Knowing that one day I would have to make the decision that my Mum needed to go into residential care was a day I dreaded. How would I know when that day had come? One of her carers offered this simple wisdom: ‘You’ll know’. Co-incidentally, this was the same advice given by friends during my dating years about knowing when I had Mr Right. And that is a bit of a complicated story! But the time came for me about Mum when she kept getting locked out of her flat and neighbours were losing patience. Then one day she went missing for five hours on the bus and tram network. She had a whale of a time, while I was having kittens. I did everything I could to keep her in her own home for as long as possible, but when it no longer became safe, that’s when I knew.
If you are at this juncture yourself, or anticipate you will be in the future, I would guess it will be a result of one or more of the following: the person you care for has capacity and has decided they want to move in to care, you or your family can no longer fulfil your caring role (for whatever reason), the person’s needs can no longer be met where they currently reside.
Finding a care home depends firstly on identifying what type of care the person needs, firstly: Residential or Nursing? If it is the former, you will need to establish if it is: Residential, EMI (a horrid Victorian sounding term which stands for Elderly Mentally Infirm and generally pertains to emotional wellbeing challenges), or Dual (a place set up for both residential and EMI). Nursing care is, from my experience, possibly a bit more straightforward to search for. A Social Worker may or may not be involved. The reasons are a bit complicated to explain here and I also I am not an expert on the circumstances about when and why. But there was one in my Mum’s case following a safeguarding referral by the housing trust after the numerous ‘locked out’ incidents.
As you know, there is a crisis of staffing in social care, and a dearth of care homes. There is also the question of whether the person is self-funding (has savings or personal assets of more than £23,000) or if the local authority will be funding care. If the person falls into the second category, there will be fewer care homes to choose from, because they are unlikely to agree to a more expensively priced home if there is a cheaper one. If the local authority will be paying, you will likely get some assistance in finding a care home. If you’re in the other camp, I’m afraid you and Google will be spending even more time together.
Where to start? Depending on which local authority you or the person you care for lives in, information varies. My Mum lived in Trafford, I am in Manchester so my search covered both areas in May 2022. Trafford Age UK provided a helpful document of all care homes within their area and types of care offered. Practice seemed different in Manchester however.
If you haven’t already been recommended a particular care home, which I think is always a good start, I recommend your first port of call as www.carehome.co.uk. This is the ‘Tripadvisor’ of care home reviews, where relatives leave reviews. You can search by area and it also has a dementia search tick box. Thereafter, see the Care Quality Commission website cqc.org.uk and what they have to say about any places you are interested in. This is the ‘Ofsted’ equivalent, where each care home is rated according to annual government inspection. My advice is, do not write off any care home with an overall assessment of ‘requires improvement’. If it is ‘poor’, definitely exercise caution, but the aforementioned realities of the state of adult social care must be taken into account. I chose a care home with an overall rating of ‘requires improvement’ but the Care category was ‘good’, plus the inspection happened in the middle of lockdown when everywhere was facing huge challenges.
Further enquiries will be required: do they have a vacancies? Can they cater for the person’s specific needs? Are there any extras to the fees eg chiropody, continence pads? What type of building would suit best, a former house or something modern and purpose built? After picking up the phone or completing an online enquiry form, staff may ask some specific details about the person to help them decide if they are suited.
Thereafter, ask for an appointment for a show around. Don’t be afraid to ask questions, make a list. Try and talk to carer staff. Ask how long they have worked there, what they think of the place, what they think of the management. Better still, try to talk to a resident or relative of residents. Are the residents (where able) engaged? Is there an activities programme? Are there trips out? What is the make up of residents? After that, ask if a taster day is possible. Not all care homes do this, but some do. My Mum was all set up to move to a home after the manager and owner visited her in her flat and all seemed swell. But come the end of the taster day, it was not the right home for her. My Mum is very mobile, a wanderer who wanted to go explore other residents’ rooms, not understanding the inappropriateness of this as a result of her condition, and her behaviour didn’t fit with their resident profile. If a taster day isn’t possible, all care homes will have a four to six week trial period.
From day one after moving in, try to make the bedroom as familiar as possible: put up paintings, photos etc .Take cuddly toys or comforting items. If
you would be upset at the loss of sentimental items eg jewellery, don’t take them because with the best will in the world, things go missing. Find out how clothes are labelled by the home; there appears to be a universal truth in all care homes: occasionally you will visit and find the person you care for wearing someone else’s clothes and vice versa. You will come to find a favourite carer who will be your own support.
The most important questions for you and the person you care for should of course be: will they be safe, well cared for and loved? Remember that nowhere is perfect and there will be a settling in period. But if it is not the right place, like anything in life, nothing is permanent. Moving is always an option.
I wish you well. Vicki.