Care home and outdoors

[Graasspp]

I don't really know for sure if iabu, before I complain to my father's care home I wanted to ask here.

He's been there for 1 week, has moderate vascular dementia and is very placid and easy going, but can wander off hence they placed him in their dementia ward.

Sadly my mum is also there and very unwell, and it's possibly a home for him for a few years.

I asked them whether he's been out in the (miniscule) garden or to a local shop. He can't go alone and apparently therr aren't enough staff to facilitate a walk for him a few times a week. Even for 10 minutes.

I feel like this is inhuman, in winter it's one thing, in summer even worse.
It costs £1500 a week just for him.

I feel like I did ask this when I was viewing the home and oh yes, nothing was too much trouble and his needs would all be catered to. We were a bit short of choice as my mum insisted on a rapid move and there was barely anywhere nice that could accommodate them both straight away.

We all feel awful about home being there. It's 200 miles from where I love, otherwise I'd pop in and have a very short stroll with him.

Aibu to complain and threaten/look to move them both if this cant be promised. It's a very new home opened in January and they are not full yet, dementia ward only had 7 rooms full out of a possible 24.

I'd say you're within your rights to complain, especially if they promised it when you looked around.
Maybe start with asking what they can do to facilitate him going outside or at least leaving the home occasionally? My DH works in a care home and he said that his home includes trips to Tesco in their activities schedule through the week so that up to 8 people a week can go in the mini van for a wonder around. In the summer they do more outdoorsy stuff.

You can make a more formal complaint to CQC because it would be considered a deprivation of liberty and unless he has something legally in place they can't stop him from leaving or going outside.

I go into lots of care homes as a paramedic and from what I see the staffing levels are run to an absolute minimum and they'll never have staff for a 1:1 walk to the shops unfortunately. Especially as an impromptu one. Even without a DOLs order they still have a duty of care to insure safety. If he's on a the dementia ward then the expectation would be that he wouldn't be allowed to leave the home without assistance, and all the doors will have coded locks to prevent residents leaving.

It's absolutely mad with the amounts they charge! £1500 a week with staff numbers and wages typically being rock bottom. Yet how many residents do they have being billed £72k per year..... Someone's making an awful lot of money out of these places!

As an ex care worker this isn't unusual unfortunately. I quite often used to take my break in the garden and take a resident out with me as it was the only way I had time to do it.

It depends on his funding level, if he's being funded for 1-1 care and how many hours daily.
People seem to think that when a relative goes into a care home that the staff will give every resident the same level of 1-1. Unfortunately it doesn't work like that.
If you want your father to go out for walks and other activities, then it will have to go to a best interest meeting, which will then present its findings to the funding board.
They will then assess your father on need and give a yay or nay to the funding of staff for the activities.

It's not quite as simple as that.
There is a different criteria for different needs.
A DoLS would have been in situ prior to him entering the facility following a best interest meeting.
The residents in home which your husband works in, is a world apart from say, an EMI unit.
Unless it's an absolutely shit home who have poor CQC ratings and an even poorer attitude towards the care and safety of everyone within it.

My relative was in a dementia care home with open access to the garden and facilitated trips out weekly. This place sounds like it's not the right one for someone so able.

My DP is in a home and their care plan says they need a walk every day but they can't meet that need as they don't have the staff. Trouble is if they don't get it then I get call that they have kicked off, injured another patient etc etc. Horrible cycle for them and us

You need to set up a best interest meeting and apply for 1-1 funding to facilitate it.
Speak to his social worker.

@TheLaughingClown they have 100 residents and several units in the home, all the residents have dementia and each unit is at a different level. So it wouldn't be the nursing unit for example going out for trips, but it doesn't sound like OPs dad is that far along in his illness.
I know it's not as simple as I put it, I used to teach a DoLs training course, but as a starting point it is something for OP to consider.
It is a very tricky time for care homes, the larger homes have always had a reasonably high turn over of staff but Brexit has added to it and the wages are terrible for the work they do. My DH is a the head chef at his home but he's been there for 14 years so has seen a lot.

Into the garden might be reasonable. Walk to the shops, no.

This is very common unfortunately due to staffing. Would you be able to employ someone 1-2-1 to take him out every week for an hour?

Appreciate what you're saying, but at the home that I manage if a service user would benefit from a particular activity, then we action a meeting with that residents social worker and the funding dept to push for a 1-1 for that resident to enable that activity to be carried out without taking staff from the floor, as an additional staff member will take those 1-1 hours.
This is what others should be doing.

