only one thing that they have not got and that is somewhere to sit in the corridoors ....although I could be wrong and will have a peep when I go.


This could depend on the design of the home. Modern ones have very wide corridors, with lay-by type seating areas. Older buildings, or conversions, may have narrower corridors, so that seating areas would pose a falls risk to residents who like to walk. Many of them in later stages hug the walls, holding on to the rails.

I agree, it's an advantage to have them, but if everything else is right, I wouldn't rule a place out because of the lack.
 

DianeB

Registered User
May 29, 2008
765
0
nottinghamshire
The home Mum is in is an old convent. Its a square shape, so nobody can get lost. There is rails all around and a small garden in the middle. Its surrounded by beautiful gardens on the outside which if accompanied they are welcome to sit out there or have a stroll.
Like I say, you can't always go by the star rating, it's what feels right from the moment you walk in.
 

Canadian Joanne

Registered User
Apr 8, 2005
17,710
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70
Toronto, Canada
One question I think is important is what the staff turnover. A lot of turnover may (just may) be a sign that management is not handling things well. A happy staff make for a happy home, in my opinion.

Don't necessarily go by decor either. Just because the building is older & not as attractive doesn't mean a thing. Don't ignore your gut feelings either. That can be equally important.
 

JPG1

Account Closed
Jul 16, 2008
3,391
0
If ever anyone checks the CSCI website for the “star rating”, then please be aware of the precise date of that star rating, (and then ask CSCI the basis for that rating), which may be many months before the most recent CSCI inspection and UNPUBLISHED report. And it may also be many many months after CSCI became aware of enormous problems with any particular care home.

A CSCI rating is no guarantee of quality – and therefore no guarantee that standards have not perhaps improved massively since the last inspection and subsequent ‘rating’. Or that standards have perhaps declined massively since the last inspection and recent ‘rating’.

As we have found, a ‘star rating’ was added to the CSCI website about one particular care home, which meanwhile was being heavily investigated. Investigated because of serious concerns and problems about the level of care being provided to the residents.

That did not prevent CSCI from adding a ‘star rating’, just before and more importantly, during that investigation, and even more importantly just weeks before the findings were revealed.

And that ‘star rating’ today would be very very different from the star rating achieved between the initial inspection (9 months before the star rating appeared on CSCI website) and the appearance of that particular star rating (9 months after the inspection).

In fact, that particular care home is subject now to an enforcement notice, which is a step before closure, in order to protect all the residents living there. Even though no-one wishes to move their own relatives with dementia by force, from one care home to another, unless they are receiving less-than-acceptable standards of care.

And that care home will only be closed, if that particular care home is deemed to be operating either against the law, or against the legally acceptable care standards that should, by law, be made available to all of the residents living there.

Just a word of caution when consulting the CSCI website.

So, as DianeB said, do not believe everything you read about star ratings.

And as should be obvious by now, unless you have a way of being shown positive evidence of staff turnover, then don’t even bother to ask the question. Or any other question, unless you can be shown positive evidence.

All staff will answer questions posed to them, (as merlin says) but can anyone know the extent of their ‘tutoring’, being instructed how to answer those questions posed to them by relatives.

If a ‘purge’ is in place once a month, then that is good news. But only if those belongings can be seen to be returned to the original owner.

We should all learn to become as cautious as we can about any reply to any questions.

Yes, of course, there will be some people who have the most fantastic luck out there with choice and quality of care home. But there are also many out here who have had no such luck, and there are perhaps many of those “luck-losers” who cannot begin to find the strength to face the constant barrage of “well, we’ve never had any complaints before; most people are hugely satisfied with the care we provide”.

So, sorry to rain on anyone’s parade, but the reality is the very real and genuine reality for some of us who are not so fortunate as others.

That perhaps goes with the territory of being disabled by any single problem: some of us are perhaps more fortunate than others in our experiences. But that must grant them the right to express their words of caution, based on their own experience.
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
A lot of turnover may (just may) be a sign that management is not handling things well. A happy staff make for a happy home, in my opinion.

You're right to say 'may', Joanne.

Unfortunately, though some carers leave because they are unhappy, others leave simply for more money.

