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Best practice for assessing care homes? - Carers UK Forum

Best practice for assessing care homes?

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Hello dear friends

I wondered if anyone could advise me here.

Last year I earmarked a care home I liked the look of for my mum to have a one week's respite stay. We visited and then they came to our flat to do their own assessment. To my dismay they rejected my mum saying they felt she needed nursing care as opposed to residential care. That was back in September and she's improved since then.....her profile now is...87 year old....severe arthritis in left knee and her mobility is therefore seriously compromised.....she can shuffle with a zimmerframe to the other side of the living room and with some guidance she can just about get up from her armchair on her own.

With this in mind what might be the best practice for assessing homes for future respite stays......what I mean is I don't like to give away too much info up front for fear of an over zealous administrator telling me over the phone "oh no...we don't take on anyone like that...sorry" of course if that's how it is...that's how it is but I would prefer the manager comes and does their own assessment in person.

So essentially what would be the best way to proceed in this particular case...and of course any tips for assessing how good the home is.

Many thanks
Always do an unscheduled visit. Having worked in care homes I know the things that happen when they are expecting someone.
Also, having worked in a few, there aren't many that I would send my own mother to, but there are some real gems.
Always ask for a copy of a menu because although it can seem a little thing, to residents it becomes a big deal.
Please don't see this as as scaremongering, just check and double check first.
If you look at the "NHS Continuing Healthcare Framework" it defines the sort of things which count as "social care" - the responsibility of Social Services, doesn't require a qualified nurse on duty, as opposed to "nursing care" which requires qualified nursing staff to be on duty at all times. It should be, but often isn't, funded by the NHS. My mum moved into a nursing home last year. I visited many, but all said the same thing - as she needed hoisting in and out of bed, that was nursing care. People who can move around themselves don't need anywhere near as much care as people who can't. Dressing, finding things, being pushed around in a wheelchair, all involve far more staff. Hope that helps. I'd suggest that you arrived just before lunch, and see the attitude of residents to their food, and smell the food. If it looks good enough for you to eat, great. Also visit around 3-4pm and look at what, if anything is going on. Are the staff friendly as you walk round, do they smile and say Hello. If so, then that is how they will treat mum.
A tip to remember is that if a person is placed in a residential home and then their needs change and they require nursing care, they would have to move homes (unless the residential home in question also had "nursing" beds).

So when chosing a home make sure that they can look after your Mum until she dies, as to have to move homes would be distressing for her.

Your local SSD would be the best place to start, ask them to assess her needs and obtain a list of homes from them and visit them all! You can also obtain a report on all registered residential and nursing homes from the Care Quality Commission(I think that's what it's called) ...in fact you can see the reports on line.

Hope this bit of advice helps. Also........does your Mum receive Attendance Allowance?? This is a tax free social security benefit that IS NOT means tested! The phone number to ring about this benefit is 08457123456.

Good luck!
From my experience with my 90 yo MIL, where dementia is the major problem, I'd say that the assessement can sometimes be 'variable' (not really the right word, but let me explain).

My MIl had to move from her low-care home (semi-independent) to one that could cope with definite dementia, because she had started to 'wander'.

'Wandering' can be 'variable' and the care home she's in now had to make a judgement on just how 'wandering' she would prove to be. They aren't a 'secure' unit (with locked doors etc), but more secure than her previous place. The manager was very good and said 'we'll see how she does'....not only can 'wandering' sometimes be 'managed away' (by keeping them busy!), but a new place can stop the habit developing sometimes, and they also had 'lesser controls', such as an alarm on the front door, a bedside mat that pinged in the office when she stood on it (at 3 am, off for a wander!) (or maybe just the bathroom). There were staff on duty 24x7 so that helped too, in managing night wanders.

As I say, this was for an aspect of dementia, not physical incapacity, so may not apply, if the incapacity is more 'defined' (unlike MIL's wandering!).

One thing that may be useful for you in choosing a home - my MIl's place has long corridors (it means all the rooms have a great view though!), and the lounge and dining room are at opposite ends. A lot of the residents have zimmer frames etc, and the corridors can get 'congested'! (Especially at the mealtime rush!!!). However, there are plentiful supplies of zippy wheelchairs (the staff call them 'taxis'!), which helps speed things up, and can take them back to rooms etc, as necessary. Small point, but very helpful practically.

All the best with finding a good place for you mum.
Hi Juan Carlos,

When I was looking for a home for my mum, the most useful piece of advice I received was look to see if the home will still be able to care for mum if / when she declines. You really don't want her to have to move twice if you can possibly avoid it. The home I chose had residents on different floors of the building according to level of need. Please don't take this the wrong way but what mum needs today might not be what she needs in a year's time.

Before asking the home to do any assessment, I would drop in on a couple of homes unannounced (avoid meal times) and ask to be shown round. This will give you a clearer idea. I also got some very useful information from the local Healthwatch reports which are more detailed than the CQC ones.

Good luck, a very difficult time for you, Anne
Before making the final choice, I would go just before meal times, to see that residents were encouraged to eat, the food was good, and those needing help got it. Also, has the dining room got a nice view. May seem trivial, but for elderly people, "what's for dinner" may well be the only different thing in their lives. You need to know whether the meal is rushed, or leisurely. You will also be able to see the way that staff talk to residents.