How to pick a care home

Discussion in 'ARCHIVE FORUM: Support discussions' started by Kath TN, Oct 17, 2006.

  1. Kath TN

    Kath TN Registered User

    May 5, 2006
    Dad's thinking of going into a care home. I've read inspection reports on a few in the area and will go to visit them this week. The thing is I don't really know what to look out for at the home or what questions I should be asking. Can anyone advise me.
  2. Brucie

    Brucie Registered User

    Jan 31, 2004
    near London
    From my perspective as someone whose wife now lives in an excellent care home, I'd be looking at the following [not in any priority order]:

    1) is the place secure? Could a resident simply walk out? [bad thing for many dementia residents to do]

    2) when you walk in and around, does the place smell? does it seem clean?

    3) what are residents rooms like? Is there sharing? [best if not, in my opinion] Are the rooms en suite? [nice but rarely found at present but they are re-building my wife's home in the next few years to make all rooms en suite]

    4) is the home manager approachable? Are staff chatty?

    5) could you visit any time day or night, without notice? Or are there set times for visits

    6) what is the food like? ask to see a menu

    7) look at the residents - talk to some of them. Are they all arranged in lounges with the TV on, or are there activities? Can they walk around? Are there gardens for them? Do they have clean-ish clothes on? [in the best of homes they can't keep residents clean all the time!]

    8) if there are relatives of residents there when you go, ask them what they think of the home.

    9) is there a relative's support group at the home?

    ... that's where I'd start.

    Good luck.
  3. mw52

    mw52 Registered User

    Aug 25, 2006
    Looking for a care home

    I agree with all Brucie said. When my sister and I were looking for somewhere for mum I rang and made appointments. What sort of care does your dad need - is it nursing care. The best home mum ever stayed at was sadly the place where she fell and broke her wrist , which seemed to be the beginning of her going downhill.
    As it was purely for respite, most of the residents were mobile but it never smelt, the food really was home made and the staff did sit and chat to the residents. It was bright and airy and the rooms were clean and comfortable.
    All the places we looked at had that hint of odour - which the staff tried to mask with various air fresheners. And when they've sometimes 20++ residents to get up, washed, dressed and fed it's hard to try and entertain the ones who are up as there aren't usually enough staff to do any entertaining!
    A colleague said to me when we were staring all this - no-one will ever look after your mum like your dad does, or you and your sister and no place will be like home. How right she was. No-one will be able to look after your dad like you can and I know it will be hard for you to go through this experience.
    One thing you can count on though is a ton of support from everybody here at TP. They really are a great bunch. Good luck!
  4. noelphobic

    noelphobic Registered User

    Feb 24, 2006
    I always advise people AGAINST making an appointment for a first visit. Obviously it might be better to avoid mealtimes or going very early in the morning or late at night but I don't see any reason why you should not turn up unannounced mid morning or mid afternoon, or even early evening. If a home has a problem with unannounced visits then I would wonder what they had to hide. I have also received the same advice from social workers.

    I have had to look for residential care for my mum twice, both times under great pressure to find somewhere quickly, and it is a daunting task and a huge responsibility which I don't envy anyone.

    I would also ask lots of questions. Write them down before you go. Again, if they have a problem with answering questions then you have to wonder why.

    Also, when reading the CSCI inspection reports try to read between the lines as much as possible. If there have been unannounced inspections then look at the reason why. If it's just some kind of spot check then that is fine. If it is because CSCI have received a complaint then look at the nature of the complaint, how serious it is, and whether it appears to have been addressed and dealt with correctly.

    Ask around your neighbourhood, your workplace (if you have one) etc. The chances are that a friend or acquaintance or an associate of one of them will have some knowledge of homes in your area.

    Shared rooms are far from ideal but when we came to choose my mum's second home we decided to go for a shared room in the home we preferred rather than a single room in a home we weren't as keen on. As it happened, the sister of the lady my mum shared with later came to live there (from the same home my mum had been in, but that's another story!) and we were asked if we would move my mum to a single room that had become available so that the sisters could share. So now she has a nice single room. I doubt if any homes have ALL shared rooms, and I believe they are being phased out anyway, so that could be an option. It did go against the grain a bit that the charges weren't any lower than for a single room but we just had to accept that.

    I hope that some of this is of use to you and if you have any other questions then fire away. If I can't answer them then I am sure someone else can!
  5. Áine

    Áine Registered User

    hi Kath

    I'd agree with all the points the others have mentioned. What I'd add is ..... think about yourself and the other people who will be visiting dad. Is it easily accessible for them (near a bus route, have adequate parking spaces). Is it fairly near to where you live or work (or where dad's other family and friends live or work)? Will you feel comfortable visiting there? Do you feel OK with the carers/matron/whatever? Do you feel you can ask questions, offer an opinion etc? ........... Think about how you might feel visiting, spending time there: what will you do? is there a quiet place to sit? can dad have his own room and TV where you can be comfortable? is there a garden? are there parks or a nice pub nearby that you can easily visit?

