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Compiling list of questions for a potential dual registered care home.

Muttimuggle

Registered User
Dec 28, 2021
334
0
I am at that stage where a move to a care home for my mother might happen soon. She is currently in hospital recovering from both a neck of femur fracture and asymptomatic Covid. It has been a lengthier stay than it should have been. The next stage is a 6 week stay in a Council Rehab Centre which will look just like a nursing home I presume. Then, I understand, as that stay nears it's end, I will be contacted by a Social worker about what's going to happen next for the best.

So I have compiled a list of more local care homes which are dual registered for residential and Nursing...and had a phone conversation with most. I am going to ask to visit them. I already have some good suggestions from members on here which I will include on this question list which I am starting here. Do any other members(especially with the wisdom of hindsight) have any other suggestions please?
  • Please could you tell me about the food which is provided for residents (as my mother is still focused upon eating a healthy and nutritious diet)? Is there a choice at meal times? Is any or all of food prepared freshly on site? Although my mother is not a fussy eater, she likes fruit and she has been in the habit of preparing herself a bowl of fresh mixed berries for breakfast with milk. Would that be, for example, too prescriptive a request?

  • What is the ratio of males to females, generally(might be relevant to mother)?

  • If dementia in my mother should progress to anything unexpected, what behaviours or conditions would be not tolerated and cause you to have to terminate her stay? (I am not currently expecting anything like this - but I am aware, from other sharing forum contributors, that things can change to something unrecognisable and very difficult).

  • What times are getting up and breakfast times and going to bed times for those who are able to attend communal meals? I ask this because I just phoned another care home who said that they were just getting breakfast at 10am... maybe they were just clearing away? My mother has always been an early riser even with the dementia - it might not be relevant or valid to ask this?

  • What sort of stimulating activities do you provide? - a care home I phoned about recently told me to look at their facebook page and I saw that, just in the month of July, they had a visit from 2 shetland ponies(inside the home!) and owls, apart from lots of other interesting things. I thought that was nice.

  • Do you have ensuite rooms? I know many do but not all. My mother has always, to this point, maintained a modesty around toileting and washing herself, if she is able(and she hasn't been that able in the hospital and has only had the catheter removed today after several weeks) - In her earlier years she was the sort of person who couldn't have a bowel movement anywhere else than her own toilet - and I think she, for better or worse, retains a little of that feeling now.
  • What is the ratio of staff to residents? Does that fluctuate a lot? Do you have a strong permanent staff who have stayed(Just thinking about what I saw on the news yesterday!)

  • I am already asking about pricing - and my Mum will be initially self funding. Do I need to ask any more about that? - like when was your last price increase?

  • Can they accept Local Authority rates when self funding runs out?

  • What sort of outdoor space is there? Do I think it would be somewhere Mum would enjoy sitting sometimes?

  • Tricky question to negotiate - but somehow(? )try to find out how stable the home's finances are. Are they in any immediate or near immediate danger of closing down?(Ideas welcome on how to get an idea around this one please). Maybe is it a long standing family run business? Are staff retained for a long time? These might be clues to stability.

  • How is visiting time arranged at present/ in the future/ before Covid?
So this is just some brainstorming from my ignorance(well near ignorance - my mother's second husband went into several care homes due to Azheimer's and I saw then, and especially noted, that sometimes the home could look very nice but wasn't offering the best care). I am using CQC ratings as a guide now but I know, also, that that isn't always reliable - but I don't know where else to start.
Any further suggestions for questions would be welcome. Thank you.
 
Last edited:

DreamsAreReal

Registered User
Oct 17, 2015
431
0
Poor Mum getting covid on top of everything else! 💐

Although I've no experience of care homes, I'd want to know if they accept the local authority rates when self funders run out of money.
 

Sarasa

Volunteer Host
Apr 13, 2018
5,035
0
Nottinghamshire
When we were looking last year for my mother and mother in law I was very much focused on the feel of the place, which isn't something you can put a finger on. What we quickly realised is that what would suit one wouldn't the other. For instance there was a home which we liked with MiL in mind where she would have been very disturbed by some of the other residents, whereas it wouldn't have bothered my much less nervous mother at all. On the other hand a home with a lovely garden we looked at for my mum wasn't suitable as it was an old building with unsecured stairs and mum was a wanderer, she also has no interest in gardens.
Activities are great and I chose mum's first home because of the amazing things it did. However my mum didn't want to do most of the activities, and only got involved in things if I was there to join in. When I was we had some good times.
One important question is about how secure their finances are. The home with the lovely garden mentioned above has now closed as it was running at a loss.
 

