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Can anyone recommend a good nursing/residential home near Derby?

16 replies

StripeyKnickersSpottySocks · 06/04/2008 14:08

My gran needs to go into one.

She can't walk very well, can't see much and takes meds and is a bit incontinent but doesn't really need intensive nursing care as such.

I would love some personal recommendations rather than just going on what social services say. I don't live in the area so have no idea of good/bad ones.

thanks.

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SmugColditz · 06/04/2008 16:52

Go and LOOK at them. Go and smell them. Speak to the residents, ask about an activity schedule, and more importantly ask about UPTAKE on activities. If they say "Oh well most of them aren't interested" be unimpressed.

Corner the most inexperienced, young member of staff you can find and ask her what time people start getting up in the mornings, what time people start going to bed in the evenings, and what about if they are a bit reluctant to go when it's most convenient for the staff. The more senior members of staff or the managers will lie. The new ones won't know what should be happening, they'll tell you what is happening.

Social services will 'recommend' the cheapest, and the cheapest ones run on a skeleton of badly treated staff.

Nursing homes have improved threefold since the influx of Polish women into this country - they have high standards, seem to be more intelligent and hard working than the average Brit carer, and have more of a culture of respect for the elderly than young women raised here. So if you go to a home with a lot of foreign workers, DON'T be put off, as it is not necessarily a bad thing.

really, you have to see inside the home - just turn up without an appointment and ask to be shown around. Do this at about 3 pm as the staff should not, at that time, be too busy.

Wisteria · 06/04/2008 16:55

There's a nice one here (not in derby but about 8 miles away), I think they have a bed free , it's next to the primary school so nice children playing noises to listen to.

I agree with colditz though, you need to make a list of things as she has described and go and look. A friend of mine owns a nursing home in Derby but I don't know what it's called, could find out for you though.

tiredemma · 06/04/2008 16:56

OMG Colditz has smashed the nail on the head.

I work in a care home and her post, god i could frame it.

eastern europeans and the zimbabweans that I work with are possibly the hardest working individuals i have come across.

Colditz i love you- you should be PM

SmugColditz · 06/04/2008 17:00

(I was a carer for 7 years - a lot of agency work - so I saw the failing homes, and they were sad)

Shall we compile you a list of the things you need to ask? you can cat me if you like - unfortunately I've never worked in the Derby area so can't help you really!

PerkinWarbeck · 06/04/2008 17:21

social services might not just recommend the cheapest - we do have some standards, y'know.

price alone is not an indicator. I know some really shite BUPA homes that are ££££, and not feeding profits back into improving the home.

not for profit homes (charities, the very rare council-run places) tend to be better, as they aren't trying to maximise profit, and tend have better staff pay and benefits.

you can search for homes and check csci reports (like ofsted reports) here. the csci inspectors are independent from social services.

good luck - despite bad press, there are some lovely places around. it's unfortunate that I work in the south, so can't make a personal recommendation.

StripeyKnickersSpottySocks · 06/04/2008 17:26

Thanks Colditz thats really useful. She's in a temporary home at the minute. Bramble Lodge - if anyone knows it, but its due to be closed down. I'm not impressed with what I've seen so far.

A carer "gave" her some tablets and apparantly my gran walked off withouttaking them. So the carer came to her in the lounge (in front of me) and gave her the tablets she'd left in hte dining room. Gran said she hadn't had them earlier as she had no water - so the carer filled a used, empty cup and gave this to m Gran. Gran then ased where the little brown tablet that she usually has was as it wasn't with the others. The carer said she must have taken it and not the others. Gran was adament she hadn't, the carer said she was confused and forgotten.

Well maybe so, but if thats the case surely someone should be watching her take the tablets????

A list of what I should ask would be great! I am worried about staff lying to me and me not realising.

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tiredemma · 06/04/2008 17:32

Perkin- I work for that 'profit making' company you have just mentioned. Im glad someone else has seen it for how it is. I only work PT to help me through uni, If i had to work there FT It would be soul destroying.
I could write a list about unhappy I am with tem as a company. Its all about making money- very distressing.

It saddens me to see people sat day after day in a shabby lounge watching tv- with the only activity being 'mealtimes'- its not how I would want any loved one of mine spending their last days.

SmugColditz · 06/04/2008 18:05

tiredemma can help too!

1 FOOD When is the last meal of the day, and when is the first - if tea is at 4 and breakfast at 8.30, that's 16.5 hours without food. If they say the residents get supper, ask them to specify. Tea with a biscuit is not a meal. ask them what their policy is on food out of kitchen hours - the last place I worked, the other staff would make toast or heat soup, but other places lock the kitchen door so the staff can't eat antyhing. Ask them about fresh fruit, ask to see a copy of the menu (they should have a menu, I think it['s the law), ask about diabetic options if appropriate.

2 STAFFING ask them how many staff they have on each shift - then (and this is important) go and ask junior members of staff the same question. The legal limit is 1 memeber of staff for 10 residents, but these must be on site and not just on call, and they must all be care staff - the cleaner does not count. A well staffed home will have 4 or 5 staff in the morning and 4 in the evening for 30ish residents. Ask if the night carers have housekeeping responsibilities too - it's surprises people how much of the donkey work (veg prep, ironing, cleaning) is done by the night staff, of whom there is usually only 2. Ask about the training level of the most senior staff on EVERY shift - I was sometimes left, completely unqualified, to run a shift. Ask about percentage of staff with an NVQ2 in care at least. Ignore 'working towards' - that's a legal requirement, nothing to boast about.

