Choosing a Care Home – A Checklist

Choosing a care home can be a daunting prospect. Where to start?

Make sure the home provides the level of care you need or could need in the future. Often you will know of the care homes in your area and local reputation will count for a lot. Big brands are not always a reliable guide - good care homes are created by the people in them and an independent home may often be as good as if not better than a recognizable national chain. However, how do you determine the good from the bad? The starting point is to draw up a shortlist based upon geography – where would mum or dad like to live? A great way to do this is to use Care Quality Commission’s website. This allows you to pop a postcode in as the centre of your search area and search within a defined radius. The results will be returned in increasing distance from the centre of your search postcode. 

In the results, you can access the Care Quality Commission’s inspection reports on each home, information about who runs the home and contact details. You may come across a home which has a great reputation locally but may have a poor inspection report. Don’t dismiss these out of hand. If the home was on your shortlist, take time to visit the home and discuss the report with the home manager and find out what they are doing about it. Make sure the shortlist of the homes you’ve drawn up provide the level of care you need or could need in the future.   

A visit to the home is essential – not just once during the core of the day, but at times when staffing may be reduced, such as evenings or weekends. A checklist for your visit should include (some of these points may seem a little obscure, but they each have a purpose):

• Is there an activity programme and is it being followed through on (all well and good to have a programme, but do they actually do it!)
• What are staffing levels like at evenings and weekends?
• Do residents look dishevelled?  Ladies should look like ladies, gentlemen like gentlemen.
• Are residents’ spectacles clean?
• Are residents wearing hearing aids?
• Are the ladies wearing stockings/tights?
• Are there urine odours?  Urine odours are an indicator not of incontinent residents but of poor continence management.
• Are residents being stimulated or are they left to sit in a circle around a TV?
• Try to visit when medication is being administered.  Are residents being afforded privacy and dignity in the administration of medications?
• Do residents get support at mealtimes to encourage them to eat and hydrate or are meals just left out in front of residents?
• After meals, are residents left with food stains on clothing?
• Is the manager out and about in the home?
• How is laundry managed?  Is it tagged/marked so residents’ clothes don’t get lost?
• What is the food like?  Is there a good range of food choices available.  Is it ‘grey’ or is there a balance of colours, textures and tastes?  Is alcohol available?
• Do care staff respect residents’ privacy (are room doors left open so that visitors can look inside?)
• Is staff turnover high?  What levels of qualifications do the management team and staff have?
• What is your impression of interactions between staff and residents? Caring, kind, empathetic, encouraging, involving etc? Or not?  

Make sure that you understand the fees and charges – what is included and what is not included. There will be some add-ons for essentials like haircare and chiropody, toiletries etc. However, the main factor in residents settling well into a home is their active participation in the decision to move. Solicit mum or dad’s views and have them participate in the decision. Sometimes our views (as the children!) differ from our parents and we tend to view homes that we would like to live in rather than viewing it from their perspective/needs. Remaining connected to the local community and friends is very important. Unfamiliar surroundings coupled with lack of meaningful socialisation can accelerate a deterioration in the condition and wellbeing of a resident. When you visit a home, always but always look for standard of care above environment. 

For more help and a downloadable checklist, please go to Independent Age. Independent Age is a charity providing free, clear and impartial advice and resources on remaining independent into older age.

John Kirk is a Senior Care Consultant with over 14 years’ experience in senior care including leading a large residential & nursing care home group, high quality care at home services and the provision of specialist consultancy services to residential, nursing and domiciliary care providers.