imthedaughter

Registered User
Apr 3, 2019
826
0
These are good questions! I will say though that ratio of men to women will 1/ vary as inevitably people will leave, and 2/ all the care homes I have seen are mostly women. We live longer.
Retained staff is a very good sign. My dad's home is family run and they have people who have been there for years and years.
I should hope the food is nutritious - and flexible up to a point. Dad's home coped very well with his vegetarianism (which now fluctuates) and also will feed him toast and fruit if he's ever hungry early or between meals.
I did ask them about more err 'exotic' meals like curries and various vegetables but they said through years of experimenting they find older people tend to regress to more 'traditional' meals. My dad was quite adventurous but now seems to be around primary school in terms of what he requests - god help us - plum duff and spotted dick etc. But he's further along now - it's been more than three years.
 

Louise7

Volunteer Host
Mar 25, 2016
3,151
0
Hi @Muttimuggle you've got some good questions already but maybe ask about their visiting hours/arrangements? Some homes seem to have a 'visit anytime' approach but others can be a bit more restrictive so worth asking. With regards to food perhaps ask if there a choice of dishes at mealtimes and could something else be prepared if your mother wanted it - is the food prepared fresh on site? My mum's home are happy to meet resident's dietary needs/requirements, even popping to the local chicken & chip shop for a resident who wouldn't eat anything else! If 'extras' such as hairdressing, chiropody etc can be provided how much do these cost? As already mentioned, you will get a feel for a place when you visit so hope you find a good one.
 

Muttimuggle

Registered User
Dec 28, 2021
334
0
When we were looking last year for my mother and mother in law I was very much focused on the feel of the place, which isn't something you can put a finger on. What we quickly realised is that what would suit one wouldn't the other. For instance there was a home which we liked with MiL in mind where she would have been very disturbed by some of the other residents, whereas it wouldn't have bothered my much less nervous mother at all. On the other hand a home with a lovely garden we looked at for my mum wasn't suitable as it was an old building with unsecured stairs and mum was a wanderer, she also has no interest in gardens.
Activities are great and I chose mum's first home because of the amazing things it did. However my mum didn't want to do most of the activities, and only got involved in things if I was there to join in. When I was we had some good times.
One important question is about how secure their finances are. The home with the lovely garden mentioned above has now closed as it was running at a loss.
Thanks. Edited my list now.
 

Muttimuggle

Registered User
Dec 28, 2021
334
0
These are good questions! I will say though that ratio of men to women will 1/ vary as inevitably people will leave, and 2/ all the care homes I have seen are mostly women. We live longer.
Retained staff is a very good sign. My dad's home is family run and they have people who have been there for years and years.
I should hope the food is nutritious - and flexible up to a point. Dad's home coped very well with his vegetarianism (which now fluctuates) and also will feed him toast and fruit if he's ever hungry early or between meals.
I did ask them about more err 'exotic' meals like curries and various vegetables but they said through years of experimenting they find older people tend to regress to more 'traditional' meals. My dad was quite adventurous but now seems to be around primary school in terms of what he requests - god help us - plum duff and spotted dick etc. But he's further along now - it's been more than three years.
Thank you - and yes retained staff and family run might be a relevant detail.
 

Muttimuggle

Registered User
Dec 28, 2021
334
0
Hi @Muttimuggle you've got some good questions already but maybe ask about their visiting hours/arrangements? Some homes seem to have a 'visit anytime' approach but others can be a bit more restrictive so worth asking. With regards to food perhaps ask if there a choice of dishes at mealtimes and could something else be prepared if your mother wanted it - is the food prepared fresh on site? My mum's home are happy to meet resident's dietary needs/requirements, even popping to the local chicken & chip shop for a resident who wouldn't eat anything else! If 'extras' such as hairdressing, chiropody etc can be provided how much do these cost? As already mentioned, you will get a feel for a place when you visit so hope you find a good one.
Thanks - will amend my list now.
 

try again

Registered User
Jun 21, 2018
511
0
It's not just behaviour, can they look after them to end of life (unless that's part of being a nursing home)
 

Yankeeabroad

Registered User
Oct 24, 2021
90
0
Great list of questions.

You should be able to search Companies House for past financial statements.

i wish I had done this for the community where my parents live. I later found out it’s been running at a loss for a few years (it has a big endowment behind it so no danger of closing). The result is a lot of turnover of higher admin. It doesn’t affect my mom’s day to day care — the on the ground staff are great — but disrupts my handling of my parents’ admin and frustrates the staff.

You could ask about rate reviews and pay reviews to open the door on staff turnover. My parents community is very upfront that rates are reviewed and adjusted 1x year. Typically pay rates are reviewed around the same time. However this year hourly staff received a pay raise around 6/7 months (clearly communicated to us) in to be able to retain staff in a competitive market.

