Questions to Ask Care Homes: A Guide for Families Facing Dementia

Choosing a care home for someone with dementia is one of the hardest decisions you will ever make. You want the best for them, but you are juggling work, your own family, and probably feel guilty about not being able to care for them yourself. The right questions can help you find a place where your relative will be safe, happy, and treated with dignity.

Why the Right Questions Matter

Walking into a care home for the first time is overwhelming. The brochures look perfect. The manager is friendly. The lounge smells nice. But you are making a decision that will affect the rest of your parent's life, and you need more than a good first impression.

Most care homes will give you a tour and answer basic questions. Some will be excellent. Others will be poor. The difference is not always obvious. You need to know what to ask and what to look for. You need to separate the sales pitch from the reality.

The questions below will help you dig deeper. They cover care quality, staff training, daily routines, costs, and what happens when things go wrong. Some questions might feel awkward to ask, but good homes will welcome them. Poor homes will dodge them.

Before You Visit: Getting Organised

Do not go in unprepared. Make a list of your questions and take it with you. Take notes during the visit. If possible, take someone with you. A second pair of eyes will spot things you miss, and they can help you remember details later.

Visit at different times of day if you can. A morning visit might show breakfast routines. An afternoon visit shows activities. An evening visit shows how staff handle the busiest part of the day. You want to see the home at its worst, not just its best.

Trust your instincts. If something feels wrong, it probably is. If staff seem rushed or residents look unhappy, ask why. If you cannot get straight answers, walk away.

Questions About Dementia Care

Understanding Their Expertise

Not all care homes understand dementia. Some just see it as old age. The best homes know that dementia is a specific condition that needs specialist care. Ask these questions to find out if they really know what they are doing.

• How many residents here have dementia? If most residents have dementia, the home should be set up for it. If only a few do, your relative might not get the specialist care they need.
• What dementia training do your staff have? Basic awareness training is not enough. Staff should have proper dementia care qualifications. Ask how often they train and who provides it.
• Do you have specialist dementia units? Some homes have separate areas for people with dementia. These units often have better facilities and more experienced staff. Ask if your relative would be placed there.
• How do you handle challenging behaviour? People with dementia can become agitated, aggressive, or wander. Good homes use distraction, reassurance, and environmental changes. Poor homes use restraints or medication. Ask for specific examples.
• What happens as dementia progresses? Your relative will need more help over time. Ask if they can stay in the same home or if they will need to move. Moving someone with advanced dementia is traumatic.

Staff and Staffing Levels

Staff make the difference between a good home and a bad one. Dementia care is hard work. It needs patience, skill, and time. If staff are rushed or untrained, your relative will suffer.

• What is your staff to resident ratio? During the day, one carer for every six residents is reasonable. At night, it might be one for ten. Dementia units should have more staff. If they cannot or will not tell you, that is a warning sign.
• How many permanent staff do you have? High use of agency staff means poor continuity. People with dementia need familiar faces. They get confused and anxious with constant changes.
• What is your staff turnover rate? If lots of staff leave, there is usually a reason. Happy staff stay. Unhappy staff leave. Ask why people leave and how long the average staff member stays.
• Who is in charge when the manager is away? There should always be a senior member of staff on duty. Ask about their qualifications and experience. Ask what happens at weekends and bank holidays.
• Can we meet the staff who will care for our relative? You should meet the carers, not just the manager. Talk to them. Ask them how they handle dementia. See if they seem kind and patient.

Daily Life and Activities

Your relative will spend every day here. The quality of that daily life matters. They need more than a clean room and three meals. They need stimulation, companionship, and things that make life worth living.

• What is a typical day like? Ask for a detailed schedule. When do they wake up? When are meals? What activities happen? Is there flexibility or is everything rigid?
• What activities do you offer for people with dementia? Generic activities like bingo might not work for dementia. Look for music therapy, reminiscence work, sensory activities, and simple crafts. Ask to see the activities calendar.
• How do you personalise activities? Everyone is different. Your relative might have been a gardener, a teacher, or a musician. Good homes use this information to create meaningful activities. Ask for examples.
• Do you have a garden or outdoor space? Fresh air and nature are important. People with dementia often like being outside. Ask if the garden is secure and if residents can access it freely.
• Can residents bring their own belongings? Familiar objects help people with dementia feel safe. Ask what they can bring. Can they have their own furniture? Can they hang pictures? What about pets?

Food and Nutrition

Eating becomes difficult with dementia. People forget to eat. They forget how to use cutlery. They might refuse food or eat too much. Good homes understand this and adapt.

