Moving into a care home is one of the biggest decisions an older person can make, yet many still make the move without looking at the alternatives. Dan Parton reports.

When Beryl Purdy first went to visit Seely Hirst House, a care home in Nottingham, she was nervous about what she would find.

While Beryl had been living in sheltered accommodation – where services such as meals were provided for her – she realised she needed greater care and a residential care home was the only option. But this was still a big move for her and one that she wanted to ensure was right for her needs – and happiness.

Seely Hirst had been recommended to Beryl by friends, so she decided to pay a visit. She turned up unannounced so she could get a feel for the place: “I was naturally nervous at first, but I did like what I saw.”

Nevertheless, Beryl wanted to see more before deciding whether Seely Hirst House would be the right move for her. Fortunately, the home’s manager was more than accommodating. “They said I could come for a day to see what it was like; I did and I liked it. Then I came for a day and a night.”

Spending this time at Seely Hirst House made Beryl’s final decision far easier – she now knew how the home was run on a day-to-day basis. She enjoyed the pleasant atmosphere, the friendliness and helpfulness of the staff and the proximity of the home to her local shops and church, which lessened the upheaval of the move.

Beryl has never regretted her decision: “I’ve been here several years and I’m still happy.”

Look around you

The vast majority of older people, however, fail to investigate a home thoroughly before moving in – and many are unaware of the minimum standards that care homes are obliged to provide.

For John Burton, a former care home inspector and writer, doing the research is essential, particularly as a minority of homes do not reach accepted standards. He says prospective residents or their relatives should visit several care homes and not be shy about asking probing questions: “There is an odd thing about asking questions because it’s almost as if the big question is: ‘Will they take me?’ or ‘will they take mother?’ People are so anxious they are disempowered.

“If you are buying a house or renting a place you look at it carefully. You wonder: ‘Is this going to be worth the money? What are the problems?’ You might still buy it even when you know what the problems are; you weigh it up, make a decision and you’re not frightened to ask questions, but in a care home you are.”

As well as asking questions – which managers of good care homes will not mind – relatives should also spend time in the home before making a decision. John continues:

“Often it’s not the prospective resident who makes the decision, it’s the son or daughter. They need to go with their parent and say, ‘we’d like to come for a meal’.”
A little snooping at some ‘behind-the-scenes’ aspects of a care home can be a good indicator of its quality: “Looking at the laundry really reveals what’s happening. If you see piles of laundry all chucked in together, it is unlikely to be a good place.”

The little things

But moving into a home is also about feeling comfortable and happy, so prospective residents should pay attention to the minutiae that really make a house a home. For Val Shepherd, a resident at Lamel Beeches Nursing Home in York, what look like minor considerations such as a room with a view, whether furniture fits into a room and the cut of the curtains are all important factors.

People should also look at the relationship between staff and residents. “If you see staff rushing around, it just causes stress to the residents because they can’t rush,” Val says. “Also, if staff frown a lot, don’t look happy and are always saying ‘I’m tired’, you know you are on dangerous ground.”

Likewise, smells are a good indicator of what a home is really like. Val continues: “The older we get the more urinary infections we get, especially women. So if you notice any unpleasant smells in a home, don’t go.”

Prospective residents should also pay attention to what type of activities the home offers. For example, Lamel Beech offers poetry reading, design classes, exercise classes, inter-denominational prayer groups and holy communions, among other activities. Many care homes will now have a dedicated activities co-ordinator.

Spending time in a care home and being observant is crucial because residents and relatives cannot just rely on reports and reviews of a home. “It’s a big choice,” Val says. “[The regulator, the Care Quality Commission] doesn’t see it all.”