What to write down on a care facility visit

Book the visit, then ask about a second one

A booked tour shows you the place at its most prepared. That is worth seeing, but it is one data point.

When you book, ask plainly whether you may also come back at a different time of day — late morning, mid-afternoon, or around a mealtime. Ask what times are difficult and why. The answer to that question is itself informative, and a place that welcomes a second visit is telling you something.

Ask how long the visit will take and who will show you round. Ask whether the manager will be available, and if not, when they are. A tour with a salesperson answers different questions than twenty minutes with the person who runs the shifts.

Go with somebody else if you can, and split the roles before you walk in: one person talks, one person writes. Agree in the car park that you will not discuss opinions until you are back in the car, because the first person to speak sets the other person's view.

Bring the printed question sheet and a pen. Typing into a phone reads as distraction; a clipboard reads as diligence.

Request the paperwork before you go

Ask for these by email when you book, and read them before the visit. Half your questions will answer themselves, and the remaining half will be sharper.

If a document is not provided before the visit, ask for it on the day and note whether you received it. Whether paperwork arrives when asked for is a fact worth recording in its own right.

• The full fee schedule: what is included in the basic rate and what is charged extra
• A sample contract or residency agreement
• The most recent inspection or regulator report, and the date of it
• The weekly activities schedule and a sample menu
• The complaints procedure, in writing
• The visiting policy, including evenings and weekends
• The staffing pattern: how many staff on duty by day and by night
• What notice is required to leave, and what happens to fees in that period
• Whether there is a waiting list, and how it works

What to write down while you are there

Record observations with a time beside each one. Not conclusions — observations. "11:40, main lounge, nine residents present, one staff member in the room, television on, three residents asleep" is a usable record. "It felt a bit sad" is not, and it will not help you compare three places in a fortnight.

Write the time you arrived and the time you left at the top of the page, along with the name of whoever showed you round.

Use your senses deliberately and write what you actually noticed. Smell as you come through the front door and again in a corridor. Noise level in the lounge. Whether call bells were sounding and, if so, for roughly how long. Whether staff used residents' names. Whether doors were propped, corridors were clear, and the temperature was comfortable.

Look at ordinary things: the state of the bathrooms at 3pm rather than 10am, what was actually served at the meal you saw, whether people were dressed and wearing their own clothes, whether there were personal belongings in the rooms you were shown, and whether there is a way outside and whether anyone was using it.

Write it in the moment. Anything you postpone until the car park is already half lost.

• Arrival time, departure time, name and role of whoever showed you round
• Time-stamped lines, one per observation, throughout the visit
• Entrance and corridor: smell, temperature, noise, clutter, lighting
• Lounge at a specific time: how many residents, how many staff, what was happening
• Call bells: heard or not, and roughly how long before they stopped
• Whether staff used names, and how they spoke to people
• Bathrooms, mid-afternoon rather than mid-morning
• The meal you saw: what was served, how it was served, who helped
• Rooms: personal belongings, own furniture, locks, window views
• Outside space: whether it exists, whether it is open, whether anyone was in it

Questions for the manager

Ask the same questions at every place, in the same order, and write the answers on the same sheet. Differences only become visible when the questions are identical.

These are administrative and contractual questions. Anything about your parent's specific needs is a conversation for the professionals already involved.

• How many staff are on duty in the day and at night, for how many residents?
• How much agency or temporary staff do you use in a typical week?
• What is your staff turnover, and how long has the manager been in post?
• Will there be a named person responsible for my parent, and how do we contact them?
• What is your process when someone's needs change — who reviews it and how are we told?
• How and when are families told about an incident or a fall?
• What is your process for handling and recording medicines?
• What has the fee increased by in each of the last three years?
• What triggers an additional charge, and can you show me examples on a real invoice?
• What is the notice period on both sides, and what happens if funding changes?
• What happens if my parent needs to go into hospital — is the room held, and is it charged?
• May I speak to a family member of a current resident?

Talk to the people who actually live there

Ask, before you walk round, whether you may speak to residents and visitors. Then do it, briefly and politely, and write down what was said.

Good questions are ordinary ones: how long have you been here, what happens on a normal day, what is the food like today, what time do you get up. You are listening for detail and specificity rather than for verdicts.

If you see a visiting family member, ask them one question: what do you wish you had asked before your relative moved in. It is the highest-yield question on this page and it costs you thirty seconds.

Note who you spoke to only in general terms — "a visitor in the front lounge", "a resident by the window" — and write what they said, not what you inferred from it.

Also note who you were not able to speak to, and why. A place that will not let you speak to anybody is giving you information as surely as one that will.

Compare on paper, not from memory

Build one comparison sheet with the places as columns and your questions as rows. Same rows for every place. Fill it in the same evening as each visit, not at the end of the fortnight.

Add four rows at the bottom that are easy to forget and decisive later: total weekly cost including the extras you were told about, notice period, distance and journey time from whoever visits most often, and whether they had a place available and by when.

Score each row one to five if it helps you, but keep the written observation beside the number. The number lets you sort; the observation is what you will actually use when you talk it through with a sibling.

Leave one column headed "what I could not find out", and fill it honestly. Those gaps are your follow-up call list.

Then send the sheet, not your opinion, to whoever else is deciding. A shared sheet with times and quotes on it turns a disagreement about feelings into a conversation about facts, which is a much shorter conversation.

Questions