Choosing a care or nursing home can be a challenging and emotionally

highly charged task, particularly if you have a relative who is reluctant to

leave their own home but needs to. In my experience, men are usually

more reluctant than women to leave their own home!

 

Here’s a list of things to consider when making a choice, to help you and your loved one focus on the practicalities required and hopefully not get too overwhelmed by the emotional aspects of this big change. I have personally chosen care and nursing homes for elderly relatives on three occasions.

 

In the UK the Care Quality Commission (CQC) website is a great place to start http://www.cqc.org.uk/care-services

You can search by postcode. I’d suggest only considering places which have outstanding and good ratings for everything. If you know somewhere that has lower ratings at least ask them questions about why the rating wasn’t so good & check what the latest CQC report actually says.

 

Things to consider include:

1. Location in terms of convenience for those who will visit most frequently.

2. CQC rating i.e. only consider homes where all aspects have scored good or outstanding.

3. Fees: what’s included i.e. are there any extras and what level of care does that include? What if level of care required reduces or needs to increase and how that is assessed?

4. The ambience of the home, is it friendly and welcoming. How does it compare to any homes you already know (but possibly not in the right location).

5. How does it smell i.e. not urine or cabbage!

6. How clean are the bedrooms and communal rooms? Look under the beds and in the corners of the bathroom floor.

7. What are the residents’ rooms and communal rooms like. Especially the residents’ rooms currently available. Check which room they are offering you. Are there alternatives?

8. Does the preferred room have ensuite facilities? A shower & toilet is important, particularly if incontinence becomes an issue. As someone gets older they are more likely to need assistance with a bath so an en suite bath becomes less important than a shower. A seat in the shower is often helpful.

9. Is there a view from the room: this becomes more important if someone becomes bedbound or room bound?

10. Is all furniture provided or can a resident have some/all of their own furniture?

11. Are hospital style beds provided/available when required?

12. Check that personal pictures, ornaments etc are allowed.

13. Are there phones in residents’ rooms? If not can one be installed? Check charges for installation, line rental and call charges (which may be part of the home’s telephone contract).

14. Is there internet or can it be installed?

15. Are there emergency call buttons in residents’ rooms?

16. In the communal lounges etc is the seating in small groups or one big circle facing a communal TV? The former is infinitely preferable.

17. Are there gardens and outside spaces where residents can sit?

18. What’s the food like? Ask to see a menu and preferably go in the dining room when residents are eating a meal. Ideally sample a meal yourself.

19. Check arrangements if a resident would prefer to eat in their room.

20. Check what level of activities & outings are offered and whether there are extra charges for these.

21. Check what level of medical care is available on site eg qualified nurses: during the day, 24 hours?

22. What arrangements are there for GP visits to the home or for taking residents to the GP? What is the situation if a resident needs to be accompanied to an outpatients hospital appointment (some homes charge extra for this).

23. Does the home provide wheelchairs or would you need to supply your own? 

24. How much parking is there for visitors & how easy is it to collect a resident from the front door if you are taking them out. If relevant is there sufficient residents' parking close to the front door?

25. What are the staff like? How do they treat residents? How do they treat you? What is the morale like? How accessible is the manager/matron if you want a conversation?

26. Ask to speak to a family member of a current resident and to a current resident, preferably without being accompanied by a member of staff.

27. If you have shortlisted one/some homes after visiting have a good look at the contract especially notice period if someone dies. Sometimes it’s until you move out all belongings, at some its 4 weeks regardless. Also how much of the fee is payable if the resident is admitted to hospital.

28. Is the home eligible for financial contributions from the NHS/social services (UK)? Also check if resident will get following nursing care when discharged from hospital (it seems to have a different name in every NHS Trust!) It is not means tested but there is a scoring exercise to see what level of ongoing nursing will be required.

29. Is the home able to keep residents if/when they need nursing and/or dementia care including end of life care?

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Signposts

Other resources in this series include:

• 30 activities for hospital & hospice visiting (also suitable for nursing home visits!)

• Sensitive matters at the end of life

• What to do when someone dies

• Faith in Later Life https://faithinlaterlife.org/resource-hub/

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Author & copyright: Helen Calder 2019

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