Are my concerns about my mother-in-law's respite care reasonable?

[myislandhome]

I really need to know if my expectations are too high.
MIL has been in respite just coming to her 2 weeks, with view to extending and staying. It's in the NW and not cheap at £1350 per week.
So, on our visits I have noted the following (easier to list)

• no-one was offering her drinks in the first week, they just said they walked past the room and she said no when offered. We have corrected this and asked that she has water in her room.
• she is 6 stone something and they don't offer her snacks in the day
• there don't seem to be many activities so she just sits in the room all day, except for lunch and dinner times. She is bored, and even the staff say she is bored.
• she is frail and her balance isn't good but she can walk the short distance of the corridor (and to the dining room as we chose the closest room) with a wheely walker thing but they have been sitting her on it and wheeling her around rather than encouraging mobility. One new carer was shocked to find she could indeed walk when I walked her to lunch on my visit.
• we went in one sunday and she had been left in bed until 10 and and they didn't make the bed until after 11. There are only 5 or 6 people admitted at the moment.
• the first week her washing went to the laundry but they had literally shoved it into her drawers (inside out, bunches and stuffed in) rather than being folded/hung up. Second week they "didn't know if we were taking her washing or they were supposed to do it" and I found soiled clothes just sitting on top of a chair in the corner.
• she hasn't been taken out at all (they said there might be day outings but I realise its only been 2 weeks).

She's not complaining and hasn't been negative about staff (like many old people can be in homes) though and she is on waiting lists to try other places but 1) no idea when these might become available and if they would be any better and 2) what if they're worse and we lose the place she is in?? It's been so hard to find a place

• but am I just being mega picky or are these gripes reasonable

Sorry, yes but I have been in the most as he has been at work. He visits weekends with me but I' there every other day. He was very upset about the sitting on the wheely walker.

She is 91 and has reasonable, if not with a varying degree of confusion, capacity. Some days she is great, some she seems a little confused.

It doesn’t sound great TBH, it sounds under staffed. Has she been assessed as needing residential care?

Does , doesn't it but its not. Staff are always sitting in the break room/dining room but I have always said to myself that's because we are visiting and they arent needed. The floor is quite empty

Positives - place is clean, she is being fed at meal times (not actually fed, I mean there are meals), high staff to resident ratio, big bright room?

No, she hasn't noticed any of this, I have.
I am also a health professional. It's a brand new home.
Never had any relative in residential care before though so wasn't sure if I was being too picky.

She didn't resist, sorry.
I have been there every other day and nothing ever offered. A 91 year old needs to have a jug of water in the room at all times- hydration is very important.
Sorry I realise what I put didn't make sense - they didn't get her a drink I meant. She is also very very hard of hearing and not sure she would have heard any offers.
I asked one day if there was a morning tea trolley and was told, "it's all in the dining room for then to help themselves"

she had a pre admission assessment and we were told this was her level and that they were providing showering, dressing, assistance moving around (she is a high falls risk) etc. They said she isn't nursing care.

I would agree, but they are not mobilising her but instead sitting her on her wheely walker and wheeling her around it in like a wheelchair. She also has a crash mat on her chair so if she moves it alerts them as she needs assistance - so they know she isn't someone who is getting aroud herself IYKWIM

(laundry, they said they didnt know if I was taking it home to do - that was never mentioned. It was odd as it went to their laundry week 1 )

Yes I agree, I definitely will - although she does know (she did the initial assessment)
They all know otherwise she wouldn't have the crash pad and they wouldn't be wheeling her around everywhere instead of assisting her to walk.

Wheeling her around with her sat on her walkers seat is quite a dangerous thing to do, as she won't be secured in the seat . If she's independently walking normally then they should be having her walk with the walker. Plus making sure she is hydrated etc. do they have an ' entertainments' type officer? Notice board with planned events on it? Even internal planning schedule? My dad's nursing home had a compressive events time table, both things to do inside/outside, as well as daily themed enrichment, be it singing, card games or painting.

I think the whole package needs to be right. Things like the washing seems a bit like communication issues and just need clarifying.
So the plan is that if she likes the home she will become a permanent resident? . I think you need to be happy that the staff

Not good.

My dad's place had someone come into the room - not just walk past - at least every hour to offer drinks, as well as having a jug of squash on his table. It had a minimum of 2 organised activities per day, plus day trips, visiting animals and singers, rooms with films & games and other stuff going on. They encouraged him to join in, and although not all staff took positive action to encourage mobilisation they certainly didn't wheel him about when he could move himself. And some staff were great at encouraging all sorts of movement and mobilisation - cheering him on when he was doing his physio exercises; encouraging him to pick up tablets individually when he was having trouble with fine motor control, rather than just handing them to him in a spoon, motivating him to get himself around.

That sounds so good.

It’s not good enough I don’t think. My dads place had a lively entertainment programme with something every morning and afternoon and visits from a local nursery - they went on day trips and when the weather was nice they’d sit in the garden - sometimes with their feet in a paddling pool! They’d also have an ice cream van visit on hot days, there was almost always music in and the whole place felt cheerful and bustling - it did him no end of good even though he often was only watching others coming and going.
No member of staff would ever walk past him without greeting him by name (loudly) and his face lit up at most of them.
Drinks were encouraged,
monitored and recorded as was his weight. They’d have film afternoons with old films on and even used VR headsets to take them down memory lane.
It really was a fantastic place and changed the last years of his life for the better as he’d been very bored and lonely at home.
It also changed my view of care for the better.
They saw him through Covid and were genuinely upset when he passed. True carers who were not paid enough for what they did.

@myislandhome , I would trust your instincts; sounds awful but all of the old people’s homes I saw when I was caring for my parents were awful. 😔

My aunt's care home isn't sparkly and shiny. But it's really well respected and I keep meeting people who tell me X,Y or Z person they know/ love was in there and they had a good experience.

Things about it:

1. there is always water in her room.
2. the "drinks" trolley goes around a couple of times a day - she gets tea and whoever is visiting usually gets offered some too
3. they have three full time activity coordinators and a really busy programme increasingly there are two choices of activities to try to appeal to even more residents
4. she has been encouraged to mobilise from day one and in fact it was me that suggested she could go in a wheelchair to access some of the "slightly too far to walk" external outings
5. they go out fortnightly. She doesn't always get to go as they have to share the places around but everyone knows how much she loves getting out so she goes a lot.
6. when I go in on my monthly visit (I live a long way away) the staff now know who I am (it's coming up for a year the she went in) and can usually tell me where she is. I know many of them by sight but haven't sorted their names out. But they know mine.
7. The other resident's also chat to me although their interest in me diminished when they realised I don't play bridge.
8. the activity coordinators welcome my friend's lovely teenager in during university holidays to play piano. He reckons he can play there and get praise or play at home and get told to shut up by his brother and get corrections from his Mum!
9. laundry is done beautifully. Not one of the lambswool cardigans has been boil washed into ruin yet.
10. the last time I was up it was a glorious April weekend. The staff got a tonne of the residents from her section out onto the roof garden to enjoy the sun (and applied sun screen). They had their afternoon tea and cake out there and some of the staff used the time to repot the planters that live on the roof terrace.
    My aunt's room overlooks the terrace and it was lovely to watch the interactions and care displayed for the residents. I'm sure it also allowed the staff to socialise a bit with each other too but they included the more interactive residents in the chat. My aunt knows a lot about the carers lives so I think they do talk (she seems to be more interested in them than she ever is in me!).