People run around in a panic at the last minute to find a right care home for their dad, mother, friend or relative. Are you choosing the right one? Have you had only a glimpse about how things work or did you have a detailed view? Are you forced to take decisions by the hospital team who wants to free up a bed?
Definitely you do not want your relative to be in a wrong place!!
So, how to choose a care home?
Inorder choose the right care home, you need to check how things are working inside care homes!
Facilities - All care home should be providing basic facilities as it is a requirement by the regulation. Provision for spacious room, toilet and shower room, comfortable seating, profile beds, communal areas, dining area and spaces outside like garden are considered to be basic. Anything additional, if included will boost up the price. Having a spa or on-suit, is it necessary for someone who's main care need is to keep them comfortable?. If you come across a smelly unclean place, please do not bother to carry on your viewing, bearing in mind unpleasant smells can be unavoidable sometimes.
Staff - Look around for people working at the care home. Have a chat with everyone on your visit day. See if they are happy and supported. Do they have a caring attitude? You do not want your relative to be looked after by a 'grumpy' person. Bearing in mind, most care homes employ staff who have a passion for caring.
Manager - All care home should have a care manager by Health & Social care Act. The culture of care home is a reflection of the manager. See if Manager is passionate for his job, has got the right skill and experience. Shoot lots of questions regarding the staffing, whether they use excessive agency staffing or not. Lack of permanent staffing will adversely affect personalised care. Ask the Manager what are the provisions during out of hours, will they be available for supporting their staff if needed.
System - Ask for an example for care records. Find out about care plans, risk assessments and how often it is reviewed etc. See what measures are in place for auditing the quality of the care provided. See if the care home have access to a single Doctor Surgery for continuity of care for all the residents, which seems in my experience works better. Identify provisions for accessing medications during weekdays and weekends.
Activities - This is the main area where most of the care home miss out despite the importance of keeping their service users active. Ask about the provisions for conducting activities? Is there any trained activity staff employed? Any extra entertainments happening? How often your relative will be getting attention? Any trips organised? In-order to retain the abilities of the service users, care homes need to have structured activity schedule which should be personalised based on their abilities to participate. Please do not forget your role in making your visits useful by doing something with your relative.
Some people do make unannounced viewings to choose a care home, I do not agree with the practice. Staff is always busy doing different things, if it is a planned one you will get more time to explore rather than being hurried.
Choosing a care home is a tough decision! But only you can make the decision for your dad, mom, friend or relative. Just imagine if your relative will fit into that place or not.
All the care homes are not 'bad' ones, most of them are 'good ones' with excellent staff who are capable to provide a compassionate care.
Please feel free to contact me if you are stuck with any issues related to care homes! I will be very happy to help!
If your answer is a clear ‘NO’, then it is a big worry. It is time for you to think as an Owner/Manager to find out why your care staff doesn’t worry about CQC (Care Quality Commission) rating. Is it their lack of knowledge about regulatory requirement or is it something to do with their commitment?
Care staff are the heart and soul of a care home. They are the front line staff expected to deliver 3/4th of the ‘nursing’ job with limited knowledge: The knowledge which they have acquired through ‘experience’ rather than an organised learning process. They are the eyes and ears for the Qualified staff. If the care staff failed to recognise a health problem with a resident, it will not get passed on to qualified staff – resulting in a unmanageable health crisis with that resident. Role of the care staff is vital in care home industry – even if they change their role to ‘care practitioner’ or a Nurse assistant in future. Understanding the role for meeting regulatory requirements within all the staff members is necessary to deliver a standardised care.
Lack of knowledge about CQC?
The front line staff consider CQC as a ‘big thing’ coming to inspect them once in a while to hit them with a big ‘regulatory’ stick. Some even do not have a clue who CQC is. This can be classified as fear of unknown. They even fail to do a good job on the day when CQC inspects because of this ‘unknown’ fear. So it is necessary that, Management take proactive measures to teach their care staff to understand the role of CQC. There is no point in Manager having an expert knowledge about CQC requirements, unless their staff doesn’t know what CQC expects from them. The simplest thing to do is to direct or print out a copy of KLOE, and hand it over to all your staff. Ask them read through it and ask them to come up with ideas. It engages the staff to involve in continuous improvement. Management needs to bring out new CQC publications and make them available for the staff. with these simple gestures, CQC becomes a part of the care home culture and there by driving improvements from inside.
Also make them aware that, getting a ‘Good’ or ‘Outstanding’ rating is easy as long as everyone does an excellent quality of work. On the other hand, make your staff aware of the consequences that everyone has to face if rated ‘Inadequate’ or ‘Requires Improvement’.
If your staff very well know what CQC expects of them, and still doesn’t do a good job, then it is the time to question their commitment. Caring job requires passion and dedication. It requires lots empathy. Care staff are required to respond to resident’s need in a compassionate way. In a professional view point – the care staff needs to work in contradiction to ‘The Maslow’s Hierarchy’ by putting ‘safety’ first, even before feeding the residents. The bottom line is, if it is clear that wrong attitude and commitment is the problem with an employee, it is the time to take aggressive measures to put them in the right track or giving them opportunity to leave the job.
This article is written entirely on my perception. As a Manager I feel this is a relevant issue, which needs to be addressed in Care Home Industry. I am expecting your thoughts on this matter with utmost respect. Please feel free to comment.
Some health professionals do think what is the point of getting rated as Outstanding by CQC and some others are not even worried about it. But it is different in my place, getting an Outstanding not only benefits the residents, but very much helps the staff too. The journey has been amazing since our care home was rated Outstanding since 2015.
Some of the key benefits of working in an “Outstanding” Care home are:
I should stop writing now, but the result is “Outstanding” care is delivered by “Outstanding” staff, not the five star hotel faciltiies.