Is this a good care home?

[MereDintofPandiculation]

I think it is, but have no experience, and am inclined to think well of everyone until proved otherwise. So am I being naive?

About 30 residents. Everyone seems friendly, they all know my dad, and they clearly are talking to him (or allowing him to talk to them).

I had an unscheduled conversation with the manager who offered me a copy of his care plan (ie it hadn't been specially doctored for me). A few mistakes in it regarding his previous life, but I was interested that part of the plan was to have conversations with him about his interests (and there was a note saying the info he gave was "fascinating").

There's a lot of care given to his personal concerns, and a willingness to adapt routines so that he his happy with them. On the other hand, I've given up the battle to get them to use his preferred incontinence pants rather than their pads (and, to be fair, pads are more convenient as they can be changed without taking his trousers off).

When I've worried about his symptoms, they've acted on it and called the GP.

He grumbles a lot - some of the carers are "rough" when they turn him in the middle of the night, they don't collect dirty plates quickly enough, they'll tell him they'll be back in 5 minutes and don't come back for a long time (but his perception of time is very dodgy). Some of the carers discourage him from moving around

Apart from the losing battle over the pads, I haven't seen anything that concerns me, and I'm not at all convinced Dad is a reliable witness ... but from the above, does this sound a good home to you, or are there any things that would worry you?

[Honeyroar]

It sounds fine to me. Does he seem happy? Amused? Do they organise activities and outings?

[MereDintofPandiculation]

Dad doesn't really do "amused". He's been there a month, and isn't mobile at the moment, so no idea about outings. It was an emergency admission, so we need to think about whether just to leave him there, or whether moving somewhere else would be enough of an improvement to justify the upheaval. It's so difficult to tell what a home is really like just from a visit and reading the information.

[Fortysix]

Maybe drop by a few other places unannounced for comparison purposes? Include an expensive one and a less expensive one so you can see what extra funds buy.
I guess it all comes down to 'fit'. No place will ever be just like home, there will be many compromises . Some will be more right than others... from what you say there are no obvious red flags…
These are the Qs that would be on my list, most are quite basic but it's good to tick them off... My mum's first care home was closed down by the local council even though it was purpose built and three years old. Her next one was too expensive but we had to find a new place in a nano second with lots of families competing for rare rooms. This current one is great in most departments but its entertainment & activities are poor [and would not be as good for someone with milder dementia.]

• If there was a family crisis in another part of the country and you couldn't visit for a fortnight ,would you feel you could leave him there without too much concern?
• Do the residents smile and appear happy?
• Do you ever find him particularly thirsty? or hungry?
• Are his clothes or bedding ever stained with food? Do they happily change his sweater?
• Are his glasses clean and readily available?
• Is he dry? If he is soiled and you say to someone, do they change him right away and respond promptly in a kindly way? [Rather than make a face and seem cross]
• When he's dressed has he got all his own stuff on and has there been a conscious effort to make him match and look smart and purposeful?
• Do the staff talk over him or do they wait for his answers?
• Have the staff as a group learned his quirks?
• Are you aware of his assigned staff member?
• Have you met the night staff? Can you meet the night staff?
• If you meet someone in the corridor do they tell you how he's been, what he's eaten, how he slept and display accurate assessment of his mood?
• Is there evidence that the Manager goes on to the floor and has an awareness and isn't locked in the office all day? Same question about nurse?
• Do you feel that anything you raise is acted upon positively?
• What do other families tell you about the place?
• Are there smells of pee?
• Can he go outside to sit in his chair?

My mum moved from place to place quite happily. Don’t be too disheartened by starting a fresh if that’s what you decide.

[thesandwich]

From the ones I’ve seen that sounds pretty good dint- it’s the staff not facilities that make it.

[HighwayCat]

It sounds good to me. In my experience, low level complaining was a bit of a bonding thing for nursing home residence - in the same way employees may have a moan together (I hope that doesn’t sound rude; it isn’t meant to be and it was often balanced with praise for particular employees and events). Also, things like plates not being taken away become disproportionately problematic when you lose your mobility and rely on other people to do them IYSWIM. It highlights the frustration with the situation he’s trying to adapt to and loss of independence. Cynically, IME complaints were also a way to keep me involved with his care when I think he might have been concerned I would dump him in a nursing home and disappear.

Mobility is likely a problem for many residents, so aside from outings ideally they’d have seated activities or classes. Plus things like bingo, crossword or word games, talks, musical entertainment and film screenings etc. Even if your Dad doesn’t want to join in at least he is making a choice, rather than feeling there’s nothing to do.

