Questions to ask re Care Homes ?

EdInvestor

Norman-B wrote: »

My Dad has been in a BUPA care home for the past 12 months and he loves it there! They look after his every need. It's lovely, very clean. Good food and great staff.

One would hope so with fees of 45,000 a year.It appears they take council funded residents - one rather wonders if the local council taxpayers would approve if they knew....:rolleyes:

Review of BUPA care home

morganlefay

My Mum with Alzheimers was in a home for her last 2 years, it was very nice and kindly to her:
How pleased are the staff to see visitors - we could visit ma at any time, night or day
What are the staff numbers during the day and night, so what is the staff/resident ratio (think of them trying to get several people up and dressed if there aren't enough staff)
Do the toilets look clean
Is the food homemade where posible, is there a choice, does it smell/taste nice (try visiting at lunchtime one day) Do staff help with feeding etc, do they make special foods for people who can't cope
It doesn't have to be spotless or new build, but is it a comfortable place.
Can she get her hair and perhaps nails done if she wants
Do residents go on outings
How many residents are there, Mum's home had a maximum of 48 and that was enough, more might be very threatening I think
Are the staff trained to care for dementia, is training ongoing
Do staff have time to sit and talk to residents who often need a lot of gentle one to one contact
Is it possible for residents to walk about inside the building - Alzheimers patients sometimes walk compulsively and some homes are designed to give them a sort of 'circular route' round the home to give some exercise and prevent boredom

No home will seem nice enough to you, but some are much better than others (not all the scare stories in the papers are true). What we liked in our Mum's home was the obvious kindness of the staff - from the Matron down, they were all kind, caring and patient, even when residents were sometimes abusive (the illness makes them like that) or difficult. ou want to feel that what you see is what you get, and that you like what you see.

Good luck with your search, I wish you well.

Errata

At last attention is being paid to the standards in care homes. The latest report is by peers and MPs. Ivan Lewis pointed out during interviews today that 1 in 5 care homes don't even meet minimum standards. Scathing comments have also been made about CSCI, the body responsible for inspecting care homes.
One of the diffculties faced by relatives is that it's almost impossible for them to acknowledge that their relative's care may be sub standard and that the home is anything other than 'nice' and 'lovely'. Residents whose only experience is the home they live in have nothing to measure its standards by, so it's pretty difficult for them to reach an informed judgement.
It's a very sorry state of affairs.

soolin

I've also just gone through the process of finding a home for my dad but in the end I have had to settle for the only home that actually has a bed that I considered suitable, my first home of choice has a waiting list with a possible year long wait.

I just followed my instinct though, I found the reports online a little unhelpful as they all said the same thing and none really stood out as very good or very bad. One that I found that did have a very good report I absolutely hated..it was on a busy road, the gates were often left ajar (although they said I just been unlucky on the two occasions I called by), I even saw a lady only partly dressed at lunchtime with no staff seemingly bothered. A couple of other homes I didn't even go into as they just looked so run down and scruffy.

I was offered a place at one home but so many of the residents were bed bound that I thought dad would be bored, and the home agreed that they were probably not suitable. Another were wrongly registered as being dementia capable, but actually were not, so dad couldn't go there.

The one I have found is clean, the meals looked good , basic but old style food that dad likes. There is no lawned area as it is in a busy town, but there is a large outdoor area where they have swinging seats and lots of tables and chairs. They even have some raised flower beds in case residents want to do a little gardening. Sorry I'm rambling...it is a huge guilt trip though doing this, if my dad knew what was going on he would be furious at me.

The one thing though that did shock me was the amount of places that had shared rooms and no private toilet facilities. One home that the council said was suitable would have meant dad sharing with a lady, how can that possibly be alright?

I suppose we are lucky in that dad is self funding (as long as his funds last of course so we had some choice. Otherwise another of the homes they wanted me to go to was horrendous, several hours away from me and really institutionalised, thank heavens I got to make some choices.

lastly I was surprised by how much the fees varied, anything from about £500 a week to £900, and no I didn't look at any BUPA ones as we have none locally enough.

