How do you start looking for a care home?

[skaface]

Apologies for the monster post:

My mum is not yet, I think, quite ready for a care home, but this week has been very stressful and the suggestion was made to me yesterday by the local over-75 team.

So it's in my mind. It probably won't be for a good while yet, but I can't go through many more weeks like this one with her and she has deteriorated markedly in the past few months.

Currently mum is having carers coming in three times a day and on Monday they couldn't get her to the door to open it for them. So the carers had to ring me, couldn't get through (I was driving down to Thanet from Medway) so called my sister in Norfolk who told them to call the police, which they did. The policeman turned up, broke in, and found her lying on the floor in the living room. She told him that she had been napping on the sofa (though I believe she's actually been sleeping there), rolled off it and was simply more comfortable on the floor.

He called the paramedics, by this time I had arrived, and two lovely paramedics turned up and did all the tests they could. Everything physical is fine, ECG normal, blood pressure, blood glucose, all fine. The paramedics then said she should see her GP and rang the surgery to get him out - no GP, but the over-75 team came out yesterday and it was them that suggested that she might be better off in a home.

On Tuesday I had a call to say she hadn't eaten or drunk for over 24 hours so off I went and practically forced her to eat while I stood over her - I know it's the completely wrong thing to do but I was very blunt and explained what will happen to an 86 year old who doesn't eat or drink. Yesterday she got a lecture from the over-75 team about dehydration - I've been putting a glass of squash by her to sip on over the day which the carers refill as necessary.

They recommended a load of stuff I've already got in place but mum refuses to entertain - for example they started talking about a high-density cushion which she already has but constantly removes when I place it in her chair - they made her have it on her chair yesterday but I'm confident when I go round today, that it will be shoved down the side of the chair again because it makes her feel as if she's tipping forward and she's going to fall out of her chair - I'm going to look for a second hand recliner, but she will refuse to use it.

They've also referred her to ICT (don't know what that means!) and Age UK who will be able to arrange Lifeline (which she won't use) and a keysafe (which is one of the conditions of Lifeline, up until now she has refused to entertain the idea but it's no longer a matter for discussion, she's having one!) - ICT will be able to arrange stuff like a zimmer frame and delta frame as her mobility has become very poor and for the past week she hasn't moved from her chair. No pressure sores, they checked for that, and apparently her bum is "like a peach". She does smell quite bad as she refuses personal care, and I'm going to try to persuade her to get in the shower today.

So how do you go about looking for a care home? I understand that I will need to visit each one but how do you find one? Just Google? There are two near where she lives, but I don't suppose it really matters where she goes - there's actually one across the road from me, which would be really handy for me, but if it's no good for her, then it isn't.

What do you look for? I presume you need one that specialises in dementia care, but what else?

I will involve my older sister in the decision but she's got a 3 hour drive to come down here so she can't do anything hands on and she trusts me to make those decisions. I won't expect her to do much else for mum as my sister detests her (and I understand very well why and I really don't blame her) and I wouldn't ask her to.

 

[Grannie G]

I hope this factsheet from the Alzheimer`s society will be a good starting point for you.

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=150

Choosing a care home is a minefield but there are many good ones , you just need to know what to look for.

Appearance and fancy furnishings are not always the sign of a good home.

Nor are strong smells of deodorant air sprays.

The welcome you get from staff is very important as is the seeming well being of other residents.

One home I visited had the smell of a good dinner being cooked.

It really is about viewing as many as you can.

Good luck. let us know what you find.

 

[Maldives13]

Good luck with the search. We found when we were looking that all the good ones had a waiting list so always good to look before you need to and then put her name on the waiting list. Some if the homes we visited just smelt horrible. Also ask what they do if your Mum rejects personal care. My mum has been in a home for 4 weeks now. It's a lovely home but I have to say without doubt the hardest thing I have ever done. Mum was settled but isn't now so difficult. At least if she is in a good home you know they will look after her. Also see how the carers there interact when you go in. Turn up unnannouced was good advice given to me. See how the other residents look. How often do they have a shower etc. Do look at as many as you can and good luck

 

[Witzend]

I have looked at masses over the years, for two relatives. I used to start with the Yellow Pages - I suppose you just google now or get a list from SS - and begin by phoning every one within a certain radius. Did they take people with dementia? Sometimes it was an unconditional yes, sometimes 'yes, but only if they do not disturb other residents.'

