FAQ
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Find answers to frequently asked questions about our services, benefits programs and other common topics. If you don’t find what you are looking for on this FAQ page, feel free to contact us directly.
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General Overview
Manchester is proud of our stellar reputation and the large number of referrals that we get from happy residents and their families, and is happy to provide references upon request!
Manchester Living was founded in 2009 and currently has four residential care homes which are licensed by the State of Texas as ‘Type B, small.’ Adam Lampert and Dean Krasovitsky, the owners, make frequent spontaneous visits to the houses to check on residents and staff and are actively involved in the daily details of management and upkeep of the houses and oversight of resident care issues. In this way, they get to know all of the residents and their families, which further contributes to the “family” feel that our residents rave about. We also have a Director of Nursing who visits our houses on a daily basis, offering oversight and training to our staff and visiting with residents and their families to ensure that everyone is receiving the very best level of care and attention possible. Our nurse also works closely with our residents’ physicians to ensure that our residents receive the best medical care in the comfort of our care homes.
Our houses have no set visiting hours and friends and family are welcome and encouraged to visit as often as possible, although for obvious reasons we prefer to limit late night visits for fear of disturbing other residents. Families are also able to take their loved ones out anytime. We have taken steps to ensure that all of our residents and many of their family members are vaccinated so that they can visit with each other safely, but due to the continuing dangers of Covid, we discourage any unnecessary outings.
About Our Staff
We encourage anyone interested in moving into a Manchester home to meet the staff during a house tour. In our humble opinion, our Caregivers are among the very best in the industry. Unlike most other care homes, most of our Caregivers are Certified Nursing Assistants (“CNAs”). In addition to the many hours of training that they receive prior to taking their CNA exam, our staff has hundreds if not thousands of hours of hands-on experience and training in our homes and are provided with periodic additional training. We pride ourselves on staff longevity and recognize that our staff is our most important asset. With staff retention in mind, we pay 80% of staff health benefits and we offer no-interest personal loans. All of our Caregivers are full-time W2 employees who are trained in-house. Since just about every resident at our homes has suffered some level of memory loss, every member of our staff is experienced working with residents suffering dementia and are trained to ‘meet people where they are.’
We always have resident-to-caregiver ratio of 4-to-1 or better. Each shift varies, but our staff are currently working 12-hour shifts during the pandemic. The Caregivers communicate at shift change briefings as well as through care notes that are entered in our secure web-based care program that manages medications. There is constant communication between our Director of Nursing and the Caregivers throughout each shift.
Turnover is low, but does happen. We are always hiring and training to ensure the best care for our residents. Staff training is overseen by our Director of Nursing and our Director of Training.
Yes, our staff is trained to deal with agitated residents. In the event that a resident becomes agitated, our staff will immediately take steps to identify and rectify the cause of agitation, to de-escalate tension and create a safe and calm environment. They focus on feelings rather than facts and attempt to limit distractions if possible. In addition to creating a calm environment, staff provide reassurance and utilize redirection techniques in an attempt to engage the resident in a different activity. Once we understand the potential triggers for a resident, we take steps to ensure that those triggers are minimized in order to maintain calm and ensure that all of our residents are safe and happy.
Our staff is similarly well-trained to deal with medical emergencies. In the event of an acute medical emergency, emergency medical services are immediately summoned if necessary. After help is summoned, the appropriate family/emergency contacts are notified and informed about the nature of the emergency.
Our staff are available 24/7 to assist our residents. All residents are provided with call buttons to immediately notify the staff when assistance is needed. In addition, pressure pads are utilized on the beds of residents who are fall risks or unable to utilize the call buttons. The pressure pads register movement and trigger alarms both in the common area and wirelessly to pagers which the staff wear. In addition, our staff provide bed checks routinely throughout the night to ensure that all residents are safely in their beds. IT is not uncommon for a resident to spend the night hours in a lounger in the living room with a Caregiver nearby.
Accommodations
The exterior doors to our houses are locked, and we’ve never had a security issue. Since our Caregivers are awake and working 24/7, the house is not attractive to criminals. In addition, because of the low resident-to-caregiver ratio, we are able to monitor our residents and have not had an issue with residents wandering out of the house. The staff check on each resident throughout the day and night.
Each room is painted, and the carpet is cleaned before each move in. We furnish a large wall-mounted, flat screen television. The rest is up to the family to furnish and decorate as they wish. We encourage our residents to make the rooms as comfy and close to what they had at home as possible.
We know that for some residents, cherished pets are like members of the family, and we are happy to consider them in our houses, presuming that they are well socialized, fully housebroken and up to date on all immunizations. However, for the safety, comfort and welfare of all of our residents, we reserve the right to evaluate each case on an individual basis. Residents must be able to care for the pets themselves, as our staff is not equipped to do so. Families are fully responsible for pet care and veterinary visits.
