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Elderly parents

What to look for when picking a nursing home?

7 replies

Fresh01 · 29/02/2012 13:18

Hi,

I am looking for some advice on what to look for when selecting potential nursing homes. My uncle, he had no family himself, is only 67 but has dementia which has progressed significantly in the last 6 weeks. He is already in sheltered housing but is needing more and more help each week. I can see him needing to go into a nursing home this year so want to start getting a short list together before we actually need it. Are some nursing home more experienced with dementia?

Thank you

OP posts:
FruitShootsAndHeaves · 29/02/2012 13:33

You need to look for the specific dementia ones really, as others might not be equipped to manage certain aspects of behaviour that dementia sufferers can develop. eg wandering and some residents can get aggresive or upset. Most dementia homes have some sort of secure coded access so the residents can't go wandering off.

Also look to see how clean the home is and if it smells. If your uncle is in the early stages he maybe able to go to a home that has more freedom but make sure they can still cope as his condition gets more advanced as you may have to move him otherwise.
Look at the individual rooms and the common rooms, dining areas.

My dad is in a care home. Has been for nearly 2 years, although I moved him last year because the first one was not of a very good standard.

Most do daily activities and outings, some have secure gardens and vegetable plots etc.
You generally get a 'feel' for the good ones. Visit a few before you decide. The Care Quality Commission do checks on Care Homes, here and give them a rating although I think the way they do this has recently changed.

Sorry you are going through this. It is hard and a horrid disease.

CMOTDibbler · 29/02/2012 13:34

Yes, and some are better with it than others too. I'd look for a specialist dementia home or wing. Look at how the residents look, does it smell, do residents have an opportunity to wander safely, can they go outside, do they offer memory sessions, do the staff seem engaged with the residents, do they seem happy to adapt to different needs ?

Fresh01 · 01/03/2012 22:21

Thank you for your comments on what to look out for. Very good point about making sure they can deal with all stages of dementia to save moving him again as it progresses.

I am his closest living next of kin so have had to rapidly learn about dementia and agree it is a horrible disease.

OP posts:
Parly · 13/05/2012 01:12

Get a list of preferred dementia care providers from social services (not that this really means that much but it?s a good starting point)

Decide which homes you fancy having a look at and then look them up on the CQC website. www.cqc.org.uk/ Read the info available online to get an idea of what it was doing / how things were at the last inspection and see which ones you still fancy looking at.

When you?ve picked the ones you want to see, just show up unannounced. Don?t phone beforehand on the first visit ? you need to get a glimpse of the place as it normally runs.

When you get there, make a note of the following ?

? Whether the door to the building was locked
? How long it took for someone to answer the door
? How welcoming staff were when you asked if someone had ten minutes to show you around
? What the home smelt like / how it appeared (give or take)
? How many residents were up and about in the lounges, dining room etc
? If there were several residents about, how many were wandering / unsupervised and what their appearance was like (i.e. did they have half a plate full of dinner all over their clothing, were they in nightwear unusually early / late etc)
? How busy staff were and how much time they had to stop and take five with residents ? also keep an ear out for buzzers going off and clock how long they go off for.
? If you?re shown in any bedrooms, make a note of items that make it a bit more personal (photographs, furnishings etc) or if every room looks like a sea of fitted pine furniture you might find in Travelodge.

During the first visit you can just have a nosey around and get a feel for what the place is like and how comfortable, content residents are. More often than not you?ll know within the first five or ten minutes whether you like it. If you?re tutted at for turning up unannounced or if staff say they haven?t time to see you / you?ll have to come back when the manager is there etc, forget it.

If it makes a good first impression, ask to see the manager at an arranged time so you can discuss things further.

If a home makes it to round two, make sure you ask the manager ?

? What area of the home dementia residents are cared for and if you can see it
? How many staff are on duty on all shifts covering a 24hr period to care for everyone in the home or on that particular unit.

? Whether they (the manager) works the shop floor and is ?hands on?
? What type of training staff have been given / regularly receive in dementia care
? What staff turnover is like / how long most have been there / whether they use agency staff
? What the average daily routine in the home is including times residents get up, have meals, complete activities, go to bed and whether there are any restrictions on visiting times.

? How they assess, plan and review care and whether they actively encourage relatives to contribute
? How they manage residents whose health requires additional care and support (i.e. will they do everything to provide whatever is needed so that people can stay at the home or do they boot folk at the first sign of a problem)
? Whether they allow trial periods to see how things go and what the procedure is for assessing and admitting new residents.

These are the basics really. Just show up, keep your ears and eyes open and go with your gut instinct. :)

lookoveryourshoulder · 13/05/2012 22:49

..if he is self-funding you should also ask whether they have residents that are funded either by the NHS or Social Services - otherwise a little way down the line he may be moved when his money runs out .... depends on the home...

fridayfreedom · 13/05/2012 23:04

It would probably help to get a residential care book from Adults Service ( social services) It will list all the homes in the area and the registration. You need to look for ones which are dementia care registered. There is also a booklet on paying for care.
Also you mention nursing home but he may in fact need a rest home care initially depending on his level of needs. If he is mobile, with or without aids and has no specific nursing needs or difficult behaviour then he may not need a nursing home.
You also need to check re funding. If he is self funding then he can go to a home of any cost level but if he needs Adult services to assist then he will needs a home which accepts adult services rates otherwise a third party needs to pay the difference. Also note the post above re funding if his own funds run out.
If he does need adult services funding then he will need to be assessed by adult services. They do not automatically fund if the person and family want care and may insist on trying a care package ie cheaper option first.
It is also worth noting that if he is deemed to have the capacity to say where he should live re his needs then you can not automatically move him into a home. However if he does not have capacity he can be moved using the Mental Capacity Act ( bit more to it than that but worth looking into).
If his needs are substantial then he is eligible for a Continuing Health Care Assessment re the NHS paying for his care, however this is a long and difficult process and only awarded in cases of very severe health care needs.
Sorry for the lecture!!

iseenodust · 18/05/2012 14:37

Ask your hairdresser what she knows ! Seriously they hear all the horror stories.

Parly above makes excellent points.
Turnover is very important. As dementia gets worse a sea of changing faces can exacerbate problems.
I wouldn't countenance any home which restricts visiting times. The home is supposed to be the home of the resident.

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