Twelve questions to ask on a care home tour
The questions that reveal how a care home actually runs, rather than how it presents itself on a scheduled visit.
Most tours follow the same shape. You are shown a clean room, a menu, an activity calendar, and a wall of photographs of people laughing. All of it is true, and almost none of it tells you what a Tuesday in February is like.
These are the questions that do. Ask them everywhere you go, including here, and pay as much attention to how readily they are answered as to the answers themselves.
About staffing
Who is awake at three in the morning, and what are they doing? There is a real difference between a caregiver who is up and dressed and one who is asleep on a sofa waiting for a call bell. Ask which it is. Ask how many residents that one person is responsible for overnight.
How long has your longest-serving caregiver been here? Your newest? Turnover is the single most useful number in this industry and almost nobody publishes it. A home where people stay is a home where people are treated decently, and residents are cared for by someone who knows them.
Who covers a sick day? The honest answers are “the owner comes in”, “another caregiver does a double”, or “we use an agency”. All three happen. Knowing which one is default tells you how often a stranger will be helping your mother dress.
About the day
What time do residents actually get up? Not what time breakfast is served. Someone who has woken at six every day for seventy years should not be kept in bed until a shift change, and someone who likes a lie-in should be allowed one.
What happened yesterday afternoon? An activity calendar tells you what was planned. This question tells you what occurred. A good answer is specific and slightly mundane: someone’s daughter visited, two people watched the golf, one person did not want to come out of her room and someone sat with her instead.
Where do people sit when they are not in their rooms, and can I see it now? Then look at whether it is being used. A beautiful unused lounge is furniture.
About care and change
What is your process when someone starts declining? You are listening for: noticed early, family called, doctor involved, care plan changed, and written down. You are listening against: “we monitor them”.
What would make you ask my mother to leave? Ask this one plainly. Every home has a ceiling, and a place that implies it has none is either not thinking clearly or not telling you the truth. A straight answer here is the single strongest signal you will get all day.
How do you handle medication, and may I see the log? You may not be entitled to see anyone else’s records, and a refusal on privacy grounds is a good sign, not a bad one. But the system should be describable in one sentence, and it should involve locked storage and a signature every time.
About you
How will I hear about a fall? Same day, by phone, from a named person, is the answer you want. “It would be in her notes” is not.
Can I come at a bad time? Mealtimes, mid-afternoon, a weekend evening. A home confident in how it runs will say yes without hesitating. If unannounced visits are discouraged, ask yourself what is being arranged before you arrive.
What do families complain about? Everybody has complaints. A home that says it has none has either stopped listening or is managing you. The good answer is a real, small, specific thing and what was done about it: the laundry going astray, a caregiver who was too brisk, dinner being too early.
One last suggestion. Take somebody with you, and compare notes in the car afterwards before either of you says anything definite. Two people notice different things, and the person who is less emotionally involved will often have seen something you did not.
If you would like to bring these questions here, please do. We would rather be asked all twelve than have you find out the answers over the following year.