You might also ask about staff training opportunities. My mom’s home supports all hourly staff in job related education. For example, some of the aids at my mom’s home are studying for nursing degrees and often go straight into a nursing job at the home. It’s great for the staff and great for the residents as it reduces staff turnover. And I love to congratulate them!

The questions about food/mealtimes are good. I’d also ask how accessible are food / beverages between meals. For example, I can get a cup of tea or cold drink myself any time and ice cream and fruit are always available. My mom may only drink a couple of sips of tea but it does make her feel at home.

I’d also ask about how comms are handled — both between you and your mom and you and the staff. My mom’s nursing home can’t facilitate calls between her and me although the memory care home could. And after a few months of complaints and teething pains I finally have a “care coordinator“ who is a nurse on the floor. I can coordinate outside doctors and personal care appointments thru her and get/give direct feedback on my mom’s condition. All via email if necessary (vitally important as my sister and I are long distance). She also facilitates “care conferences” between the team (therapy, nursing, doctors) and us.
 

Muttimuggle

Registered User
Dec 28, 2021
334
0
Great list of questions.

You should be able to search Companies House for past financial statements.

i wish I had done this for the community where my parents live. I later found out it’s been running at a loss for a few years (it has a big endowment behind it so no danger of closing). The result is a lot of turnover of higher admin. It doesn’t affect my mom’s day to day care — the on the ground staff are great — but disrupts my handling of my parents’ admin and frustrates the staff.

You could ask about rate reviews and pay reviews to open the door on staff turnover. My parents community is very upfront that rates are reviewed and adjusted 1x year. Typically pay rates are reviewed around the same time. However this year hourly staff received a pay raise around 6/7 months (clearly communicated to us) in to be able to retain staff in a competitive market.

You might also ask about staff training opportunities. My mom’s home supports all hourly staff in job related education. For example, some of the aids at my mom’s home are studying for nursing degrees and often go straight into a nursing job at the home. It’s great for the staff and great for the residents as it reduces staff turnover. And I love to congratulate them!

The questions about food/mealtimes are good. I’d also ask how accessible are food / beverages between meals. For example, I can get a cup of tea or cold drink myself any time and ice cream and fruit are always available. My mom may only drink a couple of sips of tea but it does make her feel at home.

I’d also ask about how comms are handled — both between you and your mom and you and the staff. My mom’s nursing home can’t facilitate calls between her and me although the memory care home could. And after a few months of complaints and teething pains I finally have a “care coordinator“ who is a nurse on the floor. I can coordinate outside doctors and personal care appointments thru her and get/give direct feedback on my mom’s condition. All via email if necessary (vitally important as my sister and I are long distance). She also facilitates “care conferences” between the team (therapy, nursing, doctors) and us.
This is very useful and food for thought. I have manually added your ideas and the government link to my "research". Thanks.
 

canary

Registered User
Feb 25, 2014
18,878
0
South coast
I just thought Id add a bit about the question of whether they could make themselves a drink and access some food at any time. Mum was in a home where there were residents at all stages, so the kitchen and food was behind a door with keypad access. The reason for this was because it was not safe to allow those in advanced stages access to boiling water and/or food storage areas. The staff, however, would always make a cup of tea and provide toast/yoghurt/fruit at any time night or day.

The home where my OH went for respite did provide an area for making tea/coffee and a little fridge containing milk and snacks, which he could help himself to. However, this unit would only accept people with early to mid-stage dementia.

Again - its swings and roundabouts.
 

VB000

New member
Jul 31, 2022
4
0
That is a great list... I would recommend asking about availability as well. My 98 year old MIL has vascular dementia and is very frail, to the point of being unable to get out of a riser chair on her own. We managed to find her a place in a nursing home 2 weeks ago. Fortunately, we had done a lot of research 6 months ago, and visited a handful of places to get a feel for what was around, knowing that we would need a week's respite care in May. We noticed that a couple of the homes were extending their properties, to meet demand. We found a place for respite, but it was a case of whatever was available, as the homes didn't have dedicated rooms for this.

For the long term, we had no choice in where she could go, as she deteriorated rapidly, and we had to find her a local place on a permanent basis, almost straight away. (This is in S Somerset, UK).

So far, the (nursing and care) home has been good. She has a room with French doors to the garden and en-suite WC. Staff say she is settling quite well, though both hearing aids were lost (MIL hides them!) but the home have so far recovered one of them! We had taken some pictures etc and they were put on the walls of her room, but hubby said they were all just piled up as she wanted to go home!

Hope you find a good solution