Choosing the right care home for an older relative is not always easy, and it’s important to ask good questions when visiting for the first time.

Your questions will probably cover all sorts of things, such as activities within the care home, opportunities for exercise and therapies, the rooms, care for specific health needs, eating and drinking, funding – all sorts.

Leaving a relative in a care home can be challenging for the whole family, and good communications with the home – and within the home – is vital for peace of mind all round.

In today’s article we’ve adapted chapter 8 of our e-guide, How To Choose A Care Home, and outlined 10 things to ask a care home about various issues to do with communication…

1. When you visit, notice any particularly vulnerable, poorly or challenging residents. How do members of staff interact and communicate with them? If you were that resident, would you be happy with the nature of the interaction you’re seeing, and the time members of staff are spending with them?
2. Are there residents with speech impairment, such as people with Parkinson’s and other neurological diseases? What kind of two-way communication is there between staff and these residents? And do staff give residents time to get their words out?
3. Is there a residents’ association? How does this work? It may not matter if there isn’t one, but it’s worth asking. The best people to provide feedback on a care home are the people who live there.
4. Does the home organise relatives meetings? It’s very important for relatives to know what’s happening at the home – and to have some kind of forum for asking questions and raising concerns, if residents are unable to.
5. Is there a written complaints procedure?And who is responsible for following up/resolving complaints? Have you met that person?
6. Is there a suggestions box? Who submits ideas – and who reviews them? How many have been implemented recently?
7. Notice the different nationalities and accents/languages amongst staff – and residents. Will there be any problems understanding staff – or staff understanding residents?
8. What happens when residents receive post or phone calls? Does each room have its own phone – with a direct number? If not, is there a private room where residents can make and take calls? And if someone is physically or mentally unable to open their own post or hold a phone in their hand, how are they helped to do this?
9. Is there a suitable space for a computer in the residents’ rooms? And is there an Internet connection? You may not think this would be needed, but a computer can be invaluable for things like Skype – to facilitate talking with family, friends and grandchildren, and seeing them on the screen at the same time. It can enrich someone’s life greatly.
10. If residents are deaf and use British Sign Language, does anyone else in the home know it?
    Read more vital questions to ask when you’re looking for a care home. Explore our e-guide, How To Choose A Care Home.

Choosing a care home for an elderly relative is one of the most difficult things to do. There are many things to consider, and one of the most vital is the degree to which your elderly relative will remain engaged with life whilst there.

We’ve all seen the stereotypical pictures of elderly people in care sitting all day with little or no stimulation. It is perhaps no wonder that in those situations they become even more withdrawn and disengaged.

Care guidelines state that people should be involved in their own care planning, where possible, and be able to exercise choice in their lives. If we take food as an example for a moment, choosing from a menu is all very well, but if the fixed choices are institutional and uninspiring, or simply not what someone would normally choose, then mealtimes – a vital positive element in a day – are no longer enjoyable.

In the same way, if the choices for day-to-day activities and daily routines are already prescribed, there’s limited opportunity for real engagement. That’s perhaps why so many elderly people describe life in a care home as being ‘like a prison’.

Studies show that having a greater sense of purpose leads to more sustained cognitive function in elderly people. This would suggest that it’s far better all round to have elderly people, where possible, involved not simply in choosing from a menu of care and activity options, but actually creating those options in the first place – and in so doing strengthening their sense of value and purpose.

This will more than likely manifest itself in stronger health and wellbeing.

You can’t really know for sure what a care home will be like until you’re living there, but there are careful questions you can ask to get a better feel for how things will be.

• How much do residents get involved in the day-to-day operation of the home? For example, if your relative likes gardening, what opportunities are there for them to do that at the home – and get involved in deciding what needs doing in the first place?
• If your relative has a hobby or special interest, how easy would it be for them to continue with that at the care home?
• Does the home have any pets? Or can residents bring their own? Resident animals can be a wonderful, stimulating tonic.
• Ask to see an activity programme – and find out how often residents actually go out, not just into the garden but out to somewhere different. Is there a specific named person responsible for planning and organising activities? Are there photos on the walls of various trips? How old are they and who decided what they would be?
• Does the home have its own transport, suitable for wheelchair users? This is vital if promises of trips out are to be upheld.
• strong>A care home brochure may say that the home ‘encourages independence’.Ask what they really mean by this and how exactly they do it.
• How can residents who are immobile get involved in activities in the home? A client of ours chose a care home for her father on the basis that it had a home cinema room. However, she later found out that none of the carers actually took him there.
• Are there musical instruments available to play? And are books and newspapers readily available?

Explore more tips about choosing a care home.

