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What Makes a Good Care Home?

Updated on August 31, 2013
Choose the right care
Choose the right care | Source

Choosing Care

If you find that your elderly relative can no longer look after their self, it can be a tough decision to do the right thing. If they are becoming forgetful, lost or neglecting certain things you may be concerned about their safety.

How Can I Tell if Something is wrong?

Certain patterns of behaviour will start to change if your relative, friend or neighbour is finding it hard to cope alone. Physical or mental impairments will cause problems with day to day living.

If the problem is physical then the elderly person may have difficulties with stairs, getting out of the house, struggling with their personal care or be prone to falls.

If there is a mental problem it could be the start of dementia. The signs to look out for include:

  • Forgetting things, such as turning off the oven or locking the doors
  • Confusion, such as putting things in the wrong place or dressing in the ‘wrong order’
  • Stumbling with words as they become forgetful
  • Getting anxious or frustrated that they cannot remember
  • Changes in personality
  • Finding daily tasks almost impossible to do, such as washing, cooking and cleaning

Physical problems with an elderly person may mean they are wheelchair bound or have other problems with walking. They may have poor eyesight or arthritis and generally feel a home is best for them.

Care Packages

Depending on where you live there are many options when it comes to care. If an elderly person is able to live in their own home but needs assistance with bathing and preparing meals, then domiciliary care could be an option.

This would be an arrangement with a community care team when carers would come around at set times to assist.

An initial assessment would need to be made however to ensure the individual is safe at times they are alone in their home.

Some elderly people are looked after by family members on a full time basis. The reason could be down to the cost of care or that family do not want to see their relative in a care home.

If this is the case, they will still be entitled to help with cost of equipment, such as bath chairs, wheelchairs, walking aids and incontinence pads. They can also apply for respite vouchers so that they can stay in a care home for a few weeks over the year. If the main carer in the family wants a break or a holiday then this is ideal.

If it is likely that the elderly person will benefit from going into a care home either for respite care or on a permanent basis, then they will need the right kind of home for them.

Residential or Retirement Homes

Residential care homes usually take in elderly people over the age of 65. Some may choose to go into a home for more help and company, while others are advised to get full time care.

Residential and retirement homes will accept a wide range of people with different levels of need as long as they are not considered to need ‘nursing care’.

Those who need nursing care include people who are acutely ill and need a care home, those who are immobile and need to be hoisted or those with medical problems and would benefit from having a nurse in the home 24 hours a day.

A nursing home will cater for more complex needs and highly dependent residents. They may have learning disabilities or dementia.

Some homes may have locked units to safeguard those with dementia and frequently wander due to confusion. They will be assessed in accordance to DOLS (Deprivation of Liberty Safeguards) for their own health and safety.

Generally a residential (rest home) or retirement home will cater for those with mild physical problems and can be assisted using walking frames, sliding boards or turntables. If the resident is quite independent and doesn't require full hoisting then a residential home should be fine for them.

Residential homes are not locked during the day and residents are free to come and go as they choose. The care staff will assist to their need and help with washing, dressing and toileting as they need it.

What do Care Homes Provide?

Care homes have a team of Health Care Assistants to provide personal care and general care for residents. Senior Care Assistants tend to take on more responsibility such as making doctor appointments, dealing with the pharmacy, showing potential clients around and updating care plans.

There will be a manager (or nurse in charge if it is a nursing home), assistant manager, administration staff for larger homes, kitchen, cleaning and laundry staff. There may be a maintenance worker and activity co-ordinator as well.

Care homes provide help with personal care, providing and serving meals and drinks, a laundry service, outside help from physiotherapists, district nurses (not for nursing homes) and other health professionals.

Each resident should have a bedroom with an en suite toilet and shower. It should also include a bed, television and bedroom furniture.

Nursing homes will provide their resident’s with correct moving and handling equipment, incontinence pads and a bath with chair lift.

There will be communal lounges for residents to sit during the day and a garden.

Going that Extra Mile

When it comes to picking a home suitable for individual’s needs and wishes, you may look for something special.

As with any home, you will look for a good atmosphere and location but you will also pick up on other things. These include:

  • A clean environment which smells pleasant
  • Nice decor and furniture throughout the home
  • A nice spacious garden to sit in
  • Plenty of friendly well trained staff
  • Nice fresh food on the menu to suit dietary requirements
  • Generally well run home
  • Happy looking residents and staff

For a top rated home, you will want to see a little extra. If you are not sure what is provided, then ask. These are the things you want to see:


Activities are important in care homes, as moving out of your own home can be a huge emotional strain. Dementia sufferers are also prone to depression, so mental stimulation is important.

Not everyone wants to participate in activities, but one to one chats or looking at photograph albums together count as an activity.

Some residents enjoy group activities such as quizzes, bingo or games such as scrabble. It is also important to provide music and entertainment of their era, show old movies and have parties to celebrate certain dates.

Some homes also provide transport to take them on outings. Trips out shopping, to pubs or restaurants, garden centres or to see shows are great ways to keep residents active and alert. Having entertainment and friends and family parties are also great for those who cannot get out.

When it comes to entertaining dementia sufferers, light, music, balloon games and puzzles are suitable.

Some dementia units will have items of times gone by for residents to make use of. Old books, type writers, shop tills and old money help them to familiarize themselves with what they remember.