Many of the carers are divorced with young families to support, and they are paid peanuts -- minimum wage for the least experienced. They can earn more on the checkouts at Tesco, so for some, though they love their jobs, economics mean they have to go elsewhere.

One of the best carers at John's home is leaving to work as an auxilliary in the ward John was in at the hospital -- our loss is their gain. She'll have more money, better hours and longer holidays.

It's easy to say they should be paid more -- of course thay should, but then fees would go up even more, SS would refuse to send people ........ it's a vicious circle.

Yes, there are bad homes, but even the good ones have problems.

PS I'm with you all the way on gut feeling. It's the best test of all.
 

Lanie

Registered User
Aug 31, 2008
293
0
Surrey
In answer to your question Care manager and Social worker are one in the same. I will ring tomorrow and find out how much they are willing to pay my guess is that it will be around the £700 maybe to £800 mark. So would I be right in assuming that it doesn't matter what NH you chose just that its in the right price bracket to be funded. That is helpful as I will continue my search around the cost then see if they are willing to fund.

Thankyou for the advice having spoke to lots of people not only on here. I now feel the most important thing of all is how your relative will be treated, how the staff interact with the people they care for that they are genuinely kind and caring and happy. I know my mum won't notice the decor as she doesn't notice it where she is now,although she does seem to like colours. She certainly reacts to how people treat her and whether they smile etc. So that has got to be important.
Also how people speak and whether english is their first language as my Mum doesn't hear to well and when she had a memory test the other week by a doctor whose first language clearly wasn't english, I noticed she became quite upset by the fact she couldn't understand. Although this will probably pose quite a problem.

Lots to think about and the process of finding the right home, I feel will be quite a challenge.

Thanks for the advice.

Lanie
 

TinaT

Registered User
Sep 27, 2006
7,097
0
Costa Blanca Spain
Dear Laine,

A lot of good information has been posted on this site and I do hope that you benefit from other's experiences. I can't stress enough how much foot slogging was involved in my finding the right home for my husband. No matter how good the advice is, it is left to you to do the actual inspecting and this can be the most disheartening experience. I left quite a few EMI Homes and couldn't even drive my car for a few minutes because I was so shocked and upset at what I had seen.

I wholeheartedly agree with all the warnings about CSCI reports. Looking back now I realise how green I was when looking for a home to believe what they had reported. I went on the CSCI website and was quite impressed by the rating given. Once I arrived at the homes which had been reported on I just couldn't believe what I saw. The stench from three homes, all privately run, left me gagging! There was no interaction between residents and staff apart from feeding and taking to the toilet! I was so shocked I wrote a list on the three establishments of all I had seen and sent it to the CSCI, The Secretary of State, and my MP. After some very upsetting further contact with the CSCI office the Secretary of State passed on a letter to me from the Chief Inspector of CSCI promising to inspect the three homes again within six months and he would send me a report.

I did not get the report and had to remind the CSCI after 9 months that I had been promised this. When I read the reports, I wondered why had I bothered in the first place!! Apart from one home where the management of medications routine had to be changed, all (apparently) was now well???

I never did go back to reinspect the three homes as I am perfectly sure I would not have been welcomed. All three homes had my complaints passed on to them by CSCI and had ample time to put things right (which I suppose they did). One Home wrote to me saying that they were astounded by my complaints and (surprise, surprise) relatives of residents were astounded to read my complaints. I suppose I can pat myself on the back that at least I did cause such a fuss that something was done to improve life for the residents.

Sad to say I was at the local hospital outpatient eye department recently when two elderly ladies were wheeled into the clinic by two care assistants. As I have an obvious interest in Care Homes I asked them where they were from - they were from two of the homes I had complained about. I watched both care assistants for over 45 minutes whilst we were all in the waiting room. One care assistant was chatting to the resident and it was so nice to see this. The other care assistant never spoke once to her charge - in 45 minutes! The lady had stinging eye drops put into her eye. No response from the care assistant!! The care assistant opened a packet of biscuits and ate them without offering her charge even a taste!!

Does this give me confidence that the home in question had changed??? You can guess the answer.

xxTinaT
 
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