An insider’s guide to asking the right questions when choosing a care home
There’s plenty of advice about choosing a care home available on the internet. But does it go far enough? As a registered nurse John has spent years working in care homes for the elderly and knows what’s important to ask. Now he’s used his experience to write a guide to the questions that will really help you decide if a home is right for your relative.
What shift patterns does the home have for its staff?
Many homes only have two shift patterns – usually 8am-8pm and 8pm-8am. These 12-hour shifts are exhausting in any job, but particularly so in healthcare, where the work involves looking after vulnerable people with complex needs. This can lead to an inadequate level of care.
It also means there is no hand-over time scheduled in, so information is not necessarily passed on from one team to another effectively.
Can you attend a relatives meeting prior to making a decision?
Many care homes regularly have what is known as relatives meetings.
Here relatives and friends of residents can meet at a scheduled time to discuss anything to do with the home, including concerns with any of the staff members.
The meetings might contain complaints, but it is worth putting these into perspective to get an overall view of the home.
A good care home would have no reason to object to this, with the exception of confidentiality issues. They might well jump at the opportunity if the relatives are pleased with the level of care their loved ones are receiving.
What are the staffing levels like?
The Safe Staffing Alliance optimistically recommends that there should never be more than eight patients to one nurse on a hospital acute ward. But it’s actually care homes that come closest to achieving this ratio, even though there are no similar recommendations in this sector.
Although the recommendations of the Safe Staffing Alliance are not mandatory, it would certainly be worth asking any prospective home whether they are aware of them, and if they do already or plan to implement it.
How often does the care home use agency staff?
Regular staff know a lot of valuable information, such as a resident’s routine, and likes and dislikes. This type of information may seem trivial, but is vital for the proper running of a home.
When a number of different people work in a home they cannot be familiar with the residents, and they are in need of constant explanation. If that happens too often it can have an impact on the running of the home.
Care homes should really only make use of an agency as a last resort, and you should be concerned if they are used on a frequent basis.
Does the home manager have any clinical experience?
Every care home should have an individual on the staff who is what is known as a ’Clinical Lead’. However, it is also very important that the manager also has some clinical experience, i.e. is or was a registered nurse or doctor.
You can check this by going to the websites for the General Medical Council (which lists practising doctors), or the Nursing Midwifery Council (which lists practising nurses).
What is the staff turnover like?
This is a question you can ask of residents’ relatives or friends at the relatives meeting. If there’s a high turnover, and agency staff are used frequently, you have to ask why.
Also look out for job ads reappearing in the vacancies section on the internet, or in a local paper. Ads that appear week after week, month after month, for the same care home, often indicate difficulty in recruiting staff, and again it is worth asking why.
What training is available for carers?
In England it is not mandatory for carers to receive training. However, you could ask a potential care home if they provide any assistance for their carers to complete a course in Health and Social Care.
A home that provides opportunities for their staff to progress in this way is likely to be one that also provides good care.
You can read John’s full article, discussing the pressures on care homes and carers, and how various private and public organisations are attempting to provide the best standards of care, at http://www.howtochooseagoodcarehome.co.uk/.
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