All too often, those of us trying to find a good care home for a relative are normally so relieved to find somewhere suitable that we sign on the dotted line without reading the contract document properly. Because of the cost of residential care, there is a tendency to focus on affordability and funding rather than other, equally important aspects such as the range of services to which residents are entitled, the care home’s obligations towards their residents, and the termination clause. Potential residents and their families should not just rely on the fact that care homes are governed by consumer law and by the Care Quality Commission (CQC) (or equivalent regulator in Wales and NI): because of the inherent vulnerability of many care home residents, contracts should be carefully scrutinised.
Introduction to choosing a home
Under consumer rights legislation, care homes are obliged to give prospective residents and/or their families all the necessary information to help them in their decision-making. This information should be easily accessible on the care home’s website and in their information packs and should include (as a minimum) an overview of the type of care provided (particularly important if you are looking for somewhere that can cover complex needs, including medical), staffing ratios and experience, fees and funding arrangements, and what additional services are offered. There should also be a link to their latest CQC assessment (although you can access that directly via the CQC website).
What should a contract cover?
A contract should be easy to read and understand, with its terms and conditions clearly laid out in fair and unambiguous terms. Unfair (or hidden) terms might include a clause absolving the care home of any responsibility if something goes wrong that was their fault, or a clause requiring unreasonable changes to fees, upfront fees, or payment of fees for an unreasonable time after a resident’s death. Below, we list the essential elements of a contract.
Fees:
Fees should be clearly set out (in a separate schedule if necessary), stating what they cover, when they are due (weekly / monthly) and how they are to be paid. Any additional costs should be highlighted (which may include personal services such as hairdressing). The circumstances and timing of any fee increases should be stated, plus the notice period for informing residents of any changes.
Level of care and ancillary services:
This should include a clear undertaking that staff are appropriately trained and will deliver the standard of care promised as per the personal care plan agreed with the resident. It should also include the provision of meals, and support at mealtimes if required, laundry, and utilities. It may also specify what extra activities are available, making it clear which are included in the monthly fee and which are not.
Obligations:
The care home must set out its commitment to observing the resident’s dignity, autonomy and privacy, taking account of their personal preferences and a promise to keep the resident safe and comfortable. Residents must be clear about their medical and care needs. Both parties should commit to regular communication so that any issues can be resolved quickly and to the satisfaction of both.
Accommodation:
Information about the room to be occupied should be included and the care home has a responsibility to ensure that the building and equipment are safe.
Insurance:
Details of what the care home’s insurance covers must be stated. Residents may be responsible for insuring their personal effects, furniture and other belongings.
Termination of contract:
The terms on which both sides can terminate the agreement must be stated plus the notice period. The care home can reasonably terminate a contract if they can no longer provide the level of service or care needed by the resident, or if the resident or their representatives repeatedly fail to pay the fees. However, all reasons must be valid and clearly stated along with confirmation that no resident (or their representative) will be asked to leave without being consulted first and that adequate written notice (28 days minimum) must be given. If the resident dies, it must clear for how long fees will be due (usually just a few days while the resident’s relatives or representatives clear the room).
Absence due to hospital (or other) stay:
The care home must state the rate at which fees will be charged if the resident is absent for any length of time, and any discounts offered.
Complaints process
Residents and/or their representatives have the right to complain. Every care home should have a transparent, accessible complaints procedure that is easy to understand and follow. Complaints should be resolved within a reasonable (and clearly stated) timeframe; and it should be clear how you can escalate a complaint if you feel it has not been adequately addressed by the care home.
In short…
Just over 441k people are living in care homes in the UK and while that represents only around 3.7% of the over-65 population, for those residents, the terms of their contract with their care home are of paramount importance. In many cases, it is the relatives or representatives of residents who will be responsible for checking the small print to ensure that the home they have chosen will fulfil their promise to care for their family member appropriately and compassionately. The hunt for the right care home can be stressful, often taking place within a tight timeframe if a relative needs a place urgently, meaning that the detail in a contract may not be properly reviewed. This is where we can help. We have considerable experience of dealing with care home contracts and can quickly ascertain whether or not it is fit for purpose. Please give me or one of the team a call and we would be delighted to explain your options.
