Selecting a care service
Choosing a care provider for your parent is one of the most important decisions you will ever make. This guide aims to help you make the right choice for everyone concerned.
Residential care or home care?
Your first decision is to choose between residential care and home care – in other words, are you looking for somewhere for your parent to live, or do you want help to allow them to stay in their own home? This is a hugely sensitive area and a decision that your parent should ideally be actively involved in. Focus on the facts and the practicalities, as well as personal preference, to arrive at a conclusion.
Once you’ve made your decision, make a list of potential care agencies or residential homes, whichever is appropriate, and then take time to check them out.
Assessing the options
A good place to start your research is the website of The Care Quality Commission (CQC) (http://www.cqc.org.uk/). The CQC is the independent regulator of every registered provider of health and adult social care in England. Their four core values are excellence, caring, integrity and teamwork, and they monitor, inspect and regulate care services, and ensure that the care provided is of a good standard. They publish both their findings and the ratings awarded, and the site is searchable to allow you to see how well an organisation is performing. For each care agency or residential home on your list, check when the last inspection was carried out and also what the results were.
Questions to ask care providers
Irrespective of the type of care you are seeking, it is a good idea to have a list of questions prepared to ask potential care providers. These should include:
- Are your staff DBS (Disclosure and Barring Service) checked? This was previously known as CRB – Criminal Records Bureau – and will mean people who are unsuitable for or barred from working in a particular sector are not employed in it.
- What training do staff complete before working? This will tell you whether staff have the right knowledge and skills to care for your parent.
- How do you, as a company, deliver quality assurance?
- What is staff turnover like? High staff turnover may be indicative of problems within the company.
- Will we have continuity of care?
With home care, or domiciliary care, your parent remains in their own home and the care they need is provided there. It is important to be sure as to what care your parent requires, and the best way to find out is simply to ask.
Things you need to ask your parent include:
- What do you need help with? Be specific – cover things such as dressing, bathing, cooking, going to the toilet, etc.
- How often do you want someone to visit? It may be that visits morning and evening, to help them get up and dressed and have breakfast, and later to prepare for bed, are enough. Alternatively they may need additional support throughout the day, perhaps at lunchtime.
- What are the best times for a carer to call? If your parent is an early riser, then having to wait until nine o’clock for someone to help them get up and dressed might be stressful. Equally, if they like to sleep until nine, then having someone call at seven thirty will not be very satisfactory. Be as clear as you can as to what you require.
The chances are you will also need to have a conversation with your parent’s GP, to be sure that their medical needs are also taken into account.
Incidentally, if your parent needs help seven days a week, make sure the agency knows that and has not assumed help is needed Monday to Friday only. You’ll also need to confirm whether there are additional charges for weekends and/or bank holidays.
When you meet with prospective care agencies, be sure to:
- Make sure they provide the sort of care your parent needs, at suitable times.
- Ask to see the contract and price list.
- Check whether there will be a regular carer, and ask how many different carers are likely to be visiting.
- Find out what can be done in the event a carer and your parent don’t get on (especially important if the conflict is with a principal carer).
- Check what will happen if the carer can’t keep an appointment for some reason.
- Check what will happen if the carer can’t get an answer when they call, or there is a medical emergency.
- Check what will happen if your parent has to go into hospital.
Residential care home/nursing home
Both residential care homes and nursing homes can vary in size and number of residents; while they will all provide twenty-four hour care and support, a nursing home also provides round-the-clock medical care from a qualified nurse.
Once you have whittled your list of potential homes down to a shortlist, make arrangements to visit and to take a good look around each one. Pay attention to how you feel when you arrive and enter the facility – is it welcoming and homely? Are the staff friendly? How do the current residents appear – are they happy and alert, or do they seem fed up? First impressions are important.
Ask to see the rooms, toilets, and – if they prepare food on the premises – the kitchen. Food is hugely important, so check whether special diets are catered for and how much choice residents have with regard to what and when they eat. Check also whether residents can make hot drinks for themselves.
Consider the location carefully, not just from the point of view of how nice the area is, but also how easy it is to get to, and whether there are good facilities – e.g. shops, library, cafes, etc. – nearby. If your parent is mobile – even if only with the aid of a mobility scooter – these can provide a welcome break.
Other questions to ask include:
- How flexible are visiting arrangements?
- What activities and outings are available?
- How much choice is there in the daily routine?
- What is the ratio of staff to residents?
- Is there good mobile coverage?
- Is there good Internet/computer access?
- Can your parent contact you privately via phone/Skype?
- What can you do if your parent is unhappy or simply doesn’t settle there?
- If your parent has to go into hospital, what will happen with regard to the cost of keeping their room?
Finally, when you reflect on your visit consider what questions you were asked by the company: did they ask about your parent’s history, personality or hobbies, or did they just discuss prices with you?
It’s a big change, but …
There’s no denying that moving into a care home – or even suddenly having carers visit two or more times a day – is a big change in routine. However, these things are often necessary to ensure our parents live comfortably in their senior years.
It’s true that you can change arrangements if they prove to be unsatisfactory, but it is arguably better – and much less disruptive– if you get it right first time. The good news is that by conducting some research and investing a little time in interviews and visits, you can give yourself – and your parent – the best chance of making the right choice.
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