Footwork Hendy - just that. Relentless slogging around so many places and spending at least an hour there and then having a second visit.
My first and most important battle was with the consultant. She wanted him to go to an EMI unit. The EMI units in my area are appaling!! All are privately run and I came away from them in pieces, emotionally drained. So my major battle was to stabalise Ken, then convince the ward staff and the consultant that he was capable of being cared for in a kinder environment than the ones I had seen.
When I go to any care establishment, I look at the layout of the place. I have to bear in mind that Ken's particular form of dementia means that he needs to wander around constantly. If the home has only one room where residents are expected to sit around - then that is immediately crossed off my list. Again to refer to the number of public rooms, is there another room that Ken could go to if he didn't like a particular resident, or to get away from a particularly noisy, disruptive resident. Is there a separate dining room which can be used for other activities during the day? He needs a corridor, preferably with some seating somewhere along the corridor and more than one room to wander in and out of. I look at the garden area - is it easily accessible? How is the garden layout? Will Ken be able to wander around the garden on safe, well laid paths? Is there seating and any shade for very hot days?
Then I try to check (without asking) how many residents there are and how many staff I can see on duty and how the staff interract with the residents. I ask can I come and have a meal with the residents as I think it is important to see how the staff deal with mealtimes. Do the staff take time and patience with the reluctant eaters? Are special diets observed? Is there a choice of a cooked meal / sandwich type food? I also ask how many night staff do they have. I try to observe how the staff interrract with residents and how long have the staff worked at the care home? How do the staff interract with each other - do they work as a team? I chat to any staff I meet and try to find this out without appearing to be too inquisitive. Have any staff been on a recent 'refresher' type course? If they do not want to chat with me or appear distant with me, then this care establishment is also crossed off my list.
I look at the residents themselves, how they are dressed, are residents wearing glasses, are the ladies wearing any bits and pieces of jewellery - a sign for me of good care is that residents still seem to have their own, individual personality, reflected in how they are dressed.
I look at what facilities the care home provides for recreational activities. Do the activities which are on the notice board actually take place? Where do most activities take place? Who organises them? Are there any outside groups which come into the home? How many TV's, DVD players, Radios? Again this supposes that there are enough rooms for residents to have a choice of whether to listen to a radio or watch tv. I sit and watch TV for a while to see if the programmes being shown are relevant to the age group of the residents. Is there a 'smoking room' and has it got proper ventillation? Is there a whiteboard where today's date is displayed, what the weather is like and what activity will take place today and is this in a prominent place and used by staff to help residents to know what today's date is.
Are the toilets clean? Are they well positioned and are there signs informing residents that they are toilets. Above all else, does the place smell clean??? Residential homes do have their own particular smell and I am not asking for pristine, Febreeze smells to gently waft around. But essentially there is a difference between an acceptable 'institutional' smell and a downright offensive, unbearable smell.
......I expect by now you are sorry you asked me Henny ------
a ps added 10/2/09 My husband has been in his EMI home for a year now and I would like to add just one or two more more points from my experiences
Laundry facilities are important. Are/is there dedicated laundry staff or is this a job just for night staff (as in some homes).
If a resident does not like to eat in the dining room, can food be served elsewhere - ie: in a sitting room, or bedroom? If a resident does not want to eat at the set time, is his/her food saved for when he/she does want to eat?
Does the home have a visiting chiropodist? hairdresser? Are there regular visits from a community psychiatric nurse to help to assess medication needs?
Will you (the main carer)ALWAYS be informed if it is felt that medication needed to be changed?
None of the above are unattainable dreams - all of the above are concerned with the quality of life which we would expect for our loved ones, and all of which I have found in my husband's care home over the past year. Good luck and every success
xxxTinaT
