Any advice for finding a care home for elderly mother.

[Tolkienista]

My mother is 95 and until she had a fall five months ago was living independently at home, shopping daily, very fit and active.
Two hospital stays later, she's still at home has carers in twice a day and between her four children we've been doing our best to support her with daily visits........cooking, shopping, cleaning etc. Mobility is her biggest issue. She has to live downstairs because the bathroom is upstairs and she uses a commode.

Over the last few weeks we've noticed a gradual decline in her health & more dependence on us, she has a heart condition too (atrial fibrillation)
We collectively feel the time has come to move up a level with care and consider moving her into a care home.

Where do we begin?
She is a self funder with her care company, owns her home (has over £23K in savings) so is this the same starting point with care homes £23K?

It's a constant worry, but after 5 months of us doing everything possible to keep her at home, we just feel it's time to move on, her home is just not suitable for a 95 yr old with decreasing mobility and a weakening heart.

Plus. How long would we expect the process to take?
Finding a care agency was relatively simple, from the agency coming out to assess her and the first care visit taking place, less than a week.
I'm expecting this to be far more complicated.

I would visit some. Look at their CQC rating. Ask to see their menus. Go at meal time. That kind of thing. I found a good one for my Dad in 3 days when I had to. Good luck.

Great advice thanks.
Was definitely going to make a visit and look at CQC rating, but wouldn't have thought about menus, or meal times.

Ask local people for recommendations, social media if you don't know anyone locally.
Ours had no visiting hours, you could turn up any time, they just asked you ring first if after 8pm. They encouraged visitors to come at meal times to eat with residents, at a small cost.
Try to find one that have long term staff, ours had the same carers 10 years on which is a very good sign. It’s a bit like schools, you’ll get a good feel of the place by visiting.
Also think of who will be visiting most often, although it seems logical to keep them local to where they live, if friends/neighbours are unlikely to visit much, you might as well make the location easy for the most frequent visitors.
I would say though, have a view to the next stage - lovely as ours was as a residential home, i think palative medical care would have been easier accessed in a nursing home for the last few months, but as my relative had been so happy there for the best part of 10 years it was hard to move them.
They moved in, in similar circumstances to your mum at 92, and got to nearly 100…

@user98265528790 thanks for your extensive reply with lots of good advice. Unfortunately we don't know anyone who is currently in a care home, so in that respect we've got a blank sheet.
We've learnt so much over the last five months along the way about accessing the care system. We were totally unprepared for what unfolded, so we're not scared of the next challenge, but want to get it right.

I've worked in a care home and it's also a good idea to get a feel about the other residents, visiting at meal times is good for this. Many of the residents were non-verbal and I know some of the other residents felt frustration that they couldn't get a good conversation and kept to their rooms. I was a housekeeper so often would chat whilst I worked so at least they had that interaction.

Ask around any local groups you belong to (I'm presuming you're local as managing to visit so much!) to see if anyone has any recommendations (or the opposite!).

Look at CQC ratings, look at websites and work out what is available locally, then arrange to visit - it's better to drop in if possible as that means they haven't 'prepped' for the visit. Look at menus, staff turnover, what the residents do all day (the ones where they sit in a lounge all day with the tv blaring are pretty grim). What does it smell of when you enter the building?

Don't be deceived by appearances - the smartest ones with impeccable grounds owned by one of the big chains may provide the poorest care. So don't worry if it looks a bit tatty. What would your relative realistically want to do there - beautiful gardens are all very well but if they can't see or get out into the garden they might as well have a car park view out the window!

If they've got space and your relative is self-finding it can happen pretty quickly.

And ask what the other residents are like, or go at a mealtime or when they're in the lounge and observe. It's very difficult to get funded for a care home so a lot of residents now have dementia rather than just being frail. That means meaningful conversation, interaction and activities are more limited for a resident who doesn't have dementia.

Definitely ask around.

