Looking for new care home and already feeling despondent...

[looviloo]

Im not quite sure what you mean by "the nicest", but if you are thinking about it looking nice, well decorated, bright, airy etc then please try and look beyond the decor and superficial stuff. The caring is the most important aspect. The care home mum was in was really quite scruffy (I initially discounted it because of that), but the caring was wonderful, it had a nice homely atmosphere and mum was happy there.

Maybe I used the wrong word - I meant that it was the best that I'd seen so far in terms of what I've been looking for. Smaller than most (36 residents over two floors), wide corridors so dad can move around more easily, activities taking place while I was there the first time, tidy outside area, very clean and fairly quiet, pleasant rooms, etc. Decoration looking a little worn but that doesn't matter to me. It could be just right if I wasn't so concerned with the staff ratio, and of course the potential for needing nursing care.

Dad's current home has been perfect for him, which could be why I'm having such a problem. It's small (12 residents), family run, very homely if a bit old fashioned, lovely caring staff with a low staff turn-over (another concern). It's certainly not a palace but they look after dad like he's a king, and it's such a pity they can't continue his care.

Everywhere I've looked so far has been bigger and more 'hotel like'. Less homely. I think it might be the area we live in. Of the 10 or so residential+nursing homes I mentioned in my last post, the smallest has 41 residents and all belong to larger chains of homes. I can't find anything that remotely resembles where he is at the moment, so whatever I do it's going to be a fairly radical change for dad and i just hope it's not going to distress him too much :-/.

 

[canary]

Thanks for the clarification. Im sorry all the places you have looked at seem less homely, especially as you are now looking for somewhere to look after him until the end. Its a worry, isnt it?

 

[looviloo]

It is a worry, canary, and it's causing some stress. I've just been looking for more information on my shortlisted homes and came across this article from July 2017: https://www.manchestereveningnews.c...care-nursing-homes-deemed-inadequate-13300129

This is the area dad's in at the moment and some of the homes I've shortlisted are in this article. I don't think my own area is much better. Is good & consistent care too much to ask for?

 

[canary]

It seems to be becoming an increasing problem
I dont know what the answer is

 

[looviloo]

There is no answer, unfortunately . We can only do our best xxx

 

[Sirena]

I feel that the care dad gets in his current home is better. So why move him to a place where his care might be worse?!

I think it must be more difficult looking for a second care home when you have been so happy with the first - I am sure that will blight my search if my mother ever has to move. Every home you visit gets compared unhappily with the original. I agree with you that I would avoid 'hotel' type CHs, which seem to be aimed at appealing to visiting relatives rather than the residents. My friend's mother was in a hotel type and my friend said she wished it was less smart and more friendly. I hope you find the right place soon.

 

[Amethyst59]

I wouldn’t ever choose a big hotel like one again. The one Martin is in is owned by a charity. The biggest difference that makes, as far as I can see is that there are so many volunteers visiting. This means there is more attention for each resident. It might be something worth considering. Even if your loved one is not up to interacting, it frees staff up to spend more time on professional caring, lifting, toiletting etc.

 

[looviloo]

Thanks everyone, I'm not keen on hotel-type care homes either and I know dad would be uncomfortable in one. Of course, if it's the only option then so be it . Amethyst, thanks for the suggestion re charity run homes, I'll check that out. Today I plan to visit another couple of nursing homes, on my way to and from a visit to see dad. Maybe I'll have a clearer idea of what his needs are once his current health issues settle down (assuming they do). At least I have time to do all this!

 

[nitram]

If considering a home run by a charity browsing around
https://www.gov.uk/find-charity-information
can be useful.

 

[looviloo]

I can't believe I'm still coming back to update this thread... it's been six weeks and it feels as though I'm no further on.

I visited two more care homes last week, both nursing. One was 'better' to my eyes than the other but neither seemed suitable for dad. Maybe it was the time of day, but one seemed devoid of staff/carers, while the other was cramped and noisy (dad prefers peace and quiet).

