Care homes – advice for all

If you are starting to think about finding a care home for yourself or a friend or family member, speak to your local authority contact service first as they can look at all your needs in one go, and there might be other alternatives to help you stay in your own home.

There are also several other options for housing for older people, which can be suitable when you can’t manage in your own home, but don’t need the round-the-clock support offered by care or nursing homes.

You can find out about care homes and the services they offer by searching on Help and Support Manchester. This includes their latest assessment by the Care Quality Commission, a national organisation charged with monitoring the quality of all care services.

Choosing a care home and working out how to pay for it can be complex. If you’re considering a move to a care home, make sure you have as much information as possible about what to look for, where to look and how to make the move as easy as possible.

The Independent Age website has lots of useful information, including topics such as:

• when you might want to consider a care home – the pros and cons to consider
• choosing the right care home – what to look for
• care home checklist – what to look for and questions to ask
• settling in to a care home – ways to make the transition to a care home smoother
• what happens if a care home closes – who is responsible and what you can do
• if a care home asks you to move out – why this might happen and what you can do.

The SCIE website offers lots of information about safety and safeguarding in the care home.  Two of the CQC’s Fundamental Standards, which care providers must meet, concern:

• safety – you must not provide unsafe care or treatment, or put people who use your service at avoidable risk of harm; and
• safeguarding from abuse, improper treatment, or neglect.

CQC has lead responsibility for investigating incidents where people in residential homes have been harmed by unsafe or poor quality care or treatment, while the local authority takes the lead in safeguarding cases. There will of course be cases where both agencies are involved.

The obligations of care home owners and managers in respect of safety apply to all the people living and working in their care home. They should have clear policies in relation to both.

Safeguarding should be the ‘golden thread’ that ties together all aspects of practice in care homes. This means including all staff in safeguarding training, ensuring all the home’s policies and procedures are in line with each other, and working effectively with external agencies involved in helping care homes improve.

Community Care sets out the following tips for care home managers:

• collaborate with external agencies
  • work closely and in collaboration with external agencies
  • rather than fear them, try to understand the other organisations’ roles and responsibilities and how they differ from yours – be aware that those differences may lead to an imbalance of power and focus on outcomes
• cross reference polices and procedures
  • ensure all policies and procedures are cross referenced and make connections to one another
  • this should take account of all aspects of care for example, health and personal care, daily life, nutrition and medication
• train effectively – and include all staff
  • provide adequate and effective staff training that reflects a culture of safer practice and managing risk
  • training needs to be tailored to the individual home and for all staff in it, not just care workers or nursing
  • safeguarding will not receive the validity it needs unless there is a ‘whole-system’ approach to training from kitchen staff to gardener or handyman
• make the care plan the focal point
  • make the care plan the focal point for your practice
  • ensure staff understand that if residents are treated with dignity and respect and, for example, are given medication without any errors and eat nutritious meals, it can lower levels of safeguarding concerns
• put high-quality care at the centre
  • if all elements of high-quality care are at the heart of what you do, effective safeguarding of adults at risk will inevitably follow
  • this could mean from how the kitchen staff prepare and give food, to how the rooms are cleaned, to nurse-led medication
  • each element has the same weighting for safeguarding, prevention and protection
• reflective practice for continuing professional development – managers should ask themselves the following questions as they seek to embed safeguarding in their homes’ practice:
  • think about your own values, attitudes and beliefs and how this is represented to your staff and how you show this to others within your setting
  • take a moment to reflect on your external relationships, both with professional agencies and within your local community – do these feel tense or fearful? Is there a lack of understanding? Are you working towards the same outcomes for your residents?
  • how do you review that all the elements of a joint approach to safeguarding are working together?
  • do you include all staff on training? Is training a standard item on the team meeting agenda?