Choosing a Care Home
When choosing a care home you are probably making one of the most important decisions in your life, whether the placement is for yourself or for a relative.
At Bondcare we aim to assist you to ensure that you are given all the information you require to make an appropriate decision.
You will have many questions, so make sure when visiting any potential homes, that you go prepared with a list of questions and that you get answers to them all. All homes should provide you with a brochure or prospectus which should include;
- Details about the home
- Service User Guide
- Summary of latest Inspection Report from CQC
- Copy of menus
- Copy of activities programme
When making an initial enquiry you should be encouraged to visit the home, any home which does not do this should be avoided.
Make arrangements to visit at least three care homes before making any decisions. This will give you a good overall vision of what is available in the area you are looking.
Standards of care in nursing homes can vary widely, however with the right information, ie inspection reports etc, you can make checks. Ask for lots of information during visits, to ensure that the home maintains people’s dignity, and ask whether it meets minimum care standards.
Asking friends who have visited people in a home may also help your decision. Ideally, potential residents should visit a short list of homes and give their own views.
The following is a guide on things to be looking for:
First impressions are often an important clue to how a home is run. For example:
- Are you greeted in a friendly way when you arrive?
- Is the atmosphere homely and welcoming?
- Is it clean and pleasantly decorated and furnished?
- Are there any unpleasant smells?
The best indication of a good home is that the residents appear happy and responsive, and that individuals are treated with dignity and respect:
- Do staff speak to residents in a way the residents like?
- Are residents involved in activities or chatting?
- Are they properly dressed and well groomed?
- Do they seem alert and interested?
- Do they talk to you as you walk round?
- Are they encouraged to do as much for themselves as they can - and if so, can you see any examples of this?
If the person is likely to need equipment or adaptations:
- Are the corridors and toilets wide enough for a walking frame or wheelchair?
- Are there suitably adapted toilets and baths?
- Are there ramps or a lift?
- Can residents have a single room?
- Are residents encouraged to bring in some of their own furniture and possessions?
- Are the bedrooms bright and pleasant?
- Can residents go to their rooms when they wish to be alone?
- Can residents keep pets in their rooms, or in other areas of the home?
- Do staff respect people's right to privacy, and knock on bedroom doors?
- Are chairs arranged in groups to encourage talking, rather than placed in a circle around the outside of the room?
- Is there a TV or radio left on when no one is watching or listening?
- Is there more than one room where residents can sit or where they can be quiet or see visitors?
- Are the living areas bright and stimulating?
- Is there a garden where residents can walk safely?
- Are special diets catered for, and are residents' likes and dislikes taken into account?
- Is a choice of food offered at mealtimes?
- Can residents eat in their rooms, or eat at different times, if they prefer?
- Are there facilities for making snacks if a resident feels peckish?
- Are staff trained to sensitively help people eat their food, if necessary?
- What happens if residents are unwell or need medication?
- Which doctor or doctors can residents see?
- Does the home have access to other services, such as community mental health teams, chiropodists and dentists?
- Can those residents who are safe and able to do so, self medicate?
You will want to make sure that there is good communication between relatives and the home, and that phone calls and visits are encouraged:
- Are visitors welcomed at any time?
- Are there quiet areas where relatives can spend time with residents?
- Are visitors encouraged to take residents out, or join them for a meal?
- Are children made to feel at home?
- Is information readily shared with families, and are they supported to become involved in the life of the home - for example, is there a relatives group?
Residents should be stimulated without feeling stressed:
- Does the home provide personalised activities that are suitable and engaging for residents?
- Are there opportunities for residents to help staff with small tasks if they wish?
- Are activities available each day or are residents left to sit in front of the TV?
- Are trips and outings organised and special events celebrated?
- Are residents encouraged to take exercise?
- Are residents able to choose and listen to a variety of music when they feel able?
If the person with dementia comes from a different background or culture from most other residents, you will want to make sure that their needs are catered for in a sensitive way:
- Are staff interested in learning about the person's background and culture?
- Do staff show a respect for differences that might involve diet, clothing, hygiene practices or religious observances, for example?
- Do staff find out how residents wish to be addressed, and how they prefer to relate to other people?
It is important to note whether staff seem friendly and caring towards residents and whether they treat residents with respect:
- Is there evidence of staff training?
- Do they make time to sit and chat to residents, or talk to them while they are helping them with physical tasks such as washing and dressing?
- Do they know about residents' backgrounds, habits and interests?
- Is there a key worker system operative?
A manager who is caring as well as efficient can make all the difference to a home:
- Does the manager have a friendly manner with staff and residents?
- Do they answer your questions openly, and seem to understand your concerns?
- Do they have a knowledge of the categories of care they provide, and can they deal with difficulties that may arise in an understanding way?
- Is there a full assessment at home before a resident is admitted?
- Does each resident have a care plan, and are their needs regularly reviewed?
- Is the family carer consulted about the care plan, and about any proposed changes to it?
If the home is being arranged through the local authority, the local authority will have a contract with the home. You may want to see a copy.
If you are arranging a home independently, make sure you have a contract with the home or a statement in writing. Get advice from a solicitor or Citizens Advice Bureau before signing any agreement. You need to be clear about:
- what is included in the weekly fee, what may be charged as 'extras', and how much notice is given if fees are raised
- what kind of care, and what services, residents can expect
- what happens if a resident's condition deteriorates - can they remain in the home and, if not, how are alternative arrangements made?
- how much notice has to be given on either side.
Many people think that care homes in the independent sector are only for the wealthy. You may be surprised to know that the majority of care homes in the UK are owned by the independent sector, and that 70 per cent of residents have their fees paid partly or wholly by their local authority. Bondcare cater for both local authority funded residents and those who wholly pay for their care themselves.
If you are paying all the fees yourself, you can choose whichever home you find suitable for your needs in your price range. If your local authority is assisting with funding, it doesn't mean you have to choose one of their homes. You can request any home that accepts residents funded by the local authority. However, the local authority will want to be sure that the home is suitable for your needs and doesn't cost more than it would usually pay for that type of care. If you want a more expensive home than the authority is willing to pay for, you are allowed to 'top up' their contribution from another source.
The main thing to make sure is that you are comfortable with the care provision in the home that you choose, that you feel comfortable with the staff team at the home, that you feel well informed about the contract with the home and that you have not felt pressurized into making a decision.
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