If you’re going to visit a nursing home for the first time, you’re going to walk in feeling slightly out of your depth, and that’s normal. Most people have never set foot in one. You don’t know what you’re meant to be looking for, the manager is being polite, the place smells fine, the lady at reception is friendly — and you leave half an hour later thinking, “well, it seemed nice.” That’s not enough.
We’ve been on both sides of this. We’ve had families ask us very sharp questions over the twenty-five years we’ve been running Aldridge Court Nursing Home, and we’ve also visited a lot of homes ourselves — for relatives, for friends, for industry training. There are twelve questions we always come back to. Print this. Bring it with you. Don’t apologise for asking. A home that’s irritated by a list is a home that’s hiding something.
Question one. What are your staffing ratios on day shift, on night shift, and at weekends? You’re looking for a real number. “We have enough staff” is not an answer. A typical safe ratio in a nursing home is one nurse plus four to six care assistants for thirty residents during the day, and slightly fewer at night. Some homes will dodge this question. Push gently. Then ask: when was the last time the home worked with an agency? Frequent agency use isn’t a deal-breaker, but it’s a signal — either of high turnover or of recent illness in the team.
Question two. Can I see the most recent CQC inspection report? You can find these online, but ask in person too. The manager should be able to talk you through it. If the home is rated Good or Outstanding, ask what they’re working on next. If it’s Requires Improvement, ask what’s changed since. The honest homes will tell you. Be wary of any manager who waves the question away or blames the inspector.
Question three. What happens if my relative deteriorates? This is one of the most important questions and it’s the one families forget. A nursing home should be able to provide end-of-life care. If your mum or dad gets weaker, will they be moved? Will they stay in their room? Who’s the GP — the home’s, or your own? What’s the relationship with the local hospice? At Aldridge Court we work closely with the district nurses and St Giles Hospice, and we keep residents with us through the end of life wherever possible. Not every home does.
Question four. How do you handle medication? You’re looking for a proper system. Blister packs from a single pharmacy, a Medicines Administration Record (MAR) for every resident, twice-daily checks by a registered nurse, and a clear protocol for “as needed” medication like painkillers. Ask if you can see a blank MAR chart. Ask who supplies the medication. Ask what happens if there’s an error — not because errors are common, but because how a home talks about errors tells you everything about its culture.
Question five. Tell me about the food. Specifically, tell me about today’s lunch. Then ask if you can see the kitchen. A home that’s proud of its food will take you to the kitchen. A home that’s hiding something will explain why now isn’t a good time. Look for a real chef (not a heat-and-serve operation), choice at every meal (at least two options), provision for soft diets and pureed diets, and a willingness to do birthday cakes, favourite teas, and small acts of dignity around food.
Question six. What’s your visiting policy? After COVID, this matters more than it ever did. You want a home where you can drop in, where you can stay for as long as you want, where you can take your relative out for the afternoon, where you can be there at the end of life. Watch carefully when you ask. A home that hesitates, or starts listing rules, is a home that’s still in a defensive crouch. We at Aldridge Court have always been open-doors and we don’t expect that to change.
Question seven. What activities do you run, and who runs them? A good home has at least one dedicated activities coordinator. Not a care assistant who runs bingo on Wednesday afternoons in addition to their other duties. A real coordinator, with a programme, who knows what each resident enjoys. Ask to see the activities board. Ask who came in this week from outside — a music therapist, a singer, a visiting school, a pet therapy dog. The variety tells you how connected the home is to the wider community.
Question eight. Can I meet some of the staff? Not just the manager. Ask to meet a care assistant on shift, the senior carer, the activities lead, the chef if possible. The manager has been doing this conversation for fifteen years and could sell sand in the Sahara. The care assistant on shift is your real signal. Are they smiling? Do they make eye contact with the residents they’re passing? Do they know names? Do they look tired in a normal way, or in a worn-down way? You can tell.
Question nine. How long has the senior team been here? In a well-run home, the manager, the deputy, the head of care, and the senior nurses have been there years. In a struggling home, you’ll find new faces in every senior role. Turnover at the top is contagious. Ask the manager how long they’ve been in post. Ask how long the deputy has. If the answer is “just six months” for three of the four, that’s worth knowing.
Question ten. What happens at night? Walk the corridors during the day and then ask, “what’s it like here at 2am?” A good night routine has a registered nurse on duty (mandatory in a nursing home), two-hourly checks for residents at risk, prompt response to call bells, and a calm, unhurried atmosphere. Ask if you can do a night visit if you’d like to. The willingness to let you do that is the answer.
Question eleven. How do you handle complaints? Every home gets complaints. The question is what happens next. You want a written complaints policy you can see, a named person who handles them, evidence of how recent complaints have been resolved, and a manager who is unbothered by the question. Defensive, dismissive, or vague answers are a sign that complaints are not welcome. That matters because in two years’ time, you might be the one complaining.
Question twelve. What’s the one thing about this home you wish people knew? This is the question that gets the best answers. It cuts through the script. Listen to what they choose to tell you. A good answer is something specific and lived-in — “our chef has been here twelve years and knows every resident’s favourite pudding” or “we’ve kept a husband and wife together in adjoining rooms for the last three years and we’ll do that for anyone who asks.” A bad answer is more marketing.
Beyond the twelve questions, trust your senses. Walk slowly. Sit in the lounge for ten minutes and watch. Look at the residents — are they engaged, dressed properly, in their own clothes? Are they clean and groomed? Do they make eye contact with staff, or do they look frightened? Are there fresh flowers, residents’ own pictures on the walls, things that feel like home? Or does it feel like a hospital ward with a softer carpet?
Ask if you can see the room your relative would have. Not a show room — the actual room, if one is available. Ask about the laundry. Ask about hairdressing, chiropody, the dentist who visits. Ask about the GP arrangement and how often the GP visits. Ask about religious services if that matters to your family. Ask about the home’s relationship with the local community — the school next door, the church up the road, the U3A group that visits.
And one last piece of advice. Visit more than once. Visit at different times. Visit unannounced if you can. A home that’s identical at 11am on a Tuesday and 4pm on a Saturday is a home that’s the same all the time. That’s what you want. Aldridge Court Nursing Home, Little Aston Road, Aldridge, WS9 0NN. We don’t do appointments. Drop in. 01922 455731 if you’d like to talk first — but you don’t have to.
One bonus question that’s worth asking, especially if your relative has dementia: how do you handle “exit-seeking” behaviour? Some people with dementia want to leave the home, sometimes urgently and repeatedly, sometimes with distress. A good home will have a thoughtful answer. They’ll talk about understanding why the person is trying to leave — sometimes it’s a deep memory of needing to pick up the children from school, sometimes it’s the sense of being in the wrong place, sometimes it’s a specific unmet need (the toilet, hunger, pain) expressed as restlessness. They’ll talk about engagement, distraction, redirection, walking with them, sitting with them. The bad answer is a list of locks and codes. Locked doors don’t make exit-seeking behaviour go away; they just make it more distressing.
And one final question: what’s the manager’s vision for the home over the next five years? You’ll learn a lot from how this is answered. A manager who has a clear, considered answer is a manager who is thinking about the home as a long-term endeavour, not a job. A manager who fumbles the answer, or recites a corporate line, is a different kind of manager. We’ve always thought of Aldridge Court as a family business with a multi-generational arc, not a placement to be managed quarter by quarter. That orientation shows up in dozens of small ways, year after year, and it’s what makes the difference between a home that holds together and a home that doesn’t.