If she’s likely to be self-funding for the rest of her life focus on homes that only take self-funders. Either way ask what happens if she runs out of money to self fund.

If she doesn’t have dementia then be wary - most care home residents have dementia and most homes are built round the needs of those with dementia. Ask how many residents there are without dementia and check the focus and level of activities offered.

If she likes her food then pop in for lunch. The ambience of the dining room will tell you a lot.

Even if your favourite home doesn't have space available already they will likely have an idea of how soon one will come up. It may be worth increasing her home care visits while you wait for the right place.

I think it all boils down to quality of manager and the level of training they give their team. Perfect nursing/ care home has an impressive visible manager who has been in post a while and has a nucleus staff who been there long time. It is a bit like a school. You want then to do the basics really well.
ideally go for location near public transport as that way their staff turnover is less.

Thanks for all the latest comments, continued great advice in every post and I can see a thread developing about visiting at lunch times.
I too am very wary of beautiful grounds and plush entrance lobbies. There's a care home an ex neighbour went into for respite & it was like stepping into a five star hotel, totally over the top.

Forgot to say, that she doesn't have a trace of dementia, she is as sharp as a tack, got all her mental faculties in place.

Nice care homes do exist for someone like her, but they can take a bit of finding. One of my relatives went into one that most definitely didn't take anyone with dementia and that made a big effort to provide intellectually stimulating activities.

Do you socially know any GPs? I found my GP friends a good place to start with asking which homes they would recommend. You can also ask for recent experiences on your local facebook page.

When I was looking for respite place adult SS gave me a list of places they were aware had vaccanies and unsolicited they said which ones they thought were the best on the list.

Look for ones that are dual registered for nursing as well as residential care. As things progress and her needs increase it can save another stressful move.

Most care homes politely ask prospective residents if they have enough private funds for two years.

Go visit All in your locality which have vacancies to get a feel
Ask costs
Some rooms might be cheaper
Ask about meals and visit when activities are happening and when not

Relative is in a 5 * and is able to pay for now. Visiting is very pleasant. Cheaper one was old Victorian dark house and not so nice feel. Maybe there is something in between .

As she is 95, even if she doesn’t need nursing level care now I think it’s wise to find a care setting that would be able to accommodate possible future needs. They will almost certainly have a questionnaire to determine what level they feel your mum is at now.

But if they are elderly, many of the residents will develop dementia. What would happen then?

It wasn't a home that could support residents with dementia, so they'd have had to move to a different home.

My parents are in a home that has 3 sections, depending on mental and physical health of the resident. Each section has a lounge and dining area. My dad is in the dementia unit and my mother (who is early stage dementia) is in the other ground floor unit but can go to sit/have coffee/eat with my dad at any time. Ask about activities too. We have two dedicated activities staff and the residents can go to any activities they fancy. We feel so lucky dad's social worker placed him there (before our POAs came through) and she said the council typically let them stay there when their funds run out. Worth asking SS about that too.

And it isn't "many" elderly people who develop dementia, it just seems like it because social care funding for care homes is so difficult to get for "just" frailty.

It's 1 in 6 people over 80, rising to 1 in 3 of those over 90. Which means the majority of elderly people don't have dementia and won't develop it.

I love visiting clients in care homes. Have a look around a few, you'll get a feel quite quickly.

It also depends on what your mum likes to do. Does she want activities, singing, drinks in the bar etc. Or just peace and quiet? Some homes, I have to track clients down because they're in the kitchen, baking.

Another option is a home which has supported accommodation on site. So residents are more independent but still go to the main building for meals and entertainment. They can have a broader mix of resident.

When you visit it is worth trying to observe/find out what is done to help residents socialise with each other. This is really important for an elderly person who does not have dementia. My relative is lonely and would really like a friend in the home, but so many residents are non-verbal, or have dementia or, like my relative, have no mobility so they are stuck where the staff put them.

I didn't say most, I said many.