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Tips on getting the right care at home

Care at home isn’t just about basic tasks. It’s also about preserving our parents’ personal independence for as long as possible. There are a whole range of support services that can help our parents to continue enjoying life in their own home.

We asked Paul Westgarth of daily care provider Home Instead Senior Care to explain what care at home can offer, and how to get the best for your parents.

When do you have that conversation with your parent about asking for more help?

The ideal is to have it sooner than later – prepare for the inevitable, which sadly few do. Many suddenly find themselves needing help in a crisis. They might involve healthcare and social services, but find the process is too complicated, the service offered is too basic, or they just don’t qualify for state funding. They decide to pursue other options, such as talking directly to homecare agencies.

What are the options in home care?

It’s not just about nursing care. You can find virtually anything, from 24/7, 7-days- a-week live in care to companionship, personal care, light housework, local transport, meal preparation and/or specialist dementia care. Care is not necessarily about people in uniforms – care in the home should be about someone helping your parent to live happily, comfortably and with dignity in their own home for as long as possible.

What can carers do for those they are looking after, and what is beyond their remit?

There are various options available. For example, at Home Instead Care Givers we will do anything around personal care and domestic duties but not medical procedures – unless the carer has been specifically trained by a professional, such as a district nurse showing them how to change a dressing. Similarly, a carer can’t pop a pill into a clients’ mouth but can ask if they have taken their medication, and will liaise with the pharmacy to provide appropriate pill dispensers.

How do we decide what sort of care is best for our parents?

That’s best determined following meetings between the client, care manager and any family members that want to be involved.

It’s entirely dependent on the individual and their physical health, mental attitude, age, and so on. For example, if the parent is frail and can’t get out to shop on their own, a carer could either accompany them to the shops, or could introduce the parent to internet shopping, and then be there to put the shopping away.

A parent with dementia would need an entirely different type of care. In the case of one of our clients with early onset dementia, social services were providing the personal care. We were asked to provide respite for the client’s husband. Our team visited and discovered the client enjoyed music, so developed a music-based care strategy. The same carer would arrive every Saturday morning for three hours, beginning by re-establishing a relationship with the lady, and then together they would sing-a-long to a Mama Mia DVD. The client then would teach the carer to play the piano, and ended the morning feeling more positive and emotionally secure.

What are the questions we need to ask when finding a carer for our parent?

Care Quality Commission
Is the supplier regulated by the Care Quality Commission (CQC)? There are two categories of care– personal care, which falls within the remit of the CQC, and home help/companionship for example a general home help or shopper which doesn’t. Given how important it is to be confident in the care being given, we would always recommend choosing a CQC-checked agency or carer, and researching their reports.

Does the care provider have as a minimum personal liability and professional liability insurance? Clearly inviting a stranger into your parents’ home carries risks, and you should always ensure they are appropriately insured.

Disclosure and Barring Service Certified (DBS)
How are the carers recruited, are they DBS certified (CRB-checked) and is their DBS/CRB an enhanced one? Home Instead recruits for behavioural compatibility, empathy and reliability first and foremost.

Do they have the two or more references required by CQC? A combination of personal and professional are advisable and more than two is a bonus. Home Instead require six references.

Continuity of care
Will there be continuity of care, with the same person visiting and at the agreed time each day? Building a relationship, particularly around personal care, is important. Some providers do this, some claim to do this but don’t and some just don’t do it.

Is there a process to ensure carer and parent are compatible and get on? After all the carer will often be the only person your parent sees on that day.

Meeting your parent’s needs
How will the provider ensure that what a relative needs is what they get and will they provide it when they say they will? This is about developing a good relationship with the provider’s care manager as well as the carer and undertaking regular reviews, something which Home Instead works very hard at.

Risk assessments, care plans and contracts
Will a risk assessment and care plan be produced? It’s mandatory. Will there be a contract – what does it look like and will it suit you and your parent?

What do we need to provide for the carer?

Regardless of the care provided there are two major considerations:

  • For health and safety reasons the environment must be safe – requiring the installation of grab rails for example.
  • The family would need to organise appropriate mobility aids through an occupational therapist and might include a bed, hoists, wet room or an accessible bath for example.

How do you prepare a relative for the arrival of a stranger in their home?

  • Start care early – try it, have a go, little and often. If it doesn’t work change it
  • Involve the relative where possible in the discussions about care
  • Make sure you are there when the provider introduces the care giver to the relative
  • Ensure that there’s a connection – if not, change the carer or if necessary the agency.

How can you judge if the arrangement is working as well as it can?

  • Feedback – a formalised system will enable you to see at a glance. Ensure that there are regular review meetings between the relative and care giver. The log in the home should detail tasks completed as agreed in the care plan
  • Consider whether the care being provided is enabling your parent to do what they need, when they want, and with dignity and respect
  • Go with your feelings, as well as those of your parent

When is it time to move on to the next stage?

  • When your parent is no longer safe – at the point when a parent’s condition deteriorates and their physical and/or mental health means that they are no longer safe on their own
  • When your parent wants to move on

For more information about Home Instead Senior Care visit Home Instead’s website or call 01628 299097.

If you’re looking for live-in care, Paul recommends the The Good Care Company and there are many more nationally and locally.

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