Chooosing a Care /Nursing Home

Discussion in 'ARCHIVE FORUM: Resources' started by hendy, Mar 26, 2008.

  1. wolfman

    wolfman Registered User

    Aug 19, 2009
    Care Homes

    Hi All
    I am a new member and have been reading the comments about quality of care and nursing homes. This is my first contribution.
    Until recently I was a Care Team Leader in a Residential Care Home. I am now an NVQ assessor and travel to various homes.

    Please, when choosing a home ask if the care staff have received dementia training. You may be suprised at the answer. The homes I worked in had no training although about 90% of the residents suffered with dementia. Also ask how long the care staff have worked there. Some homes have a high turn over and there is usually a reason for this.

    Ask to visit the home at meal times, this can show how settled the home is and how the residents are treated. Some homes have protected mealtimes but should still let you visit. Ask about activites and what they consist of. The minimum were I used to work was 15 hours a week, which is a joke.

    Another give away is to see how the residents react when the carers are near, their facial expressions particularly.

    A couple of years ago I was assessing in an EMI home for one of the larger companys and I was horrified by the way the residents were being treated. It ended up with the home being reported for abuse. As for the CSCI inspections, from experience, they seem more interested in checking paperwork than the actual care provided. Even the unannounced inspection are prewarned by them sending out questionaires to the staff and families. So you know they are coming usually within three weeks, so things get tightened up.

    It may look that I have a low opinion of care homes, but in fact it is the opposite. I have worked with a lot of lovely people who work themselves into the ground for the residents they look after. They are out there.
  2. NewKid

    NewKid Registered User

    Mar 26, 2009
  3. JPG1

    JPG1 Account Closed

    Jul 16, 2008

    I am glad you're here, because I've got a few questions to ask, and if you find the time to reply then I for one would be grateful.

    All the questions you suggest are all the questions we asked, before care home arrival, and we trusted the replies that came our way. Which, of course, were all answered fairly positively in advance of arrival in care home.

    It turned out - later, much later - that there had been:

    1. no dementia training for most of the staff working there;
    2. no training in record-keeping;
    3. no training in 'what is a GP' or 'how do I contact a doctor' or even 'what is the NHS and the dial 999 procedure';
    4. there had been no training at all in diabetes for all of the staff working there, or any other medical condition - and I am talking about the nursing staff, not the support-workers/carers;
    5. there had been no assessment of the ability of the nurses to handle the conditions they were handling;
    6. there was absolutely no supervision of those staff, either by the Manager, the Deputy Manager, or the Regional Director;
    In fact, why was it allowed to be called a CARE HOME? Are you able to advise on that one? Because I'm still trying to work it out.

    Can you suggest what 'paperwork' we should all ask to take away with us from our recce of care homes, so that we can go home and assess it all. Asking the relevant questions and receiving an acceptable reply (or not) to those questions ... means nothing, really, if it subsequently turns out that what we were told was untrue. But that only becomes obvious later, of course, much later.

    Yes, there was an activities organiser, but nowhere near 15 hours a week. Perhaps 4 per year would be near. And most of those 4 consisted of moving from one 'space' to another 'space' to watch ... TV. Regardless of whether anyone wanted to watch TV.

    As for NVQs:

    May I temporarily divert you, and ask about the NVQ assessments that you are involved with as an NVQ assessor.

    Can you show us what is required for someone to achieve an NVQ level 1, or to aspire to an NVQ level 2. I won't ask about levels beyond that, because so far the levels 1 and 2 would have challenged most of the non-English speaking people that came our way.

    Is someone allowed to complete an NVQ in the language of their origin?

    Can you enlighten us all to the requirements to achieve an NVQ in care?

    Thanks, and if you find the time to answer even one fraction of this, then I will be forever grateful.

  4. jackie place

    jackie place Registered User

    Aug 4, 2009
    eccles manchester

    These would be the replies that I am interested in.

    I feel that the social side of the care home is not enough. My Husband has Alzheimers allthough he is being cared at home by me I might have to have a consider a care home at some later date ( when I cannot cope with) so I would be interested in the answers of the above

    Also I have a questions perhaps someone can answer I have heard of the Admirals Nurses ( they were on a programe on TV the other day and one of my family memebrs suggest that I get in touch, but before I do aI would like the opinion of anybody else who has used them, are they Good? and would anyone recommend them ? Keep the good work Up and Thank You
  5. Cazza W

    Cazza W Registered User

    Oct 22, 2009
    west yorks
    Thanks for that. I've just joined this forum today and calderdale is my local authority!
  6. Ladywriter1968

    Ladywriter1968 Registered User

    Oct 2, 2009
    London UK
    thank you for the information

    thanks for info, useful
  7. julie essex

    julie essex Registered User

    Sep 29, 2009
    I have been a carer in care homes for some time and have nvq 2 and dementia training, amongst many other various training standards that go with the job. With regards to the question of asking if staff are trained, i am beginning to feel it has no relevance whatsoever. more to the point is. Does the establishment allow someone to work within there training criteria? I have yet to come across a care home that allows for this and the low staff ratio to residents is always a factor.

