Things to look for in a Care Home

Discussion in 'I care for a person with dementia' started by Julie33, Dec 11, 2019.

  1. Julie33

    Julie33 New member

    Feb 2, 2019

    I have been a member for the last six months and have gained so much insight from other members, so thank you.

    My mum is 69, with LBD, diagnosed in May 2019. She is regressing rapidly and we (me and my brother) are now looking for respite care in the New Year with a view to it becoming full time withinbthe next year..

    We are visiting one on Friday, I would appreciate if other members could lend some insight in what we should look for?

    I wish there was a Manual for this - I'm only 34 and never imagined I'd be here already..
  2. Louise7

    Louise7 Registered User

    Mar 25, 2016
    #2 Louise7, Dec 11, 2019
    Last edited: Dec 11, 2019
    Welcome to the forum. It can be really difficult to find the right home but these guides will hopefully be useful, and the Age UK checklist can be printed out and taken with you when you visit:

    From personal experience try to look beyond the décor - look at the standard of care provided. Some homes provide all sorts of extras such as cinema, bar etc - and the charges reflect this - but there are some good homes out there that may not look the best but are well managed and have really good standards of care. You can check reviews on-line and also Care Quality Commission reports although bear in mind these may not be up to date. I'm sure others will be along to add their thoughts but hopefully the attached guides will be a good starting point. An initial short respite stay will give you a good opportunity to see how things are before making a decision about a permanent placement. Good luck with your search.
  3. DesperateofDevon

    DesperateofDevon Registered User

    Jul 7, 2019
    Please get a Clinical health care assessment done. Dad now has to be moved after a year from dementia care to nursing care, horribly distressing for all concerned. x
  4. canary

    canary Registered User

    Feb 25, 2014
    South coast
    when you are looking at homes try and look at them through your mums eyes - things that are important to us may not be important to her - and try and look to the the future. Many care homes (even the ones that say they specialise in dementia care) only want the early, easy stages of dementia and once the dementia advances they give notice.

    My mum was in a dementia unit (not a nursing home) for three years untill she passed away there. My OH is now in respite in a residential (mixed dementia and non-dementia) and the difference between the twp homes is very obvious.

    The place that OH is in has a very "hotel" feel - lovely decor, a library, dining room kitted out like a restaurant, he can walk down to the paper shop down the road to buy a newspaper and it suits him very well at the moment, but would not be a good place for permanent placement. OH has unusual symptoms; he has lost the ability to perform most tasks and is beginning to need help with personal care, his language is dwindling, he has an indwelling catheter and his mobility is going, so that he now requires a zimmer frame to walk. He is unaware of the extent of his limitations and insists that he he is still able to do things. He does not have problems with his short-term memory, though - it is his long-term memory that has problems and the further back you go the worse it gets - but as his short term memory is OK he does not get confused about where and when he is, does not go out and get lost and does not repeat himself.
    The home he is in is best suited for the elderly frail with only very early short-term memory loss. It is not a secure unit, so people could easily walk out and get lost, there are few carers so there are often public areas (the lounge, the library etc) where residents have no-one watching over them to make sure that they are not having problems and the entrance hall has large plants in pots which would be an open invitation for people with advanced dementia to wee into!

    The home that mum was in was very different. It was quite shabby and looked outdated so that I had originally discounted it in my mind. Actually it was the best place for her as the care was excellent. There were always staff members around who knew exactly how to cope with dementia. Mum was coxed into having a shower and putting on clean clothes within 48 hours of being there and nothing fazed them. Mum got angry and hit one of them with her walking stick soon after she moved there and I was horrified, but they just shrugged if off as "one of those things". It was also a secure unit so mum couldnt walk out and get lost. She was very happy and thrived there and she lived there for three years, tending to her through her last days.

    It is also worth looking at the other residents and seeing what stage of dementia they are at as this will tell you what stage they cannot cope with. In OH respite home none of them have obvious dementia symptoms (although Im sure a lot of them do have some dementia), but in mums home there were people at very advanced stages too. It is also worth asking what sort of behaviour they could not cope with. This will give you an idea of when you will have to move her.
    Dont worry about the age difference. OH is the youngest in the home by many years (he is 63), but does not seem worried about the age gap.
  5. Sirena

    Sirena Registered User

    Feb 27, 2018
    I'm sorry to hear about your mum, you are so young to be going through this. The most important thing is to ensure the manager is confident they can cope with your mother's needs.

    I agree with Louise and Canary, look at it through her eyes. She is unlikely to use a cinema, bar, or beauty salon (these things are there to impress visitors, not help residents). My mother's CH is a bit shabby decor-wise, but there was a lovely welcoming atmosphere, the staff are cheerful and helpful. The residents were all clean and well dressed and seemed content. I just thought my mother would fit in well - and she did.

