Choosing a care home: what to look for and ask on a visit

• Read the CQC report, especially Safe and Well-led, and note the inspection date
• Check the home is registered for the care needed: nursing, dementia, or both (types of care home)
• Read the reviews on the home page here and note anything you want to ask about
• Write down the three things that matter most to the person moving in, and take the list
• Ask for the visit at a busy time: late morning or a mealtime shows more than mid-afternoon

Use your senses before you use your questions. Does it smell clean, or of air freshener covering something else? Is it warm? Is there noise: conversation, a radio, laughter, or a television nobody is watching? Are residents dressed and up, or in nightclothes at eleven in the morning? Are there people in the lounge, and is anyone talking to them?

Look at the notice board for the activity programme and whether today’s activity actually seems to be happening. Look at the menu and ask if you can stay for lunch. Ask to see a room that is actually available, not the show room, and the bathroom nearest to it.

The best homes are slightly untidy in a lived-in way. The worrying ones are either immaculate and silent, or chaotic.

Ask to meet the manager, and ask how long they have been in post. A registered manager who has been there for years is the single most reliable sign of a stable home. Then talk to a carer on the floor, not the one showing you round, and ask how long they have worked there and whether they like it.

Watch an interaction. Do staff crouch to a resident’s eye level, use their name, wait for an answer? Or do they talk over them to you? If you can, talk to a resident or a visiting relative on their own. Ask what the food is like and what happens when they press the call bell.

• How many carers are on duty by day, and at night, for how many residents?
• How long has the manager been here? How many staff have left in the last year?
• Do you use agency staff, and how often?
• How do you assess someone before they move in, and what happens if their needs change?
• Who is the GP, and how do residents see a dentist, optician and chiropodist?
• Can residents get up, go to bed and eat when they like?
• What happens on a typical day? What happened yesterday?
• Can family visit at any time? Can we take them out? Can they keep a pet, a phone, their own furniture?
• How do you handle complaints, and can you tell me about the last one?
• What is your approach to end of life care, and can people stay here to the end?

Most homes are straightforward about money once asked, but they wait to be asked. Get the answers in writing, ideally on the home’s own fee sheet. Our guide to what the fee includes goes into detail; the short list is:

• The weekly fee for the room you have been shown, and whether it changes with care needs
• The written list of what is included and what is extra
• Last April’s increase, and the notice given
• Deposit or admission fee, and the notice period to leave
• What is charged during a hospital stay and after death
• Whether the home accepts the council rate, and what happens if savings run down (see who pays)

• No registered manager, or a manager who has been in post a few weeks
• Staff who cannot tell you how many residents they are looking after today
• Residents left in wheelchairs facing a wall or a television, with no one talking to them
• Call bells ringing for a long time
• A strong smell of urine in corridors, not just in one room
• A reluctance to let you visit unannounced, stay for a meal, or talk to residents
• Fee answers that change between the phone call, the visit and the contract

Go back unannounced, at a different time of day, and see whether it matches. If it does, ask about a trial stay: most homes offer two to four weeks and the contract usually has a trial period. Save the home to your shortlist here to compare fees, ratings and reviews side by side.

Then write down, while it is fresh, what the person moving in said and how they seemed. In our experience that is the thing families most regret not doing.