Good homes should invest in having televisions and DVD players for each resident. There should be a wide range of DVD’s, books and music to listen to.

Having fresh flowers and plants make for a nice touch, as well as pictures and ornaments around the home.

It is also nice to have animals such as rabbits in the garden or calming fish in tanks indoors. Some homes allow pets, so ask if you want to bring one in.


Being in quiet surroundings have benefits and therefore very appealing when moving home.

Other factors to consider include:

  • Nice views to look out at
  • Good transport for visitors and for outings
  • Close to amenities such as local shops or a church
  • Close to Family, friends and doctor’s surgery

Inspection Reports

You should be allowed access to inspection reports (such as the Care Quality Commissions).

The reports are based on standards of care, dignity, risk and fire assessments, health and safety, nutrition, good working conditions and up to date care files.

From reading these reports, you should get an idea of the home’s strengths and weaknesses.

Home Layout

The layout of the home is important for many reasons. It needs to be suitable for wheelchair users and have wide corridors, doorways and ramps. There must be a lift if it is more than one floor and the home must be homely rather than clinical.

Having a number of lounges makes it nice for those who want a quiet area and those who want to participate in activities. Easy access to the garden is important to get out into the fresh air and easy access to toilets is a must.


If the person going into the home had hobbies important to them it will help to continue with them.

Knitting, crocheting, gardening, DIY (supervised!), and crosswords all help with person centred care.

Extra Touches?

Care homes can be unique as they all have different added extras. Different things impress different people, depending on their level of need or interest.

Look out for:

  • Happy Hour – some homes set out a bar area for happy hour
  • Casino nights – some have parties for friends and family and have themes
  • In house physiotherapy – arm chair aerobics and bowling are great for rehabilitation
  • Pet Corner – animals are very therapeutic, so stroking cats or dogs help some people
  • Music time – the home may have a piano to play on for example or have a harpist
  • Sensory rooms – lava lamps, aromatherapy oils and soothing music are great, especially for those with onset dementia
  • Games room – some still enjoy playing pool, darts or poker
  • Arts and crafts – making things in a group
  • Charity events – sponsored walks, raffles and garden parties bring the community together


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    • Emma Harvey profile image

      Emma Harvey 5 years ago from Berkshire, UK

      I currently work in the care sector so I see families who have to come to terms with the fact their relatives can no longer look after themselves.

      Those with dementia can be quite a challenge and need full time support, and those who have physical difficulties also need emotional and physical support.

      I have worked in this field for a number of years in different areas of care. The support available may be different depending on where you live, but there is help out there.

      Thanks for stopping by.

    • tabrezrocks profile image

      Md Tabrez Alam 5 years ago from Calcutta, India

      hey Emma Harvey can i help you for this

    • Emma Harvey profile image

      Emma Harvey 5 years ago from Berkshire, UK

      Thanks tabrezrocks for your support and advice.

      Going though the process of searching for care and support isn't easy.

    • tabrezrocks profile image

      Md Tabrez Alam 5 years ago from Calcutta, India

      Hey leahlefler there are lots of community and groups available in west newyork, just serach on google and your problem will be solve.

    • tabrezrocks profile image

      Md Tabrez Alam 5 years ago from Calcutta, India

      Excelent hub every point and indications of the hub is absolutely correct and fine.

    • Emma Harvey profile image

      Emma Harvey 5 years ago from Berkshire, UK

      Hi Linda - it's so important to find the right care package for a family member and the right home for them.

      It's okay to be fussy when checking out homes in the area. You need to feel comfortable with the place, supported by the staff and feel as though the residents are well looked after.

      It is a difficult decision. Knowing what you should be provided with can help with this tough time. Thanks for your comment.

    • lindacee profile image

      lindacee 5 years ago from Arizona

      What a thorough and informative Hub about assisted care facilities. My mother was in a residential home and then a corporate run, assisted care facility. She suffered from dementia and required round the clock care in a secure environment. There are so many factors to consider when choosing a home for a loved one. This Hub will help many people faced with this difficult decision. Thanks for providing this resource.

    • Emma Harvey profile image

      Emma Harvey 5 years ago from Berkshire, UK

      Hi meloncauli, finding a good care home or one you feel comfortable with is hard. Sometimes we are restricted by location and what's available, and it makes things harder when the person concerned finds the move distressing.

      I wish you all the best of luck though and thanks for reading.

    • meloncauli profile image

      meloncauli 5 years ago from UK

      Great hub Emma full of information for those with an elderly relative. We are struggling with my dad in his home right now, even with outside help. Great read and thanks.

    • Emma Harvey profile image

      Emma Harvey 5 years ago from Berkshire, UK

      I think the assisted living is a great idea. We have apartments with wardens to be on call for emergencies. I don't think they are like you described though - it sounds perfect for those who need someone there but want their own independence too. Then can be gradually moved when they need more care. I like that.

      Thanks leah!

    • leahlefler profile image

      Leah Lefler 5 years ago from Western New York

      There is a really nice community near our house where people can live in their own patio homes, then move to assisted living (have their own apartment but can go down for breakfast/dinner, etc) and then move to skilled nursing when it is needed. It is such a beautiful retirement community - I wish every place had one like it!