    I have done the 8 week course run by the altzheimers society, enjoyed it very much and felt it benificial. On the downside it felt like a huge gap between how things should be and how they really are. A question was asked...Is it possible that care staff can offer the best support, whilst working fast? obvious answer is why do i feel like i have just finished a shift in a human warehouse?
    Another question was....Would i put a relative in the home? and if any of us answered no then we had to change things untill the answer was yes.....someone tell me how, without loosing my job or being treated badly.

    whilst training is an important question to ask, also find out the staff to resident ration.

    un-fortunatly i am reluctantly thinking of leaving the profession before i am kicked out for speaking up to much
  8. kitchenmama

    kitchenmama Registered User

    Nov 19, 2009
    im a activities co-ordinator in a care home - having worked for one of the biggest owners of care homes in the country i can safely say that small private /independant homes are better than the bigger ones run by huge organisations - the home i work in has 30 residents some 85 % of whom have a form of dementia - it is hard work and the training does not always help - the ytt course is good and very helpful but i agree it does leave you thinking that we are not always doing our best. all i can say is keep doing what you are - speak up for your service users ( i hate that term) they have no voice you have to be it and remember you may be in there one day so wouldnt you want someone on your side . the proffession needs more carers like you :)
  9. javeria

    javeria Registered User

    Aug 10, 2007
    care homes

    this is really interesting to me,i have tried respite twice but was shocked and dissapointed at the standard of care my hubby recieved.In fact we ran away from respite when i took him home after only two days of a planned respite of two weeks.Since that time the Social Worker has tried in vain to get me to try again but i have lost confidence and can not put the look on my hubbys face out of my mind.I want respite at home and this seems to be a really big problem,the social are fighting me and was seems to be mental blackmail.I can have respite at home 4wks in a year at home but up to 8wks if he goes to a nursing home.When i ask why no answer.I would love it if any body has the answer to this.Why is it so different if i want respite at home.Where is the new choice they say we are going to have/Why is everything in the careing world such a fight.? Look forward to any replies.Jay:confused:
  10. Sandy

    Sandy Registered User

    Mar 23, 2005
    Hi Jay,

    I should think that is was down to costs.

    Four weeks of respite at home equals 672 hours of carer time that needs to be paid for. So if the council can contract services at £10/hour, that's £6,720/year.

    If £6,720 was to pay for 8 weeks of respite, that would be £840 for a week's care home respite, which seems a bit on the high side, but might be about right depending on the level of need and the location of the home.

    It may be some other factor, like difficulty getting carers to cover 24/7, but money seems likely to be the main factor.

    Take care,
  11. JPG1

    JPG1 Account Closed

    Jul 16, 2008
    Hello javiera

    You live in Birmingham, and the known-factor is the postcode lottery. Which means that each and every local authority has been given – from somewhere/someone on high! - the ability/power to decide how it spends the money that comes the way of the local authority, via council taxes, via government ‘contribution’, and so on.

    So, Sandy is right, methinks, in saying that what you are facing is all to do with money, or rather the way that “the money” is dealt out. And the way that your local authority has arranged its contracts with all those ‘agencies’ providing the contracted and negotiated-services. And those ‘contracted services’ may have a 5, or 10 or 15 more years added into the contract to provide services to your local authority.

    So, how do you move forward from now, where you are now?

    What I might suggest is that you ask the Social Worker to provide you with his/her decisions or reasons in writing. By letter, and with full explanations.

    It is so enormously important, if you really want to understand it all, and to be able to wake up another day and say to yourself “did the Social Worker really say that?”. It may not be important for many people, but unless you have that letter in your hand, explaining all their reasons ... then you have nothing left to refer to. Apart from your own memory of it all.
  12. julie essex

    julie essex Registered User

    Sep 29, 2009
    hi jay.
    i am inclined to agree that cost is a huge factor in these things. I am also inclined to think that misplaced spending doen't help much either. I have heard so much lately of nintendo wii's being introduced into homes and will clearly never be used. A small cost on its own but spread across the board amounts to a lot. There may be homes that have benifited from this but from feedback iv'e had, they havn't even been out the box. A silly example i know, but how much money is being spent on things that are really irrelivant when it comes to careing.
  13. javeria

    javeria Registered User

    Aug 10, 2007
    respite at home

    thankyou every one that replied or not,I can see it is about money,and that is a very good idea to get everything down in writing,but the SS will not like it.Oh I am so worried,I think not.Thanks to all Jay:mad:
  14. Ladywriter1968

    Ladywriter1968 Registered User

    Oct 2, 2009
    London UK
    thanks for that link

    Thanks for that link, its a good site.
  15. Polly H

    Polly H Registered User

    Nov 26, 2009
    Care homes


    Another "quality" indicator could well be ..."what percentage of the residents" are taking anti-pschotic drugs?" If the recent research reports are anything to go by then many are taking them because they are aggitated when the reality is there is very little in the way of engagement or activity provided and residents are bored and frustrated.

    Polly H
  16. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    #36 jenniferpa, Dec 10, 2009
    Last edited: Dec 10, 2009
    Even that isn't a great indicator - homes that specialize in the most challenging behaviours will tend to have a higher proportion of residents on anti-psychotics, and we have a few members who have family members who still live at home who are also on anti-psychotics so that they can stay at home. Over medication is never good, but sometimes, medication is necessary.

    There's not an easy "one size fits all" approach when choosing a care home - you have to put in the time and the leg work.

    Woops - and I forgot to welcome you to Talking Point :)
  17. Polly H

    Polly H Registered User

    Nov 26, 2009
    care home search

    Thanks for that. Must give my posts more thought. Just a little raw about this topic.
  18. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    Polly - I think that is inevitable (the raw feeling) if someone you love has been overmedicated. And there is a fine line between effective medication and over medicated.

    I think you're right that there can be a correlation between lack of stimulation and over medication. There is also a correlation between insensitive handling and over medication, and a whole bunch of other poor behavioural management techniques.

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