    It might all sound a bit selfish ....... but dad's life will be affected by visits from you and friends and family, so the easier and more pleasant it is for you, the better it will be for him in the long run.

    happy home hunting :)

  6. noelphobic

    noelphobic Registered User

    Feb 24, 2006
    Aine, I just wanted to say that you've made some really important and relevant points there, and ones that just didn't occur to me! Both of my mum's homes have been really close to my sister and I (who also live really close to each other). The first one was about 3 miles away, close to a train station and not too far from a bus stop. The second one is even nearer, and again close to a train station and a bus stop. My sister and I are the most frequent visitors and we both drive anyway but if we had to (or wanted to exercise) we could walk there. Also, if there is an emergency, we can be there really quickly. There are also pubs, shops and restaurants close to her present home, although unfortunately she is not that interested, but for those who are it is a great location for getting out.

    My brother doesn't drive but, given that the public transport links are so great, I'm not sure why he hasn't visited her since January when she moved in there!
  7. currywurst

    currywurst Registered User

    Jan 29, 2006
    Thank you for asking this question Kath as it is one I wanted to ask myself :)

    I also wanted to ask TP'ers any things to look out for in a brand new home that hasn't yet had any inspections. We have one opening in my area at the end of November and I have asked for a brochure and they will be inviting me for an open day when it's nearly ready for opening. It's an EMI home, which is just what mum needs. It's only for respite for now, but I am looking at longer term in case there is ever any reason why I couldn't continue to care for mum at home.

    Many thanks.
  8. noelphobic

    noelphobic Registered User

    Feb 24, 2006
    It would be tough to know how to advise you on what to look for in a new home. However, if your mum is going for respite initially then that will give you a chance to suss things out and know whether it's worth considering if and when she needs care permanently.
  9. Cate

    Cate Registered User

    Jul 2, 2006
    Newport, Gwent
    Hi Kath

    We have recently gone through the process of finding a home for mum. I agree with all the points raised, especially about turning up without an appointment.

    I would like to add, check to see if the NH is OK with dad taking as much of his own furniture / pictures etc. that you can stuff into his room to make it like 'home'. We were able to do this for mum, and I'm sure it has helped her to have all her own belongings around her.

    It is also helpful to have a 'coffee shop' in the home, in other words an area where you could go with dad and make him / yourselves a cuppa, again a nice touch rather than waiting on staff (who may be run off their feet) to make you all a drink.

    Hope this helps, and good luck in your quest.
  10. willemm

    willemm Registered User

    Sep 20, 2006
    I have to agree with all the recommendations made about what to look for in a care home, though I think the first hurdle may be one of cost. It depends on who is footing it. If private, OK, it must be assumed that the "user" i.e. the person occupying the home, can afford the charge.
    If not, and the local authority is to foot the charge, you will need to know what each home charges, and to verify from your local authority what their "threshold" level is. The threshold is the amount that they will pay (using the "user's" income to partly fund it) but any amount above this threshold, the "user" will have to pay. So if the local authority threshold is £500 per week and the home charge is £600 per week, someone other than the "user" must pay the £100 difference, or whatever the difference is.
    This finance problem, if the home is to be funded, severely limits the choice of home in the first place. You then start looking at the amenities of those within the price limit you can afford.
  11. Kath TN

    Kath TN Registered User

    May 5, 2006
    Thank you all - excellent advise

    Many thanks to you all - I've got lots to go on now! Can't wait to start making unannouced visits with my lists of questions! I'll let you know how we get on!
  12. alfjess

    alfjess Registered User

    Jul 10, 2006
    south lanarkshire
    I visited a complex yesterday, because Mum and Dad are booked in for respite. What a wonderful place. It is on 30 acres of land/gardens, lochs, canals, a fountain and even a barge on one of the man made lochs. There is also a very large walled garden which the residents can use and a courtyard cafe.
    Within the estate/ complex, are retirement bungalows, retirement flats, several care homes (which look like 5 star hotels, if it wasn't for the prevalence of incontinence pads, wheel chairs and walkers) and also a nursing home. It is beautiful. the staff couldn't have been more helpful and accomodating, as I didn't make an appointment.
    The rooms have en-suite bathroom with a bath lift? There is also a galley type kitchen where breakfast is made by a carer and served in the room, so I suppose that when I visit, I could make cup of tea.
    Downside was that when I asked about activities, the manager answered vaguely, saying they hoped to have a befriender, by November, when Mum and Dad go for respite, to organise activities.
    There was also another resident, whom the care manager said was aggresive. She tries to hit the other residents with her handbag. I can just imagine, that if she tries to hit Mum with her handbag, it will be world war 3. Mum will hit her back. :eek:
  13. Nell

    Nell Registered User

    Aug 9, 2005

    I would suggest asking for an appointment with theDirector (Manager? Matron?) of the new home and asking her / him questions about the direction s/he wants to see the new home take. This is a new position so this person has a chance to start something new. Hopefully the person will talk about issues such as maintaining dignity and respect, allowing for autonomy (where possible), achieving highest possible standards of care, etc. - and these will be things you feel are important too.

    You will get a "feel" for how the place will be managed, and also if your questions are welcome or not. You will also get a "feel" for the person in charge - does s/he seem to be genuine? have a genuine commitment to aged care? seem to be a realistic and reasonable person? etc. etc.

    The "tone" of any establishment is set by the "boss" so this interview should (at least) give you a chance to evaluate your "gut response" to the person in charge. Then you can take it from there. Good luck. Nell

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