Any advice for finding a care home for elderly mother.

My mother's situation sounds very like yours, she lived independently until she had a fall when she was 97, after which the sheltered housing where she had been living for 10 years said they didn't have sufficient levels of care for her to return home when she left hospital. Mum wanted to go somewhere that was local where she lived, although it was very unlikely she would ever go home again. We used the CQC ratings as a guide to the various homes that were local and then visited the one that looked the most likely from the ratings. One important question that we didn't consider sufficiently before we chose was what would happen if a resident eventually needed nursing care; we didn't appreciate at all the difference between general care and nursing care and my mother deteriorated to the point where she needed nursing care very quickly, which couldn't really be offered by the home we chose. We managed to make it work for the few weeks before she died with the help of her very supportive GP and visiting district nurses but it's a complication that we should have given more thought to before we - and she - chose the home she went to.

As @Straightouttachelmsford says, if she has capacity it is her decision. People take risks every day that we wouldn’t; walking alone in remote areas, wild swimming in icy water, riding powerful motorbikes etc. Just because she is 95, it doesn’t mean she can’t make her own decisions and take risks with which you and your siblings disagree. I get it. Supporting someone who wants to stay at home is hard. But I would suggest an OT visit, implementing suggested aids and adaptations, upping the care visits and a cleaner.

If she has capacity, it's her decision to move.

If it's a mobility issue, I'd look at getting the occupational therapists and physios to have a look and see if they can help.

Definitely get more carer visits.

Also look for any extra care in the area as care can be more easily ramped up in that setting.

Find out how morning and bedtimes work, especially with poor mobility.

One relative in her 90s went to one for intermediate care after a fall and they wanted her to poo in a pad and they'd change it, rather than help her onto the commode in the morning because they had limited time to get people up. She's never done that before (even in hospital she used a bedpan until she could get up, then used a commode or was pushed to a loo) and absolutely hated it.

If you didn't go to bed before the staff changeover it might take a while before you could go.

She said it was lovely during the day (nice food, activities, big gardens to sit and look at or be pushed into), but the getting up and going to bed really put her off. She's back at home with carers and family going in now and I think would refuse to go to another one, at least without asking a lot of questions first.

Another relative had dementia, so we had different criteria. Agree that low staff turnover is a good thing to look for.

I'm glad you have found somewhere for respite. I do hope it works out well for her and all the family. Just one important point that I am not sure if anyone has mentioned but now she is going in for respite it is very useful to name her clothes. Although we were very happy with all the very caring staff and my dad was happy in his home it was surprising how the laundry would get mixed up even with only 3 men in the home!

I first looked at the cqc ratings then visited about 10 different homes. The one I chose was a single owned one ie not part of a chain. The owner lived in Scotland but came over every month . He had given the matron carte Blanche to spend so much a month without running every thing via him. So for instance when it got very hot she was able to order a dozen fans etc.

it was not the smartest or most up to date home but the staff were fabulous. All of the nursing staff had been trained and certified by our local hospice in end of life care which is unusual so at the end of my mums life they were able to give her the palliative care she needed. If my mum started coughing in the morning they would listen to her chest and if they could hear a chest infection they would email the doctor who would authorise a prescription and my mum would be on antibiotics by the end of the day.
There is a very posh 5 star home near us that has a cinema and residents can have wine with their meal which us lovely but that same home queried the length of time it took one of their staff to feed someone who kept choking . It had been assessed that it took 30 minutes to feed this person. The matron said they didn't have time to do that. The assessor said " so what do you suggest then, the resident either doesn't eat and starves or eats quicker and chokes" Quite!
With my mum at the end of life in her home , it took however long it took .

My advice would be: the most expensive is not always the best, and although CQC reports are useful they don’t tell the full story. I went through all this with my mother. The nursing home she was in was very expensive: good food, fresh flowers, good quality furniture, sweet-smelling etc. - BUT we discovered too late that their ratio of staff to residents was not high enough. When my mother wanted to be helped to the toilet and rang her bell, she often had to wait ages for a carer to come, which she found very distressing.

I have since discovered that homes run by charities can be better as they often have volunteers who come in to chat to residents, make tea etc. and it takes some of the pressure off paid staff. Privately-owned homes need to make a profit and cutting down on staff to the minimum is a way of doing that.

Check if they have a daily activities programme. Some homes have an Activities Manager. Your mother might not be a joiner-in but might enjoy listening to live music or playing games like Scrabble or bingo.

See whether residents can choose to stay in their own room - at one home my mother was in temporarily, they just dumped everyone in the communal lounge in front of a blaring TV for the day, which she hated.

If possible, talk not just to residents but to their visiting families. The trouble with CQC inspections is that elderly residents usually don’t complain and inspectors just speak to a couple of visitors who happen to be there when they come. I was never spoken to by an inspector as I could only visit at weekends, but I could have told them a lot that they obviously never discovered, judging by their reports!

If your mother needs nursing care in the future, does the home have the capacity for that?

I hesitate to mention this point as I fear it makes me sound racist, but my mother 's hearing was not brilliant and she had great difficulty understanding a couple of the staff who were excellent carers but had strong foreign accents.

In the end, most of it boils down to the number and quality of staff. Low staff turnover is a good sign.

Good luck!