3 Activities - ask how much formal entertainment is laid on for the residents, and who they book (if they flounder, they might not actually be laying any on). Ask how often this occurs. Ask what the uptake is on this - it should be fairly high - if they say the residents aren't interested, I'm afraid this sometimes means the staff can't be bothered to organise it. Ask about trips into town and ask which taxi firm they use. Make it clear she will want to go out and that you expect her to be taken out. Be aware of 'Fillers' - 'watching a dvd' is not an activity, 'reading the paper' is not an activity, ditto 'tea and biscuits in the lounge', or 'had visitors'. These should be everyday life, not special occasions.

4 specialist care Hairdresser, chiropodist, district nurse, dentist(very often gets neglected), optician, continence nurse - what arrangements are made for the residents to see these people?

5 Toileting and personal care. How often are incontinent residents taken to the toilet? HOW MANY FUNTIONALLY DISABLED ADAPTED TOILETS AND BATHS DO THEY HAVE? Ask to see these (they do usually smell, it's not evidence of lack of cleaning if they are a little bit whiffy) - and check if they are clean, is the toilet clean, is the bath clean, is the floor clean, is the bin overflowing etc. Where is personal care carried out? In the bathroom? The resident's bedroom? How often do the residents have a bath or a shower - once weekly is not actually enough, but is 'normal' because there is barely enough time to bath 30 residents on a skeleton staff even once weekly. Do they have a shower? Are all the adapted bathrooms in good working order? (often they break, and are never repaired, but left 'for show'). Ask about how the clothes are cared for, and what about items that need to be dry cleaned. Label EVERYTHING, every last pop sock. Every shoe. Glasses. Dentures if you can! Ask if she will be bathed 'when she asks' (remember, she may never ask) or on their schedule, and how often will she be prompted. How often will incontinence wear be changed, how often will she be checked at night, will they wake her to use the toilet or just leave her to wet herself. Normal 'toileting times' are on rising, after breakfast, after tea break, after lunch, after tea break, after tea, then at bed time. On demand in between all these tmes is standard practice. Someone who is known to wet the bed should be woken in the night for the toilet.

That's all I can think of right now, may be back later!

VictorianSqualor · 06/04/2008 18:17

Just to add to Colditz's post ask HOW they are bathed/changed/lifted from wet beds etc.

I worked in an RCH and we used to always lift with two members of staff or a hoist, other homes I know of had numerous accidents by residents being dropped because they weren't being lifted properly even the tiniest lady in the world can be really awkward to lift by yourself.

Don't worry too much about carers being young either, the best care staff where I worked were aged between 20-25, there were quite a few over 40 who would've seemed more mature and therefore sensible but were actually more resentful about the job.

The people I worked with my age group tended to look at the residents more like grandparents and were pretty much carefree so didn't bring any issues they had outside work in with them. Sadly elderly people can be an easy target to unleash some tension.

VictorianSqualor · 06/04/2008 18:20

Also, wrt the tablets, medicene should be dispensed pretty much the same as at a hospital, each resident given their medication, watched take it and then signed off on a chart, this must be done by someone who is in a decent enough position too, not just any old carer. It was only senior carers running the shift or RGN's allowed to go anywhere near meds at the RCH I worked at.

StripeyKnickersSpottySocks · 06/04/2008 18:43

Is it bad if the resident's lounge smells of urine?

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VictorianSqualor · 06/04/2008 18:53

Not necessarily, there could have been tons of accidents and an old carpet, I'd be more inclined to check things like shelves in bedside tables, it's the sort of thing easily skimmed if the job isnt being done properly.
Does the whole home smell of urine?

PerkinWarbeck · 06/04/2008 19:00

agree with VS - sometimes clearing up all the wee is like painting the forth bridge.

I don't mind a scruffy looking building either - think there's more important things.

the majority of residents should look neat and tidy though - men shaved, fingernails clean and trimmed, clothes in decent repair, hair kempt and trimmed. i think attention to detail with personal care shows a good level of respect for residents.

getting out very important. would prefer a place with its own minibus(es) myself.

StripeyKnickersSpottySocks · 06/04/2008 19:10

The wee smelling place is the temporary one she's currently in. I've only been in the lounge - have no idea what the bedroom is like. Though am gong to see her again next weekend.

Tea there is at 4:30pm which I thought was early and the day I was there it was a fantastic choice of pork pie and salad or bread & butter and salad.

The sooner I get her out of there - the better.

Oh and the other thing is according to a message on the answer phone Friday afternoon they've had to sedate her as she's getting violent with the staff. I can imagine if she was annoyed/scared she would lash out as she does have a temper. I know the staff can't expect to be physically assaulted even if it is by a blind 91yo who can't walk......but am suprised this has happened so quickly. I can't imagine she's consented to this. Can they do it without her consent or do they have to/will they section her?

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PerkinWarbeck · 06/04/2008 19:14

I'm not a fan of sedation by medication. this should not routinely be used. situations should be managed by increased environmantal security, better staff ratios, and de-escalation techniques.

the consent issue is VERY complex

she doesn't have to be sectioned IF she lacks capacity and is not actively refusing medication. but since the mental capacity act come in this year, she would have to be assessed and subject to deprivation of liberty safeguards.

I'm afraid I'm not entirely sure of the exact nature of the safeguards as this is new legislation, and my training's not until June

PerkinWarbeck · 06/04/2008 19:15

at own shocking spelling/grammar

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