HealthInfo Waitaha Canterbury

Checklist to compare rest home and hospital-level care facilities

Rārangi hihira kia whakataurite i ngā whare pēperekōu me ngā whare manaaki hōhipera

We suggest you consider the following questions when comparing residential care facilities. This list is by no means complete. We hope it stimulates you to ask other questions.

Atmosphere

Staff should show warmth and empathy with residents. There should be a noticeable involvement in conversation, activities (active or passive) rather than residents sitting around the edge of the lounge where it's difficult to connect with others. The rest home or hospital should have a comfortable, inviting and confident feel about it.

• Do the residents appear happy and well cared for?
• Are they treated with respect by the staff?
• How do staff relate to one another?
• How are visitors greeted and treated?
• Are residents involved in activities? Are they chatting to each other?
• Is the facility clean, warm, odour-free?

Rooms

Residents' rooms should be clean and comfortable and have enough floor space. Communal areas should be accessible for your dining, relaxation and activity needs.

• If you're considering a particular room, is there space for your own furniture and other personal items? Are you able to personally adjust the heating?
• Are rooms sunny and well lit, with an outside window?
• Are toilets close by and easily accessible? Ensuites aren't always essential but consider how practical a full ensuite might be (especially if you need assistance).
• Is there easy access between areas? For example, no tricky stairs.

Care

A current, regularly updated care plan for each resident should be kept by the staff.

• How will you and your whānau (family) be involved in your care plan?
• What are the registered nurse hours and the carer to resident ratio?
• Is there regular input from other health professionals, such as physiotherapists?
• What qualifications do the main caregivers have?
• Is it practical to keep your own general practice team?
• Is there a house GP on call at all times?
• If your level of care changes, will you have to move to another room or facility?

Activities

There should be a range of activities for those who wish to be involved and alternatives for those who do not. A list of the week's activities, outings or events should be on display.

• Is there an activities programme displayed? Who decides on the programme?
• How frequent are the outings? Are there any associated costs?
• How well are individual interests catered for? What provision is there to pursue individual interests, such as gardening, woodwork or going to your club?
• What qualifications does the activities coordinator hold?

Meals

Meals should be varied, interesting, nutritious and appropriate (for example, some people may require a soft diet). A daily menu should be on display.

• Are the meals nutritious, appetising and the quantities sufficient for you?
• Are there choices at mealtimes?
• Can you help yourself to drinks, fruit or snacks at any time?
• Can a relative or friend join you for morning or afternoon tea or main meals occasionally? If so, is there a cost?
• Can you have meals in your room?

Safety

The facility should have systems and procedures in place to ensure resident safety. Staff should be confident with all emergency drills.

• Is the nurse-call button within easy reach? Is it answered promptly?
• Are the buildings and grounds secured at night?
• How often are fire and emergency drills held?
• Do staff have residents' emergency next-of-kin contact details?
• If a resident has an accident, how is this managed? It should be recorded, family informed (generally) and steps taken to prevent it happening again.
• What does the facility do to ensure safe medicine management?
• What are staffing levels like at night or over the weekend?
• What is the staff training schedule? Is a quality programme used?
• What system do staff have for updating each other between shifts?

Dignity, privacy and independence

Residents should be encouraged to keep their individuality and make their own decisions. But staff also need to be sensitive and make sure things that have been important to the person in the past aren't neglected, such as applying make-up, shaving and so on. These things help the person keep their dignity.

• Who controls your personal finances?
• How well is resident privacy managed?
• Do staff knock and wait for an invitation before entering residents' rooms?
• How well are individual preferences catered for? For example, are bedtimes flexible? Do you choose what to wear for the day? How often can you shower?
• Can you have your own telephone and TV in your room?
• Do residents have a collective voice – is there a residents' committee?
• How are residents' ethnic, cultural and spiritual values and beliefs respected and upheld?

General

• Are there any additional costs? If you agree to any, remember to ensure these are itemised on your agreement and included in your budget.
• How are any complaints dealt with? Ask residents and their relatives about their experiences. Residents have the right to make a complaint.
• Ask how long certification has been granted for. Longer periods, such as three years, generally indicate greater compliance with standards and requirements.

In addition to the previous questions, those looking for dementia or specialist hospital care may also wish to consider the following.

Specialist dementia and specialist hospital care

If viewing a secure facility, enquire about what is provided for the special needs of residents. Staff in these facilities should be trained in this specialised area of care.

• What kind of activities are provided for the special needs of residents?
• Are key relatives or former carers able to be involved in making or revising care plans?
• How are challenging behaviours managed?
• How is restraint monitored? There should be a written policy on restraint.
• Do staff regularly interact with and oversee resident activity?
• What is registered nursing staff cover like?
• How is the resident's dignity maintained?

You can view Te Whatu Ora – Health New Zealand's standard contract by visiting Te Whatu Ora website.

  HealthInfo recommends the following pages

• Consumer NZ – Rest homes

  More information about issues with rest homes, including a checklist of questions to ask.

• Eldernet – Residential care checklist

  General information about residential care, including a detailed checklist of questions to ask.

• Age Concern – Residential care

  Information about moving into a rest home or helping somebody else to make the move.

From Care Publications – Where from Here, March 2012. Adapted by HealthInfo clinical advisers. Last reviewed March 2023.

Sources

Page reference: 53015

Review key: HIRRV-48277