 

Find out what’s happening with each Southern Cross Healthcare care home

If your relative is in a Southern Cross care home, you may be concerned about who’ll be taking over the home, now that the Darlington-based Southern Cross group has collapsed.

The group has, until now, been the largest UK care home operator, running 752 care homes with 31,000 residents. However, the care homes themselves are now being reclaimed by landlords and the running of the homes transferred to new operators.

This process should be complete by the end of October 2011. However, not all homes have secured new operators, which raises the question what will happen to the residents of those particular homes once Southern Cross ceases trading.

This article in The Guardian newspaper lists the different Southern Cross care homes and outlines what’s happening with each one.

Southern Cross has 97 care homes in Scotland, 34 in Wales, 25 in Northern Ireland and just under 600 in England. The biggest landlord, NHP, will run 249 homes as a joint venture with Court Cavendish.

London & Regional, the second biggest landlord with 90 homes, will assign the running of the homes in the north of England to Orchard Care Homes and to Minster in the south east of England. Loyd’s Property is another landlord with 54 homes, but as yet without an operator.

250 homes will be transferred back to landlords who are also operators, including to Four Seasons. However, those homes for which an operator can’t be found may end up closing, leaving families and elderly residents facing uncertainty and painful upheaval.

If you have a relative in a Southern Cross care home, you may decide to move them somewhere new. It can be a difficult process – and it’s often hard to know whether the new care home really will provide good care for as long as your relative needs it. Our practical guide, How To Choose A Care Home, gives you some vital questions to ask a care home manager before you make a decision.

Current media reports show that Southern Cross Healthcare, which runs 750 care homes right across the UK, is facing serious financial difficulties. If a solution can’t be found, over 30,000 elderly people may have to be rehomed. It’s a distressing situation for all.
Finding a care home can be difficult – and it’s hard to know if you’re making the right choice. It’s vital to ask good questions when you visit, especially about the financial stability of any care home company, how they operate and the morale of the staff.

These 7 key questions will get you started:

1. Does size matter?

Bear in mind that the size of a home, the corporate brand name and any official inspection reports don’t necessarily reflect the quality of care or the day-to-day life that people actually experience in the home. Bigger is not always better, and well-known brand names don’t necessarily provide better care. That’s why it’s vital to visit the home in person – preferably more than once and at different times of the day. It’s also a very good idea to ask people you know in the local area whether they know someone who is resident in a particular care home – and then to ask that person’s family for their views and feedback on the home.

2. How does the care home respond on the phone?

You can gauge a lot from phoning a care home. Do they have time to answer the phone? Is it answered by someone who knows what they’re talking about? Is there a lot of background noise? What questions do they ask you? This is just as important as what you ask them. Do they offer to send you their brochure? How professional do they sound?

3. What’s the manager like?

A good manager will have a very positive effect on his/her staff, and that also filters down into the care given to residents. A defensive manager, on the other hand, may have something to hide – even if it’s their own lack of experience. An overly confident manager may not listen to new ideas or complaints. Again, it comes down to your own judgment and instinct. Does the manager also own the home? If not, how long has he/she been in post? What’s his/her background?

4. Who owns the care home and how stable is the company?

Today there are a relatively small number of large companies who own the majority of care homes in the UK. Is the company financially stable? Are they likely to invest in upgrading the home as and when it needs it? Are they committed to providing care for the long term? It’s heartbreaking to hear of care homes closing and residents having to be split up and sent elsewhere. Find out as much as you can in advance.

5. What percentage of nurses or carers on any given day are brought in from agencies?

Agency carers and nurses are not based at the care home. Instead, they’re a bit like office temps – they go to whichever home needs them on the day, and so they may not know you or be familiar with your needs. The greater the percentage of permanent staff at a care home the better it will be for you.

6. How many fully qualified nurses are there as part of the permanent staff?

What are their specific qualifications? And what about the qualifications held by the other care staff? What’s the staff/resident ratio during the night? What about the ‘after lunch slot’ when staff are taking their own lunch break? And how long has the longest-serving member of staff been at the home?

7. What insurance does the home have?

This could be contents insurance for your possessions, accident insurance, public liability insurance and/or professional indemnity insurance. Does this include insurance to allow staff to help people walk and exercise, etc. If not, and if you’re not very mobile (or you have an accident), the care team is unlikely to help you keep your joints supple and mobile and you may have to pay for regular physiotherapy.

It’s the less obvious questions that give you a better idea of what the home will really be like. Read more here about going into a care home.

And remember, just because you have some savings or a property doesn’t necessarily mean you have to pay for care – no matter what the care home, Social Services or the NHS may have told you.

The NHS has a duty to provide fully-funded NHS Continuing Healthcare (covering 100% of care home fees) for elderly people who are in full-time care primarily for health needs. Read more about going into a care home.