This care home was made up of a row of big, old, houses. Lots of glamour and original archetictural features in the front with a more practical extension on the back. They only had a couple of the big sea view rooms with bay windows so they went for a chunky premium. Wasn't expected to live terribly long so it was thought better to spurge on the lovely view. Terms can vary wildly between care homes though so it's worth asking questions about what happens if xyz occurs. It is an emotive decision because you want your loved one to be safe and well cared for but you also need to consider practicalities.

My DM’s care home (an Abbeyfield, specialist and purpose built for dementia) took both self- and council funded residents - I’d guess maybe around 50/50. They all had exactly the same type of ensuite room, and enjoyed the same facilities. Of course the self funders subsidised the others, but we had no quarrel with that.

Have you discussed this idea with her? If she has local friends she may have visited / heard about various local homes. Could you try increasing the number of daily carer visits and adding in a cleaner for support?

My father went into a home at 96. He's coming up to his 102nd birthday with no sign of stopping. Going into a home can often mean an upturn in physical health - regular meals and snacks between meals, medicines on the dot does an awful lot.

To someone who was largely confined to their room, particularly someone with cognitive impairment, that would be as bad as moving to a different home - especially as the larger homes tend to have teams of staff assigned to different areas, so she might not even be seeing the same faces.

Not all homes will keep people on.

We found that if you had funds to pay for a minimum 3 years privately they’d be willing to keep you on at council rates but you might have to move rooms. Relative had a nice big room, en-suite, with a sea view. There were much cheaper rooms round the back with shared facilities.

@MereDintofPandiculation MIL is being funded from the sale of her house. The funds should last 6 or 7 years which hopefully will be OK. She's frail and 90. There are also some savings. I think OP's mother is 95.

Better that the money be spent on her living somewhere nice than be inherited by us.

Somewhere that is convenient and pleasant for you to visit as well. My mothers nursing home was on the seafront which made walks out very pleasant.

I can only say what we did twice - for FiL and later, for DM.

Made a list of any that seemed suitable, phoned them all. Discounted any that asked us to make an appt. just for an initial look around - any good home should be happy for you to do this - except at very busy times like mealtimes.

Visit them all (yes, it’s time consuming) and go on your gut feelings, and (from experience) try not to be influenced by smart ‘Homes and Gardens’ decor. All too often IMO it’s there to influence relatives who are choosing. Cosy and homely, even if a bit shabby round the edges, and cheerful, friendly staff, are IMO far more important.

One of the very worst we had experience of - an old aunt of dh was voluntarily there for a few weeks while her usual helper was away, was one of the most expensive, seafront views and very plush, but the staff were surly and miserable - she absolutely hated it there.

I'm feeling gloomy about homes at the moment as we may try and move my mum from one to another. I see patients in them too, and there aren't many I like. Having said that, your mum sounds exactly the kind of person who might thrive in the right home.

The best one I've ever seen is the one my mother in law is in. I don't know what they pay the staff but they keep them a really decent length of time. I'd say the more that you see staff interacting with residents, the better the home. And by interaction, I mean that the staff adapt what they do and say to the resident - they don't just have a laugh/talk to other staff members over the heads of the resident. You can usually tell when they're acting it out for you as a visitor.

Sorry if I've missed it - is she onboard about moving? Moving people out of their own homes at this age can be detrimental to their health so usually the home care visits are increased first to see whether that would help. Assistive technologies also can be put in like a lifeline alarm.

As she doesn't have dementia, it might be worth looking at extra care supported housing. Generally, carers in extra care are on site 24 hours but she would have her own flat so retain some independence. In our area they can usually deal with high physical care needs (eg; hoisting, catheter and stoma care and some memory loss but not full down dementia ie; wandering etc.). Rents are much lower than care home costs.

However, if she wants the full residential care home experience ie own room but communal meals, activities then start by looking at the CQC (care quality commission) reports for each home then visit.

More than 1 lounge, so there can be a quiet one for reading or chatting, one for TV etc. My dad's second place had one done up as a 1950s diner, with help-yourself drinks and cakes, which was great.

Clear signage for residents to find their way around and a way for them to easily identify their own room (some have a personal photo montage, which also give staff a talking point to get to know them).

If it's divided into wings or floors, do the staff stay in one zone and get to know residents or rotate around? Do they use agency staff?

How easy is it to get from each room to the dining room, activity rooms, lounges etc? First place my dad was in had all social stuff downstairs, he was in a room upstairs so never went - there was a lift but the psychological barrier was too great (also only one lift, so when it broke he was stuck).

A small point, but music - if there's a singalong, or music playlist in a lounge, is it approriate eras for the ages of the residents or are they still stuck in the mindset that 'old people' = wartime and playing wall-to-wall Vera Lynn to people who grew up with rock and roll?.

But think how long the momey will last, because if you choose a home that doesn't take Council funded people, she'd have to move out when her money ran out.

Onve her savings are gone, then the rest will come from the sale of the house.

I would look round a range. We found that for similar weekly rates the difference in quality could be massive.

A couple were like hospital wards with very cheap furniture and smelly shared toilets; for an extra £75-100 a week two homes are more like 5* hotels.

If your DM is likely to be fully self funding we found that for a slightly higher rate the couple of homes that didn't take council residents were much nicer because PIL wouldn't be subsidising anyone else, all of their money was spent on their own care.