Errata

Thanks for your interesting post Soolin. The problem of shared rooms is slowly being addressed, however it will be a long time (perhaps never) before homes are furbished so that each resident has a room with some kind of en suite facilities apart from a washbasin and commode in the room itself.
I'm as puzzled as you about the mixed sex share. Perhaps that's something you could query with the council in due course?
I've occasionally commented on CSCI reports, I don't beleive they are of much help in choosing a home as they are so bland.
My feeling is that if relatives, and residents, complain formally about bad practice/conditions the pace of improvement will speed up. I do accept that's quite a difficult thing to do, but I've found that if complaints are well founded they can bring about changes that the home manager wants but hasn't been able to push the owners to bring about.
Fortunately the direction of travel is towards extra support accommodation so people can live as tenants in a small flat amongst many others, with communal areas and 24/7 qualified staff. More cost effective and they provide a superior outcome on all measure to residence in a care home.

Biggles

EdInvestor wrote: »

One would hope so with fees of 45,000 a year. It appears they take council funded residents - one rather wonders if the local council taxpayers would approve if they knew...

I think most homes would take council funded residents - but I don't think that necessarily means that the council will pay the whole fees, the family can be asked to top up.

On the other hand, in East Sussex I wouldn't have thought £900 pw was that unusual.....

evab_2

HI, I've been a carer for 15 years and now an NVQ assessor/teacher in health and social care, as someone who's been on both sides I can say that you need to do some research although I appreciate you probably haven't got a lot of time to look around.

Some of my tips would be:

* Don't judge it straight away - I've been in some homes that are immaculate but the care is not up to scratch, and likewise in one home where I assess it's not decorated to a high standard but the care, activities, outgoings etc are fantastic.
* Try to visit a couple of times at different times of the day and week e.g. a morning and an afternoon to get a feel for what happens there.
* There shouldn't be mixed rooms and those rooms that are shared should be a minimum, there are measurements detailed in Care standards that they should follow.
* Ask as many questions as you want - you shouldn't feel like they are hiding anything.
* See if there is a comments book that you could read or ask to speak to other families of residents
* Find out if they have links with organisations such as RNIB, Alzheimers society, which chemist they use for medication, how often do they have reviews with GP, dentist, chiropodist, yourself and MIL

I can't think of anything else at the mo but will post when I do x

EdInvestor

I suppose we are lucky in that dad is self funding (as long as his funds last of course so we had some choice. Otherwise another of the homes they wanted me to go to was horrendous, several hours away from me and really institutionalised, thank heavens I got to make some choices.

Re the funding, have you looked into buying an immediate needs (care) annuity? This will pay out a guaranteed income for life to top up your dad's pensions, attendance allowance and any other income so he won;t run out of money.

If paid to the care home the income is tax free.These annuities are based on age and state of health and pay out much more than an ordinary pension annuity. It's essential to get quotes from all four providers as there are often big disparities on what they will pay out.

Some examples here:

https://www.hsbcpensions.co.uk/nhfa/pdfs/is6.pdf

soolin

Biggles wrote: »

I think most homes would take council funded residents - but I don't think that necessarily means that the council will pay the whole fees, the family can be asked to top up.

On the other hand, in East Sussex I wouldn't have thought £900 pw was that unusual.....

I have links to the head of our local social services and found out that the care home we have chosen has a difference of £150 per week between what private funders pay and the lower rate paid by the local borough, and apparently that is normal. I tried for a discount but with no other beds available that I considered suitable I had to accept the higher fees.

I have however written to the borough that dad currently lives i (we are moving him across boroughs) to see if they will help at all, but have already been told that I stand absolutely no chance of receiving any help towards the fees.

Errata

Soolin, the situation you describe looks very much like financial abuse as self funding residents are being discriminated against. Would it be worth pursuing by way of a formal complaint? Have a look at the Action on Elder Abuse website http://www.elderabuse.org.uk/
It has a freephone number, it might be worth discussing the situation with them?HTH