Next I would ask about visiting just for an initial look around, and immediately cross off any that asked me to make an appt. Any good care home should be happy for you to drop in at more or less any time within reason, just for an initial look, but it's probably best to avoid mealtimes since staff will often be particularly busy then.

I soon learned to disregard 'stylish' decor - it is IMO usually there to impress the relatives who are choosing. When it comes to dementia IMO cosy and homely are far more important. Even a wee bit shabby may not be a bad sign. And whether the staff look generally cheerful, and the residents look clean and tidy, reasonably dressed. Though if the odd one isn't, it's not necessarily a bad sign - more than once I found my mother in trousers with her nightie under her jumper - she had refused help to dress and could be very stroppy at the time. And of course no obvious nasty smell, though where they have incontinent residents it may be impossible to avoid the odd whiff now and then.

One of the worst places I ever encountered was a very smart looking place with fantastic sea views. An old aunt of OH's (no dementia) booked herself in for a couple of weeks while her cleaning lady/helper was away. The atmosphere was dreadful, staff were surly and the manager looked exhausted and depressed. They would not let me sit with her at lunchtime, and were rude and abrupt in saying I was 'in the way' - I certainly wasn't - and they treated her like a naughty child when she slipped a roll into her bag for later - she had a fear thing about being hungry in between meals.
Horrible place - she hated it, and the only reason I didn't complain at the time was that the aunt was afraid of them 'taking it out on me'.

My mother's CH is a specialist dementia and staff are invariably friendly and welcoming. The atmosphere could not be more different.
I think your instincts are often the best guide - somewhere will either feel right, or it won't. In both our cases we looked at an awful lot before finding what felt right, but there's usually somewhere out there - just try not to get depressed if the first few are nowhere near right.
Good luck!

 

[joggyb]

Apologies for the monster post:

My mum is not yet, I think, quite ready for a care home, but this week has been very stressful and the suggestion was made to me yesterday by the local over-75 team.

So it's in my mind. It probably won't be for a good while yet, but I can't go through many more weeks like this one with her and she has deteriorated markedly in the past few months.

Currently mum is having carers coming in three times a day and on Monday they couldn't get her to the door to open it for them. So the carers had to ring me, couldn't get through (I was driving down to Thanet from Medway) so called my sister in Norfolk who told them to call the police, which they did. The policeman turned up, broke in, and found her lying on the floor in the living room. She told him that she had been napping on the sofa (though I believe she's actually been sleeping there), rolled off it and was simply more comfortable on the floor.

He called the paramedics, by this time I had arrived, and two lovely paramedics turned up and did all the tests they could. Everything physical is fine, ECG normal, blood pressure, blood glucose, all fine. The paramedics then said she should see her GP and rang the surgery to get him out - no GP, but the over-75 team came out yesterday and it was them that suggested that she might be better off in a home.

On Tuesday I had a call to say she hadn't eaten or drunk for over 24 hours so off I went and practically forced her to eat while I stood over her - I know it's the completely wrong thing to do but I was very blunt and explained what will happen to an 86 year old who doesn't eat or drink. Yesterday she got a lecture from the over-75 team about dehydration - I've been putting a glass of squash by her to sip on over the day which the carers refill as necessary.

They recommended a load of stuff I've already got in place but mum refuses to entertain - for example they started talking about a high-density cushion which she already has but constantly removes when I place it in her chair - they made her have it on her chair yesterday but I'm confident when I go round today, that it will be shoved down the side of the chair again because it makes her feel as if she's tipping forward and she's going to fall out of her chair - I'm going to look for a second hand recliner, but she will refuse to use it.

They've also referred her to ICT (don't know what that means!) and Age UK who will be able to arrange Lifeline (which she won't use) and a keysafe (which is one of the conditions of Lifeline, up until now she has refused to entertain the idea but it's no longer a matter for discussion, she's having one!) - ICT will be able to arrange stuff like a zimmer frame and delta frame as her mobility has become very poor and for the past week she hasn't moved from her chair. No pressure sores, they checked for that, and apparently her bum is "like a peach". She does smell quite bad as she refuses personal care, and I'm going to try to persuade her to get in the shower today.

So how do you go about looking for a care home? I understand that I will need to visit each one but how do you find one? Just Google? There are two near where she lives, but I don't suppose it really matters where she goes - there's actually one across the road from me, which would be really handy for me, but if it's no good for her, then it isn't.

What do you look for? I presume you need one that specialises in dementia care, but what else?

