Care Homes

A very difficult thing to do, my sympathies to you and your Aunt-in-law. She will have to be the one that feels comfortable with the home, without her buy in you'll all be wasting your time.

 

@strongylodon

This is part of some advice I gave someone who was looking for a place for their mother. It was some years ago so any money I mention is likely to be considerably out of date. The bit about asking questions is important. Don't let them just give you their standard talk.

Here are some thoughts that might be of help.

There are many different things to look at when trying to find a home.

The first question that has to be asked is, can she afford it. It will probably cost over £20,000 - £25,000 per year if she has to pay for herself. She is already receiving attendance allowance (possibly the higher rate) and will not lose this if she goes into a home if she has to pay for herself.

If she can afford it then she has to decide which type of home is required. There are three types that I know about. Nursing homes, residential homes and homes that are a combination of both.

Nursing homes are for people that need medical nursing and usually charge a little more than residential homes.
Residential homes are for people that need some assistance in everyday matters. e.g. some help in getting in and out of bed and getting dressed and undressed, needing help in the bath and other basic living matters. They are used to people being confused and expect them to be like that. None of these require actual nursing skills but the home will still be able to dispense her normal medicines.

You will need to look in the Yellow Pages to find all the homes in your area, or ask social services for a list (if they have one) and some advice. When trying to assess the homes you need to look round them and also ask quite a lot of questions.

Make an appointment to look round the home.

If the home smells of urine then cross it off the list.
See what the bedrooms are like and what facilities are in them, and if they can be personalised (we put mum's own bed in her room and some of her furniture).
See what the communal rooms are like and try to visualise them in the hot weather and when it is raining or very dreary out.
See what the ground are like, especially if mum likes sitting or walking in the garden.

When asking questions, try and word them to get more information than they apparently ask for.

"What are the visiting hours?" - you want a home that allows you to walk in whenever you like, not just at set times.

"What is the maximum amount of visitors per resident?" - there shouldn’t be any limit, within reason.

"Are there times when you don't want family or friends to take mum out and what time do you like us to bring her back?" - you should be able to take her out whenever you wish and bring her back as late as you like.

"What time do you get them to bed?" - they should be allowed to go to bed as late as they like.

"Do you have a timetable for entertainment, group activities or hobbies?" - they need some stimulation at least once a day.

"Is there more than one communal room with a television and are the residents able to change the programmes themselves?" - this would, of course, depend on how many residents there are but more than one room will allow a choice of programme.

Your mother should be able to have a TV in her room but it is better if she can watch whilst she is with other people (this is better mental stimulation and it makes it a lot easier for the staff).
Ask to see a menu of the meals. (It should be good PR for the home to have a weekly menu on display for relations of residents to look at.)

"What times are the meals?" - breakfast should be whenever the resident wants it, within reason (it should be easier for the staff if they don't all have breakfast together because the morning is likely to be the time when they are busy helping some of the residents get up and get washed etc.)

Expect lunch to be somewhere around noon and supper (a light meal) to be about 5.30 (by the time the staff have served the meal, helped those who need a little help with eating, cleared away and washed up it doesn't leave them much time to get those residents ready that like to go to bed early before the night shift come on duty. (There are usually less night staff than day staff and they are more likely to be agency staff.)

I used to, occasionally, pop in just before lunch and was always asked whether I wanted to sit with them and have lunch. I also gave them a hand with serving and clearing away. It made it more like a family lunchtime if I was sitting at the table with the residents and we all used to have a good chat (usually the same conversation every time! )

"How many residents do you have?"

"How many staff do you have during the day and at night?" - I don't know what the recommended ratio of staff to residents is but it will help you compare the homes.

"How many of your staff are employed by you and how many are agency staff?" - I know that homes are finding it more and more difficult to get staff and are having to use more agency staff which doesn't help continuity.

"If mum deteriorates physically and/or mentally, will you still allow her to stay here?" - a very awkward question for them but very important for mum. She will get to consider the home as her home so will probably not want to leave.

The home my mother was in said that they would keep her there as long as she didn't need professional nursing. She was with them 6 years and when she got cancer they still continued to look after her. The district nurse came in to administer her morphine and the staff were able to look after her until she finally died. Try and get their answer to this question put in writing.

 

A good point

We visited eleven homes, for my mother, all by appointment. Then we turned up unannounced at the three that we had shortlisted. That way we were able to compare the expected visit with the unannounced one. To be fair to all three, they weren't much different each time - but some of the others we had visited were not very good.

I also, on the impromptu visit, asked to see the kitchen whilst they were preparing lunch. I've had catering training so knew what to look for.

One thing I did ask for that was not usual was to be there when the Inspector came. Although the Inspector wasn't keen on me doing it I went round the home with him and the manager. I did that because I was interested and because I didn't think that a previous inspection report was fair to the home. They got a fair report that time.

 

The home always phoned me immediately the inspector turned up.

I agree. Minimum wage is not sufficient and the home my mother was in paid above that level (not a lot). Even with them paying above minimum they had trouble getting regular staff for the night shift (there were a lot of homes in the area). They usually paid a senior member of staff to sleep at the home and she was only called if the agency staff had a problem. Quite a good solution to their particular problem.

We were fortunate that the home was nearby (one of the factors in choosing it) and I was able to pop in for ten minutes almost every day. We also took mum out to restaurants occasional (she loved Indian food) and always took one of her friends from the home with us. When possible, we (the family) turned up to help with the entertainment. Even if it was just joining in the 'sing song'.

A lot of this is not possible if you don't live nearby, but we used to get upset that some of the residents didn't get family visitors even when they did live nearby!