• What are mealtimes like? Ask to see the dining room. Is it calm or chaotic? Do residents eat together or alone? Is there enough staff to help those who need it?
• Can we see a sample menu? Food should be varied and nutritious. Ask about portion sizes. Ask if they cater for dietary needs and preferences. Can your relative have their favourite foods?
• How do you help people who struggle to eat? Some people with dementia need finger foods. Some need prompting. Some need one-to-one help. Ask what support is available.
• Are snacks available between meals? People with dementia often forget they have eaten. They might want food at odd times. Ask if snacks and drinks are available all day.
• Can family join for meals? Sharing a meal can be a nice way to visit. Ask if you can join your relative for lunch or dinner. Some homes charge for this, some do not.

Personal Care and Dignity

Personal care is intimate. Your relative will need help with washing, dressing, and going to the toilet. They deserve privacy and respect during these moments.

• How do you ensure privacy and dignity? Staff should knock before entering rooms. They should close doors and curtains. They should speak respectfully. Ask for their policy on dignity in care.
• Who helps with personal care? Ideally, the same staff members should help each time. This builds trust and reduces confusion. Ask if this is possible.
• What happens if someone becomes incontinent? Most people with dementia become incontinent eventually. Ask how often they check and change pads. Ask about skin care and preventing sores.
• How do you support people who resist care? Some people with dementia refuse to wash or change clothes. Good homes use gentle persuasion and distraction. Ask for their approach.
• Can residents choose when to get up and go to bed? Routines are important, but so is choice. Ask if there is flexibility around sleep times. Can someone stay up late or sleep in?

Medical Care and Health

Dementia comes with other health problems. Your relative might have diabetes, heart disease, or mobility issues. The home needs to manage all of this.

• Do you have a nurse on site? Not all care homes have nurses. Some rely on district nurses visiting. Ask who is available and when. What happens in an emergency?
• How do you manage medications? Mistakes with medication can be fatal. Ask how they store, record, and administer drugs. Ask to see their medication management system.
• Who is the GP? Some homes have a visiting GP. Others expect residents to keep their own doctor. Ask how medical appointments are arranged and who goes with your relative.
• What happens if my relative becomes ill? Minor illnesses can be managed at the home. Serious illness might need hospital. Ask about their protocol. How do they monitor health? When do they call a doctor?
• How do you prevent falls? Falls are common with dementia. Ask about their prevention strategies. Do they use bed rails or chair alarms? How do they assess risk?

Questions About the Building and Safety

The Physical Environment

The building itself affects quality of life. People with dementia need space that is safe but not institutional. They need clear signs, good lighting, and rooms that feel like home.

• Is the building adapted for dementia? Look for clear signage with pictures. Look for different coloured doors so rooms are easy to find. Look for circular walking routes so people can wander safely.
• Can we see the room my relative would have? Do not just see a show room. See the actual room. Check the size, the view, the bathroom. Is there space for their belongings?
• Is the home clean and well maintained? Look at the state of the carpets, walls, and furniture. Look in corners and behind doors. Smell the air. A home should smell fresh, not of urine or disinfectant.
• How secure is the building? People with dementia can wander. They can get lost or hurt. Ask about door locks and alarms. Ask how they prevent people leaving unsupervised.
• What happens in a fire? Check for smoke alarms and fire exits. Ask about their evacuation plan. Ask how they would evacuate people who cannot walk or who might panic.

Questions About Costs and Contracts

Understanding What You Pay For

Care home fees are complicated. The basic fee often does not cover everything. Extras add up fast. You need to know exactly what you are paying for and what costs extra.

• What is included in the basic fee? Ask for a written list. Does it include laundry? Toiletries? Activities? Hairdressing? What about physiotherapy or chiropody?
• What are the extra costs? Some homes charge for everything from newspapers to tea bags. Ask for a full list of additional charges. Ask for examples of recent bills so you can see real costs.
• How often do fees increase? Fees usually go up every year. Ask by how much. Ask if increases are capped. Ask what happens if you cannot afford an increase.
• What happens if care needs increase? As dementia progresses, your relative will need more help. Some homes increase fees. Some do not. Ask about their policy. Get it in writing.
• What is the notice period? If you want to move your relative, you usually have to give notice. Ask how long. Ask if you have to keep paying during the notice period even if they have already left.

Get Everything in Writing

Verbal promises mean nothing. Ask for a contract before you commit. Read it carefully. If you do not understand something, ask. If they will not put something in writing, do not trust it.