I will involve my older sister in the decision but she's got a 3 hour drive to come down here so she can't do anything hands on and she trusts me to make those decisions. I won't expect her to do much else for mum as my sister detests her (and I understand very well why and I really don't blame her) and I wouldn't ask her to.

I started by doing a Google search. Your local authority may also have a list available. From there, I checked the CQC reports on each home, and formed a view as to whether or not they were even worth considering.

Then we visited the ones we'd selected. As others have already said in answer to your post, don't be fooled by plush, swanky-looking, or brand new places. It's the care that's paramount. Do there seem to be enough carers around? Are they actively engaging with the residents? Does everyone seem reasonably happy/content? Is the food home-cooked? Are there activities laid on? Can residents stay there for the rest of their lives?

My father's care home was definitely in need of a cosmetic overhaul when we visited, but it was evident from the start that the level of care was as good as we could possibly hope for. The food is lovely, cooked from scratch on the premises, and they are very accommodating of fads and foibles! Dad is well looked after by a good team in whom I have absolute confidence.

A few months on, and the cosmetic overhaul has begun, too

 

[Isabella41]

ICT stands for Integrated Care Team. They will assess your mother to see what her needs are and where these needs could be best met. It could well be that they reccomend a care home as the best setting but they could also reccomend other things like increasing her package of care in her own home and the addition of a key safe at the front door so the carers can gain easy access.

 

[Moonflower]

Remember that most good homes will have waiting lists, but that you can ask to be put on the list, and say "not yet" if a place comes up before you are ready.

 

[Pickles53]

Our LA has an excellent care services directory on its website, which includes care homes. They have their own quality grading and also a good checklist of 'what to look for' and 'what questions to ask when you visit'. Do have look or phone your LA as this was a really good place to start, along with CQC reports and ratings.

We made a list of our 'must haves' and 'nice to haves' and first sent emails to all the homes on our shortlist with a brief summary of mum 's condition (especially as her mobility was very poor) and some basic questions. As mum was self-funding we also asked for copies of terms and conditions/service user agreements/sample contracts/fees.

Those who couldn't be bothered to reply got a black mark! Several replied explaining that they didn't think the home would suitable for mum because of her mobility problems, usually small homes in older buildings.

By doing this before visiting, we were able to avoid wasting our time or theirs with patently unsuitable options, and also when we visited we could concentrate on really observing what was going on as we already had a lot of the basic factual information (eg staffing ratios, types of activities, menu options, en-suite rooms or not)

 

[Essie]

Hi skaface, I'm sorry you (and your Mum) find yourselves nearing this decision, it is never easy.

I would pretty much reiterate what everyone has said, shabby doesn't necessarily mean shoddy, care homes take a lot of 'wear and tear' and how they 'feel' is so much more important.

This is link to the CQC's website http://www.cqc.org.uk/ which will list homes in your area and show current and previous reports on the home.

I would say re the 'just drop in and catch them unawares' plan that it isn't really fair or realistic to expect a proper tour of the home if you do that - staff are always busy so if you want someone's attention, to answer questions, show you round, have a chat with, make a proper appointment - you could always go in person to make the appointment just to see them 'as they are' but TBH if the manager was able to just wander round for an hour at the drop of hat I'd be a bit suspicious that they were not as busy/conscientious as they should be!

Good luck.

 

[Fred Flintstone]

I mentioned this question to my parents' general practitioner, and he arranged for the manager of a certain care home to ring me for a talk a couple of days later, and then I saw her and the CH the next day.

The GP has several of his patients there, and it is not a place he gets a bad feeling about, unlike some.

The CH manager told me that about two thirds of her residents are listed with him or one of his partners at one of the two main local practices, and the GP partners from there all keep in touch with their own patients. The other, smaller, general practice leaves all the patients in the care of just one of its partners, (a doctor I know and don't think very well of, as a matter of fact). My parents' GP is ace, however.

The CQC website is a useful resource, but you might do quite well by finding out what your mother's GP is like, what sort of relationship he has with patients in the local CH, and indeed whether s/he knows much about the local CH at all.

Some GP's practice managers are very skilled and knowledgeable, and you could do worse than ask to speak with him/her.

Lastly, a friend of mine asked a certain clergyman, in place for several years, if he could recommend a CH in his own town. His immediate answer was no (!), but that he could recommend one in a neighbouring town. Local knowledge is everything.

Good luck!