So I've been speaking to an independent (private) social worker in our area, who rang me last night to discuss the situation. Interestingly she mentioned that the kind of home dad seems to need is very hard to find (high-dependency). She agreed with the first social worker I spoke to that dad doesn't need nursing care, which is in contrast with the manager of dad's current home/GP/Alzheimer's Soc, who all told me that he does need nursing care. She was of the opinion (and I've heard this before) that nursing homes tend to have residents who are distressed, noisy, aggressive etc. I'm not sure I agree - surely it depends on the home?

Anyway, she suggested a residential home that I was initially optimistic about... until I looked up the CQC rating... 'needs improvement' after being inspected just a couple of months ago. In 4 of the 5 inspection areas.

How much emphasis should I put on CQC ratings?

Part of my problem is that to visit these homes I have to travel quite a distance, so obviously it's taking time and a lot of effort. I'm trying to tie it in with visits to see dad but my life is now revolving around it and the stress is making me feel unwell.

 

[Angela57]

Both my parents are in different homes, one is outstanding in all areas and the other good in all areas, and I'm very happy with my parents care in both. But, I have recently worked as a carer in 2 (sister) homes in my town and left because I personally didn't feel the needs of the service users were being met. I worked 3 weeks in one of them, and 2 weeks in the other. Since leaving, I checked their CQC ratings, to find that they both needed improvement in all areas. So I would take the ratings seriously.

Of course it can make a difference how the home presents to you, depending on the time of day you visit, but I would be concerned if there were a lack of carers around. There are always times when homes are noisier than than others. I know you are struggling to find time to visit the homes and that it's a very stressful time for you. But it could be worth visiting any homes you feel are the top of your list a second time, but at a different time of the day.

Wishing you luck.

 

[Amethyst59]

I pretty well ignored CQC ratings at the first establishment we used, and I bitterly regretted it. Someone else also advised me to look at Charity Commission website, for homes that are run by a charity, to look at financial reports and this influenced my choice of home this time round.

 

[Witzend]

Yes, it can be very dispiriting. We looked at a lot both times (FiL and my mother) before the one that instantly felt right 'turned up', so to speak. Take heart, I'm sure the right one is out there somewhere! The hunting can be very time consuming, though.

One thing I soon learnt is that when it comes to dementia, any kind of immaculate 'Homes and Gardens' feel is there largely to impress the relatives who are choosing. A cosy, homely atmosphere with friendly, cheerful staff is IMO far more important, even if it's a mite shabby round the edges.

 

[kindred]

Both my parents are in different homes, one is outstanding in all areas and the other good in all areas, and I'm very happy with my parents care in both. But, I have recently worked as a carer in 2 (sister) homes in my town and left because I personally didn't feel the needs of the service users were being met. I worked 3 weeks in one of them, and 2 weeks in the other. Since leaving, I checked their CQC ratings, to find that they both needed improvement in all areas. So I would take the ratings seriously.

Of course it can make a difference how the home presents to you, depending on the time of day you visit, but I would be concerned if there were a lack of carers around. There are always times when homes are noisier than than others. I know you are struggling to find time to visit the homes and that it's a very stressful time for you. But it could be worth visiting any homes you feel are the top of your list a second time, but at a different time of the day.

Wishing you luck.

I do so agree about time of day. At my husband's nursing home, the atmosphere in the morning is upbeat and lively but as soon as sundowning begins (any time from say two). Things are contained, and that's worth looking out for, too. But to see the home at its best, then between ten and twelve is a good time, I think. Warmest, Kindred.

 

[love.dad.but..]

I looked at the most recent cqc report and the one before that to see which direction it was heading if improvement was reported as needed in either report. Am not sure I agree with SW..in dad's dementia NH there were a variety of residents in a variety of stages and that is what I woukd have expected so unlike some that I looked at where I couldn't see dad and his stage slotting in...I could in the one I chose and could see them taking dad even with the odd blip or two to end of life which happened. I agree with seeing a home at the best and worst of times to gain a good overview and see how staff react and handle situations..how they interact with residents at differing stages. ..staff ratio at busy times..etc.

