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More questions to ask when choosing a care home

By Kathy Lawrence

How can you really get under the skin of a care home to know if it’s going to work for your parent? There’s plenty of advice on general questions to ask but here are a few more thoughts for you to consider.

These questions are based on the experiences of my family and our readers at When They Get Older. They’re all about things we didn’t realise and may have made a difference to our choices.

Who’s the manager?

Care home managers can come from a range of backgrounds – accountancy through to long-term nursing. Each has its benefits. Do you feel a home needs financial and administrative expertise at management level or an understanding of how to care for individuals? And to whom are they accountable – the residents, the family, the larger business that owns the home and perhaps shareholders? The home my family knows best has had five managers in one year, suggesting that it’s a really tough job.

What’s staff turnover like?

Ideally carers are allocated to residents to ensure a continuity of care and the opportunity to build relationships. That’s not going to happen if there’s a high staff turnover, which happens in homes where employees feel undervalued and frustrated. Can you have a quiet chat with residents and staff about how long carers and nurses stay in their posts? If not long, why not?

Will your parent’s home be their castle?

How does the home view the room that your parent is going to occupy? Is it simply a bed that’s been allocated or do the staff understand that this is now someone’s home? Showing respect for privacy and ownership is rightly very important for many older people. Simple things like knocking and waiting to be invited in are indicative of how the staff views the status of their residents.

What’s day-to-day medical attention like?

What’s the arrangement for calling in the GP if residents need care? Homes often pay an astronomical amount to the local surgery to ensure a weekly visit from the GP. And your parent will probably have to change their GP to the surgery contracted by the home and simply see whoever turns out that day.

You might also want to find out just how often residents get sent off to hospital by the GP “just in case” rather than being treated in the home, and whether this is particularly true of out-of-hours services during the night and weekends.

How are relations with the local hospital?

There’s little choice about which NHS hospital your parent can visit, but asking about service at the local hospital is a good move. If a parent is taken into hospital it’s unlikely that the home will be able to find out news, so it will be down to the family to keep in touch with hospital and home.

How are medical appointments managed?

Another area to ask the home about is how residents get to and from routine appointments and back from hospital in-patient stays. If patient transport is used, what’s that experience like? Hot and long? Comfortable and efficient? If hospital transport isn’t good, what are the other options and their costs? There are other appointments to think about too. Does the home have visiting chiropodists, opticians, audiologists and dentists, or is it down to the resident and family to organise these? Does the resident have to pay extra for a carer to accompany them if they go out for an appointment?

Can you try the food?

Preparing enjoyable meals is a tough one for homes that need to cater for everyone on a limited budget. You may be able to experience a meal as a guest. If your parent is finding the food unpalatable, will you be able to bring in tastier, crunchier alternatives or even a spare salt cellar? With healthy eating so high on the agenda in many care homes, will anyone challenge your gifts?

Who keeps in touch?

Are there regular meetings for residents and families with the management team to discuss activities around the home such as care, meals, entertainment, staffing and maintenance? And are they at useful times? Or can you see the minutes if you can’t get there?

Possibly more important is to know how staff communicate if a parent is taken ill but is nursed at the home. Almost certainly they’ll call the family initially but the onus may be on you to keep in touch to keep track of progress.

Does anyone answer the phone?

If you’re calling to find out how a sick relative is you’ll need to be able to get through to the nurses. If no one specifically answers the phone – especially out of hours – that could be difficult.

How hard is it to talk to anyone about anything over the phone, including administration and less urgent issues, and are they willing to give out email addresses?

Who repairs the building?

Maintenance is a continuing challenge. It might be major issues such as leaking windows or smaller ones like replacing light bulbs, but there always seems to be something that needs looking at, especially in older buildings. So who looks after the day-to-day repairs and can you see signs of bodging? Larger tasks – such as replacing those leaking windows – might need funding that has to be applied for from central reserves if it’s a large organisation.

Are there other questions that you wished you’d asked while choosing a care home? Do let us know in the comments box below.

Kathy Lawrence is a co-founder of When They Get Older and a freelance writer at Wrightwell.

This article was created in October 2016.

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