    But the real deal breaker is that a care home must not smell of wee. My mother's CH smells of lunch cooking, or sometimes of sanitiser. There is often music playing in the background in the lounge, and there is (almost always) a feeling of contentment.
  6. Pete1

    Pete1 Registered User

    Jul 16, 2019
    Hi @Julie33, it seems quite a daunting prospect, but once you have visited the first one you will get a feel for it (I went to six in total when looking for care for Mum). I'm assuming you are self-funding which will mean greater choice. I agree with the comments above, but also trust your own instincts and observations. It also depends on what Mum would like too, by that I mean if you think she would benefit greatly from events and activities that could be an important consideration, but not so much if she wouldn't (my Dad couldn't/wouldn't, whereas Mum got involved in a lot of activities and had a richer life for it) - so it is worth asking about that if you think it is something Mum will benefit from (they should have a weekly schedule of events they can show you). Make sure you also have a tour round the home - I know that sounds obvious but if they just want to speak to you in a quiet area for example that may not give the full picture (I had one that took that approach). The other consideration is of course availability of permanent placements. Mum was on the waiting list for 4 different providers, and ended up at my second choice purely due to availability and need at the time - it transpired that it was actually a very good choice and she settled in very well. There is also the very obvious consideration too is the location for you and your Brother to visit. Let us know how you get on, and fire off any questions that you have. All the best.
  7. andreasss86

    andreasss86 Registered User

    Dec 10, 2019
    #7 andreasss86, Dec 12, 2019
    Last edited by a moderator: Dec 16, 2019
    My parents and i have looked at so many care homes. It took us months of research and speaking to different companies and agencies until we made a choice. We simply couldn't bring ourselves to send her to a care home, especially considering we are all very busy with our work. We thought that if we put her in a home we will be seeing her even less. Plus, my grandpa is still going strong at 70, so we could not separate them in any way(even though it's hard for him at times). We spend a few months vetting at home care agenicies. And finally we found one just for us, which send us multiple carers which we interviewed ourselves. Now we have a carer which comes in 6 days a week. And she's the loveliest person ever. She gets along with my grandpa so well. They're bffs now. I hope this helps.
    I don't think I ever want to send my mo to a care home. I really hope the day won;t come.
  8. Champers

    Champers Registered User

    Jan 3, 2019
    Totally concur with above posts and points raised.

    The CH that Mother and MIL is in is more like a large comfy house than a care facility. There isn’t any fancy add on’s, but it always smells of either tempting and tasty cooking or that lovely old furniture polish. I agree, aromas are incredibly important; I’ve even rejected my own house purchases based on unappealing scents! It’s not too big - 15 other residents - and whatever time I visit, there’s always staff interacting positively with the clients. My mother always prided herself on her appearance which started to slide when she lived alone. Now, when I see her, someone has taken the time to apply some foundation and lipstick and given her a little manicure. It’s so good to see. There’s always music in the background and one of the staff members plays an organ, with requests, and gets everyone dancing along.

    We viewed another establishment which is part of a chain and it was like a five star hotel. Glitzy decor, loads of facilities, very impressive hair salon etc but I know neither of our mothers would have been that bothered about that kind of place, even before the onset of their dementia.

    Trust your instincts. You’ll know when it feels right.
  9. Helly68

    Helly68 Registered User

    Mar 12, 2018
    I would also say, look for homes that are flexible - for instance we paid for a period of "daycare" for Mummy so she got used to going to the home before she went there permanently. Sadly, you'd have to pay for this as I doubt councils will fund it. The home were surprised we wanted to do this, but it worked and they understood the logic. They also encouraged us to visit - both in the period where we were deciding and now that she is a permanent resident - I can go any time. Had to go in the middle of the night once. I would be wary of anywhere that restricted visiting.
    In the initial assessment, they included Mummy and asked her questions in as far as they could. It isn't always possible to involve your PWD in this way,but good homes always try to.
  10. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    Toronto, Canada
    To me, the most important aspect is staff turnover. Ask various staff members how long they have worked there. if there is a lot of turnover, I think that reflects badly on the management and in turn that will affect the staff and residents.

    I don't think the decor and amenities are necessarily important. What are important are cleanliness and staff ratio.

    As suggested, do visit as many as you can ahead of time. This will help if a crisis occurs. your gut feeling is very important also but as said above, look at it through your mother's eyes and not your own.
  11. Jale

    Jale Registered User

    Jul 9, 2018
    Would also say if possible speak to visitors and see what they have to say, visiting - does the home have an open visiting policy or are there restrictions. CQC reports are helpful but are not necessarily a deal breaker. The nursing home that Mum is in was rated as good for some things and needs improvement in 2 others, (it had improved from the previous year) but that doesn't matter to us as Mum is well cared for and seems happy, we can go in at any time. Is the home secure - so that residents can't go wandering off, what activities do they have.

    Good Luck
  12. CJDiva

    CJDiva New member

    Dec 16, 2019
    So sorry to hear you’re having to make these kind of decisions for your Mum. I’ve logged on here for the first time today and just posted that I feel young dealing with it at 41 so my heart goes out to you. Hope you’ve got lots of support around you ♥️

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