As far as pads/pants go, I don’t think pads are available on prescription, is that a factor or are you buying the pants and bringing them in? There are also big pads that are sort of nappy shaped but without the sides which our nursing home seemed to prefer to the pants, although did use pants before mobility was lost.

Moving into a nursing home is difficult. It’s generally not a positive life change, so people understandably don’t embrace it. If they’ve personalised a care plan and make an effort to keep a schedule he likes rather than making him fit in with institutional routines that sounds good and he probably needs time to adjust to his new home and surroundings.

[Honeyroar]

My mil's care home organises visits from bands, (chair) aerobics, dances (even those not mobile seem to enjoy watching) and petting farms bring animals in - that kind of thing. Otherwise there are always DVDs of old films going, board games being played with the staff and plenty of picture books available. So they're not just sitting around looking bored (this is a dementia ward).

[fluorescentorange]

I think just one month in, it is too soon to tell. My DFiL was admitted as an emergency last summer as he was found unconscious in his flat and he was malnourished, filthy and poorly. We lived a long way away and didn't visit often. I moved him into a care home a mile from my house and at first I thought, my god this place is awful, it smells of wee and most residents are suffering with confusion of differing levels, but my DFiL is as happy as happy can be. The staff are wonderful, he loves them and they love him. He is mobile and not confused but if he lived alone he would not eat or drink or wash himself so he is in the best place. He has gained a stone in weight and he looks amazing. Give them time to get to know your Dad and him to get used to being there. If in 6 months you feel it is not right for him then look to move him but one month is really too soon to tell if he will be happy there. Most places are very understaffed, especially at night and it may feel to him that they are rough as they will be rushing to get everyone seen to, he will also get used to waiting to be seen too. I know we pay a lot of money (£550/pw in our case) but it is the difference between life and death in our case. I found moving him into care was the hardest decision we have made, but by far the best one.

[BackforGood]

It is really difficult and I feel for you.
From what you say, it sounds fine.
I've been supporting a friend (she has no dc) who has just moved into a nursing home. She moans about how long it is when she wants something a cup of tea or a different biscuit) but she had been used to having her own carer in her home, just looking after her - it is different when the staff might be in the middle of assisting someone else when she calls them. It is what it is. A lot of adjusting all round, and a lot of time on her hands, sitting there to think of something that isn't really an issue, can become one in her mind.

[helpfulperson]

The only bit that might make me concerned is the getting the GP when you raise concerns? Were they aware of the symptoms you raised? Is it a nursing home - if so they may monitor a situation for a bit longer before calling the doctor. Occasionally staff have said to us that dad was a bit under the weather but that the nurse was happy with his temp, blood pressure etc so they were adopting a wait and see attitude. But it was always obvious that all staff were aware and vigilant.

If you are overall happy I would suggest to presume he will be fine there but do a bit of checking out other places while you have space to do so.

[MereDintofPandiculation]

The only bit that might make me concerned is the getting the GP when you raise concerns? Were they aware of the symptoms you raised? That's something that didn't worry me in the least, for various reasons which I won't go into here.

He's put on 12kg since going in, and his personal biscuit stash is lasting him a lot longer - I no longer make sure I have a top-up packet of biscuits every time I visit. They do feed them a lot - breakfast, hot two-course lunch, afternoon tea with biscuit, hot two-course dinner, supper of sandwiches and cake - and he's enjoying the food.

He gets positive answers on all of forty-six's questions - except "assigned staff member"?? Must find out about that. He seems to know and recognise all the staff (not necessarily by name) and have his personal preferences. I've also not spoken to other families, and I'm conscious that's something I should do. Manager is hands on, she's often out and talking to residents when I arrive, and I know she's several times done Dad's dressings herself.

Activities I need to look into, although at the moment he's still getting settled, and quite actively "wants to be left in peace and not harassed".

"Fluorescentorange* I wish we were paying only £550! £765 in our case.

Thanks everyone. It looks like I'm not being overly naive. His cognitive abilities have declined with every shift (eg long hospital stay just before Christmas) so I'd have to be convinced that new place was substantially better before doing another move.

[maddywest]

HighwayCat " In my experience, low level complaining was a bit of a bonding thing for nursing home residence ... Also, things like plates not being taken away become disproportionately problematic when you lose your mobility and rely on other people to do them IYSWIM. "

Very very much this, and even more so recently when Mum has been ill and pretty much confined to her room - which can make it impossible to work out which if any of the complaints are actually legitimate. And in a way they are nearly all legitimate, or at least have a kernel of truth, but as you say, disproportionately problematic. Working out when to be 'hands off' is hard. I'm wondering whether to start a diary of all the complaints, and see which come and go away without intervention - kind of like mindfulness watching thoughts come and go (which I'm not very good at!)