Services Provided
Manchester addresses residents with high needs. We do a very thorough assessment of all potential residents to better understand their needs and also to be sure that they will thrive in our residential setting. We absolutely allow our residents to age in place as we are prepared for the additional attention required toward the end of life. As a result, we tend to be the last stop for most residents.
While our residents are free to choose whichever medical care providers they would like, most of our residents have chosen a concierge physician as their primary care provider. Besides our Primary Care Physicians, we have many other specialists, including podiatrists, who routinely visit our homes to address the needs of our residents. All of these physicians are in constant contact with our Director of Nursing, in addition to making personal visits to see your loved one as needed. Other service providers and vendors visit our homes as needed, including manicurists who visit monthly, a hairdresser who visits weekly, and mobile dentistry and mobile x-ray which visit as necessary or at the request of our residents and their families. Insurance is routinely utilized, but this happens exclusively between the resident and the service provider, but NOT through Manchester.
Medication administration and charting is provided in the houses and overseen by our Director of Nursing. We use Accu-flo, a secure server-based medication administration system designed for use in institutional pharmacies, assisted living, long-term care and rehab facilities. The medicine is stored in a locked cabinet in each home and is distributed by our staff as directed.
We assist our residents with shaving, grooming and hair care, as well as makeup application and tooth brushing as needed. Residents are typically showered three times a week, or as needed, in their own private en-suite bathrooms.
The majority of our residents require assistance when they use the restroom. If a resident is, or becomes, incontinent, we check and change them regularly and try to get them on a regular cycle of going to the restroom every two hours in order to prevent accidents, and to avoid UTIs.
Our delicious and nutritionally balanced weekly menus are always posted in the kitchen, and we are happy to send a weekly menu to you on request. Breakfast time is meant to be flexible and informal, since we allow our residents to get up on their own schedule. We keep many of breakfast options on hand to cater to our residents’ personal preferences. Lunch is served around noon and dinner at 5pm. We prefer for all of our residents to eat lunch and dinner together at the dining table to encourage socialization, but we allow residents to take meals in their rooms if they prefer. We encourage family members to join their loved ones at any meal time, free of charge, although since the advent of Covid we have instituted safety measures to prevent unnecessary risk to our residents.
Our staff is trained and proficient with multi-person transfers. In addition, we have access to order Hoyer lifts if/when they become necessary.
Laundry is typically done three times a week or as needed, and rooms are cleaned daily.
We do not directly provide transportation for our residents, but we are happy to assist the family in arranging transportation for resident outings. Families may also choose to hire a private Caregiver to drive residents to and from appointments, and we are happy to help arrange that as well through our in-home care division, Cambridge Caregivers.
Costs
Our staff will meet individually with prospective clients to assess their condition and needs. The results of that assessment will determine the monthly cost of care. Subsequently, every resident’s level of care is evaluated annually or when there is a material change in the resident’s condition.
The monthly fee includes medication management through our preferred pharmacy, meals, showers, toileting, transfers and ambulation, laundry service, room cleaning, television, utilities, TV and basic cable. There is an additional fee for medication management if the family prefers to utilize a separate pharmacy.
We are happy to assist your family in setting up a payment plan from Long Term Care insurers or the VA.
Incontinence supplies, personal grooming supplies, medication, private Caregivers, supplemental nutrition (Boost/Ensure), pressure pads, personal phones, linens and clothing are among the items which are not provided by Manchester. We are happy to assist our residents in sourcing and procuring these items, and we will pass the costs directly through to our residents on their monthly billing statement.
Each of our rooms comes equipped with a large, wall-mounted flat screen television and basic cable. If a resident wishes to include additional movie channels or premium packages, the client may procure them on their own, or we arrange for service and will pass the cost of those services or a DVR box directly through to the client.
Rent is due in full on the first day of each month, and we arrange for ACH (Automated Clearing House) / direct withdrawal.
Rates assessed at admission are honored until care needs change. The annual fee increase is typically 3%.
There is a one-time, non-refundable community fee of $3,000.
Move-In Process
Rooms are available on a first come, first served basis, subject to a waiting list. Out of fairness to other families who may also be interested in a room, the only way to hold a room is with a deposit. Since we allow all of our residents to age in place, we are unable to predict availability of rooms, and often have a wait list for each house.
After your initial call with our Marketing staff, we will coordinate a call with our Director of Nursing, who will schedule an assessment (over the phone or in person). Once the assessment is complete, and we have determined what it will take to meet your care needs, we will call with a final rate before we set a move-in date. The process could take a few days, but is usually no longer than that.
Each family works with our nurse to establish a game plan and logistics for move-in. Move ins generally take place between 8 am and 2 pm, Monday through Friday. Furniture may be moved into the house in advance of resident move-in.
Transitions can be difficult, and each resident may respond to change differently. The Director of Nursing will meet with each family and prospective resident to determine what course of action is best, and will monitor the transition carefully to watch for signs that might indicate that a modification to the plan is necessary.
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