Questions About Communication and Involvement

Staying Connected

Your relative is moving into the home, but you are still involved. You need to know what is happening. You need to feel welcome. You need to have a say in their care.

• When can we visit? Some homes have open visiting. Some have set times. Ask about their policy. Ask if you can visit at weekends and evenings. Can you take your relative out for the day?
• How do you keep families informed? Ask how they communicate. Do they phone you? Email you? Send updates? How often? What happens if there is an emergency?
• Can we be involved in care planning? You know your relative best. Good homes involve families in decisions about care. Ask how care plans are created and reviewed. Can you attend meetings?
• How do you handle complaints? Things will go wrong. Ask about their complaints procedure. Ask how long it takes to respond. Ask if they have had recent complaints and how they were resolved.
• Is there a residents' and relatives' committee? These groups give families a voice. Ask if one exists. Ask what issues they have raised. Ask if the home takes their suggestions seriously.

Questions to Ask Yourself

The questions above are about the home. But you also need to ask yourself some hard questions. These will help you make the right decision.

Being Honest With Yourself

• Can I realistically care for my relative at home? Guilt is normal. But guilt should not drive your decision. If you cannot provide safe, quality care at home, a care home might be the right choice.
• Am I choosing this home for the right reasons? Is it genuinely the best option or just the closest or cheapest? Will your relative be happy here or are you settling?
• Does this home feel right? Logic is important, but so is instinct. Did the staff seem caring? Did residents seem content? Could you imagine your relative living here?
• Can we afford this long term? Dementia care can last years. Be realistic about money. What happens if savings run out? What happens if fees increase? Do you have a backup plan?
• Am I prepared for the emotional impact? Moving a relative into care is traumatic. You will feel guilt, sadness, and relief all at once. Have you got support? Do you know who to talk to?

Red Flags to Watch For

Some warning signs should make you walk away. These are serious issues that suggest poor care or worse.

Trust Your Concerns

• Staff who cannot or will not answer questions. Openness is essential. If they dodge questions or get defensive, something is wrong.
• Residents who look unhappy, unkempt, or neglected. This is what their care looks like every day. If it looks bad during a tour, it is worse when you are not there.
• Strong smells of urine or faeces. Occasional accidents happen. But persistent smells mean poor hygiene and neglected residents.
• High use of agency staff or constant staff changes. Continuity matters in dementia care. If staff keep leaving, there is usually a reason.
• Pressure to decide quickly. Good homes do not rush you. They want you to be sure. If they push for a quick decision, ask why.
• Locked rooms or areas you cannot see. You should be able to see the whole building. If they hide areas, what else are they hiding?
• Residents tied to chairs or left in bed. Physical restraint is rarely justified. If you see this, leave immediately and report it to the Care Quality Commission.

After the Visit: Making Your Decision

You have visited. You have asked questions. Now you need to decide. Take your time. This is not a decision to rush.

Go home and review your notes. Talk to the person you took with you. What did they think? What did you both see? Were there any red flags? Did anything concern you?

If you are unsure, visit again. Take your relative if possible. See how staff interact with them. See if they seem comfortable. Ask them what they think, even if dementia makes their answer unclear.

Check the home's latest Care Quality Commission report. This is free online and tells you about their last inspection. Look at ratings for safety, effectiveness, care, responsiveness, and leadership. Anything below good is a warning sign.

Talk to other families if you can. If you see someone visiting during your tour, ask them about their experience. Most people are happy to share. Their insights can be invaluable.

Making Peace With Your Decision

No care home is perfect. Even the best homes have bad days. Even the most loving care cannot replace home. You will feel guilty. That is normal. But if you have done your research, asked the right questions, and chosen carefully, you have done your best. That is all anyone can ask.

Looking After Yourself

Finding the right care home is exhausting. You are already stressed from work and worried about your relative. The process of visiting homes and making this decision will drain you further.

Remember that you cannot pour from an empty cup. If you burn out now, you will not be able to support your relative through the transition. Give yourself permission to rest between visits. Talk to someone about how you are feeling. Recognise that this is one of the hardest things you will ever do.

Once your relative is settled, keep visiting but give yourself time to adjust. The guilt might not go away immediately. You might question your decision. That is normal. Most families find that after a few weeks, they can see the benefits. Their relative is safe, cared for, and sometimes happier than they were at home.

Keep communicating with the home. Build relationships with staff. Stay involved. But also give yourself permission to step back a little. You have been carrying this weight for months or years. It is okay to share it now.

Remember, choosing a care home is not giving up. It is recognising that your relative needs more help than you can provide alone. It is putting their safety and wellbeing first. It is an act of love, not failure.