My husband is in a care home. Fortunately, it is within reasonable travelling distance from where I live, so, when my husband is feeling up to it, I take him for a short walk or we go into the garden when I visit (it is trickier in this foul weather).

I am sad to read of the chronic situation of poor staffing levels. I know my husband is left in his room for most of the day. I am told it is his choice and he refuses to engage in activities, but I am sure, if someone had the time to sit and talk to him, and build up a positive relationship, he would feel more inclined to engage.

I know this is not true of all homes, but the company who run my husband's home have several very large properties and charge well over £1,000 per week for each resident, yet the food served in my husband's home is obviously chosen for economy rather than taste and nutrition, and the care staff are paid only slightly above the minimum wage. The residents have long term mental health conditions, learning disabilities, autism or other complex needs.

My DM’s dementia-only CH was the same. There was a safely enclosed, level garden with handrails on the paths, and those who were able could go out whenever they liked.
In practice, I don’t think many did - it tended to be used more by staff wanting a fag on their breaks.

Thanks for the responses. We are on a 4 week probationary period.
So I wouldn't go down anything too official, I'd just leave if they don't sort it out. Funny when you are looking round, short staff is never mentioned. Now it's all we hear.
Idk what a dols is. We are paying privately and did all this on our own.

There is another home locally which does trips out to a cafe around the corner a few times a week, for whoever wants to go.

And yet another which had open access to wander in and out of a small garden.

But neither of those had space for both mum and dad, and even now I'd think hard, as currently they are 4 rooms away from one another on the same floor (albeit dad's behind locked double doors), and the other places would have them on different floors.

Deprivation of Liberty, its applied for if a resident does not have capacity to fully understand the risk if they leave the home or agree to their care. Did he have a capacity assessment before he moved into the home, did he agree to go, sign his contract, you say he wanders off, what happens if a staff member takes him out and he wanders off, refuses to go back, injures himself. He should have a care plan outlining all his needs which you can ask to read and contribute too. You can speak to his nurse and gp about his needs and safety. Do you have power of attorney. I think he should be able to sit in the garden but taking someone out needs a full risk assessment.

I wouldn't threaten to move them, especially if mum has been there for a while and is settled, just because another home says they go to cafe doesn't mean its guaranteed, all carehomes are understaffed and struggle.

Usually relatives take residents for this type of outing but obviously that's not possible, so as a previous poster suggested you could pay a private carer to take your dad out for trips to the shop (or wherever he'd like to go) a couple of times a week.

It's very unlikely staff would have time to take your dad out to the shops, and obviously he can't go on his own because he may put himself at risk. The only outings my mother has ever had at her dementia care home are pre-planned group outings in a minibus.

You could move him if you can find another placement, but no care home will be perfect and you may find there are other issues there.

Would it make sense to look at care home provision nearer to you? Then you could take him for short walks etc. Or is your mam really settled in this home, with lots of buddies visiting?

To be honest though - every care home has it's faults (regardless of what you're paying for it) and you have to pick the one that has the least worst faults from your perspective.

I think people perhaps have a misleading idea of what is possible in poorly staffed homes…the ones I worked in when I was young had barely enough time for toiletting, washing ,feeding and the only times I was outside the property with patients it was because they’d “escaped” (literally!)Now I’m older and having been a hcp where I visited people in care homes as part of my role, I would highlight that not all homes are the same. However needless to say, outstanding homes are often in very high demand. if you have the option , can you wait list your parents at a home that can offer them more to improve their quality of life?

Do they have activities at the home he may enjoy, my late mums home had visiting activities, a cafe, library, games, restaurant, open visiting, activities co ordinator.

Can you relocate your parents closer to where you live?

I don't think they would go for that. My mum is dying and she wants to be where all her friends can visit. Perhaps dad one day

Very few places will be able to facilitate individual walks outside the home - especially ad hoc ones. Whether they'd be able to include your dad on group outings would depend on his individual abilities and behaviour - if he'd need constant individual supervision then, again, it's unlikely many places would be able to do this unless you paid for an extra staff member to go.

Your best bet would be to look for somewhere that has free access to a fully enclosed, secure garden. Newer, purpose-built homes are most likely to have this. They are often built as a polygonal building completely enclosing a courtyard garden, so the door in the 'inner' side don't need access codes but there's no possibility of a resident going AWOL.