 

[looviloo]

Thanks everyone for your comments, don't know what I'd do without your support. I'll stick to my plan of checking out the CQC reports and letting them guide me - it's a good tip to look back at previous reports too and something I've been trying to do. I've noticed that we have a higher than average proportion of homes that 'require improvement' (or worse) in our area, and even the ones rated 'good' vary wildly in my experience...

Yesterday I visited three residential/high-dependency care homes.

The first was appalling imo, despite a 'good' rating. A care worker (who'd been smoking outside) unlocked the door for me then wandered off without saying anything. I signed in, and looked around to talk to someone... all carers (maybe 2 or 3) were busy... really busy... and there were no admin staff. I walked further in, saw the lounge & dining room. No one approached me. The place reeked of urine (and it wasn't just my sensitive nose this time). So I spun around, signed out, and left. I want to report it because this must surely be a major safety issue, but cannot for the life of me find the local authority adult services info (the web page is down for maintenance) and the CQC report page isn't helpful. I might need to ring them, but will sort it out later.

The second was better, staff more organised, large if ramshackled old building. Residents all resting after lunch. Didn't see many staff, and the carer who took me round was polite but joyless. In fact the whole place could be described as dour. Maybe this is one place that would benefit from another visit, maybe in a morning. Another concern is, there didn't seem to be any other visitors?

Third place was lovely, much like the home that dad currently lives in. Smallish, homely, care staff bustling around. Another visitor arrived at the same time and couldn't praise it enough. One resident was handing out boiled sweets (eek! choking hazard for dad!), all seemed happy. But I don't think they'd be able to meet dad's needs, so have reluctantly crossed them out.

I've seen nearly a dozen homes now and there's only one I'd entertain the idea of dad moving to. I've got another two in mind to visit today. Please wish me luck .

 

[Amethyst59]

I certainly wish you luck...maybe today will be the day!

 

[Sirena]

@looviloo I wonder if the apparent lack of staff in that care home was due to time of year? My mother has been in her care home for six months, and only once did I think they were under-staffed - when I visited earlier this month. It's holiday time so if staff are away then someone goes sick, things get a bit sticky. All the residents were still being well cared for, but it was not as well staffed as usual and I did think that if someone did a random visit they would not have had a great impression. I wonder if it would be worth going back for a second look if you felt it was a 'possible'.

 

[looviloo]

You could be right that it's the time of year, Sirena. I'm noticing that the staff in some homes are quite remote from the residents (huddled at the end of the corridor, or in a side room), which could also make them look 'absent'. It's just not the case in dad's current home, where the cares are always walking through the lounge and corridors and interacting with residents.

I've seen another two homes, neither of them suitable imo. Both were more hotel-like, which I've tried to avoid until now. Very nice but too large for dad (he's used to a small, cosy place). He'd never manage to walk any of the corridors, they're so long.

One of the homes told me that dad would have to be fully assessed for his needs & care category (residential v nursing / EMI v general) before he could move there. But how?! The mental health team referred me to social care, who frankly don't want to know! The care home manager agreed that since dad is self-funding and already in a care home (i.e. being cared for, and not at crisis point in a hospital) then he is low priority.

I'm so frustrated by it all! Tomorrow I'm going to ring adult social care again and SHOUT VERY LOUDLY. It keeps running through my head that I could relinquish my POA and walk away. Is that possible? Would they do something then? Because the stress is now too much.

 

[Sirena]

I'm so sorry you still haven't found anywhere suitable, I know the incessant stress really grinds you down. I have privately dreamed of relinquishing my POA too. My mother has a second 'backstop' attorney named in the LPA (her solicitor) so it is in theory possible, and sometimes it's tempting. At the moment things are jogging along okay but you never know when the next crisis is going to blindside you. At least I haven't yet had to rely on SS for anything - I would have expected the care home to do the assessment themselves, from a face-to-face plus the current care plan.

The staff being 'remote' from the residents sounds all wrong. At my mother's CH there is an office where there are usually one or two senior staff answering the phones and doing admin, but there are always three or four carers in the main lounge interacting with residents and doing routine care. Even on the under-staffed day there were three carers in there, some residents are at risk of falls and have pressure pads on their chairs so there needs to be a carer quickly available should one of them get up and need help.