/ Health

Are changes to the care home sector on the horizon?

Care homes

The Competition and Markets Authority has reached the midpoint of its year-long review of the care home market and published its interim findings. So are changes afoot for care homes?

There are a whole host of problems that people have come up against when they or their loved ones have dealt with care homes. We know this simply because of the stories many of you have shared with us.

Earlier this year, we asked people who had experienced a problem in a care home to share their stories with us so that we could help inform the Competition and Market Authority’s (CMA) review – and the response was incredible.

Care review

So far, we’ve gathered nearly 700 first-hand experiences from residents in care homes and people responsible for organising their relative’s care. These stories have made up the bulk of evidence for the CMA’s study.

The stories you‘ve shared have helped to uncover some real failings in the market, and once again reveal the true distress and pain this can cause people who are impacted by them.

We’ve heard people tell us that they weren’t given a contract to outline terms when their relative had to be placed in a care home.

Some have paid burdensome hefty charges upfront – one person even told us that they had to pay £10,000 before their relative could move in. And others have mentioned what a minefield it can be to find information about funding once their relative’s financial situation had changed.

So it’s safe to say, given the awful stories shared with us and the CMA, we had great expectations of the CMA findings.

CMA findings

The CMA reported that it has found some worrying signs that the care home market isn’t working as well as it should for those who require their services and support.

In particular, it found that:

  • People are genuinely struggling to make good decisions about care, due to the lack of information available, the impact of the stress and pressure people can be under at this time, or because they just find the system plainly confusing.
  • It’s a challenge to complain – many find it difficult to complain when they are so reliant on the care, but even when some do, the complaints system isn’t working well enough.
  • The future of care homes – uncertainty about the future of the sector has meant that investment for growth and improvements has been stunted in this market.

But most promising of all is that the CMA is also taking action by opening up a consumer protection case to investigate concerns that some care homes may be breaking consumer law.

Future of care

As the CMA continues with its review, we want to see it continue to take action where it’s needed.

But there are still five months to go until the regulator concludes its investigation, so there’s plenty of time for more of your voices to be heard by sharing your experiences of care homes.

Have you had experience of the care home sector? How do you think care homes could be improved for residents and their relatives?

John B says:
22 October 2017

In 2001, we had to place my father in care. He had several health issues, but primarily arthritis of the spine, which rendered him incapable of walking and, eventually, unable to stand unaided. My brother, sister and I worked full time, and my mother was unable to care for him alone. As Dad was also doubly incontinent, carer visits would not have been a practical option. We therefore made the joint decision to find a suitable nursing home, where he could be looked after and we (mom especially) could easily visit him. Dad was a very kind, polite, undemanding man, but the combination of incontinence and immobility meant he frequently requested toilet assistance. We found a place for him in a small, locally run home, but the staff were very unsympathetic to his needs and we soon moved him, this time to a larger, more modern establishment, run by a major national healthcare group. Initially, this seemed much better, but problems soon began to arise which were very upsetting to Dad and the family. The majority of care staff were good and helpful, but we had to complain on more than one occasion about the belligerence of two staff members, who were simply bullies. Dad’s clothes regularly went astray, despite being clearly labelled, and we would often find him wearing those belonging to someone else. A succession of other lesser but nonetheless annoying incidents persisted for around two years and, although we are understanding people and not predisposed to complaint, we regularly found ourselves doing exactly that. During this period, Dad’s mental state deteriorated; he was a bright, intelligent and interesting man, but he became very withdrawn and institutionalised. On my final visit to Dad, I noticed that he had drunk very little. I encouraged him to drink, but he seemed unable to do so. I reported this to the nursing sister on duty, who assured me that they would monitor him. Late the next day, I received a call from my sister to tell me that Dad had been admitted to hospital and was quickly deteriorating. Before I could reach him, I received a further call to say he had passed away, apparently due to multiple organ failure. I very strongly suspect that, had the nursing home been properly monitoring his fluid intake, Dad would have not died at that time.

As a result of that experience, the family have been determined that, if at all possible, no other loved ones will have to suffer being placed in a care/nursing home. Our own circumstances have changed, which has made this resolution more practicable. I was made redundant in 2006, which coincided with the onset of Vascular Dementia in my Mother-in-law. I moved in to care for her in 2008, followed two years later by my wife when she retired. We have looked after her 24/7 ever since. I won’t go into the details; those who have cared for dementia sufferers will understand what we have endured for the last 9 years but, despite this, I still would not subject her to the ‘care’ experience of Dad.

My own mother has also needed daily assistance and care visits in recent years and, two years ago, we moved her to sheltered accommodation. Despite the strain it places on us all, we are equally determined that she, too, will not go into ‘care.’ My brother and sister visit her on a daily basis and I go as often as I can. This, combined with visits by (thankfully good) care workers has so far enabled Mom to remain independent. We just hope and pray that her mobility does not deteriorate to the point that we cannot handle her and we are forced once more down the care/nursing home route.

We have been scarred by my father’s treatment. There has to be a sea-change , to not only ensure higher standards for care/nursing homes are established and met and many more places made available , but we also have to be realistic and recognise the immense cost to the nation of such care in an ageing population. There should be a parallel campaign to encourage and support care at home, as my family are now doing. We are in a very fortunate position, insomuch that four family members are now retired and we can afford to care for my mother and mother-in-law, both in terms of time and finance. The paltry Attendance Allowance and Carer’s Allowance help, but would be no substitute for salary, were we still working. There also has to be a cultural shift; I’m afraid far too many elderly people are viewed as an encumbrance by those who should love and care for them. We are all too ready to expect others to take on our responsibilities.

Jan P says:
23 November 2017

My husband suffered from Dementia and, at first, we coped with the help of an excellent company providing carers in the home for which we were happy to pay. He also attended a local Day Centre – also excellent. When we could no longer cope with him at home, we were lucky that there was a vacancy in a Care Home only a short drive away. I have nothing but praise for the home and the care he received until his death in August. As we had savings, I had to finance his care myself. My only slight annoyance was the fact that I was, to a certain extent, subsidising the care of those whose fees were paid for by Social Services. During the whole of his time in the home he was treated with respect and was obviously content there. During his last few weeks, he was constantly checked on by the care staff ( and even the cleaner! ) whose patience seemed never-ending. I am horrified by the experiences of other people.
I think that the whole system needs a good overhaul. There is a great discrepancy in standards and advice. So much depends on where you live and the care my husband received should be available to all.


I would just like to say following the first gentlemans comments, that after having worked as an agency care assistant that I have personally witnessed how bad they can be & to be honest that’s even the ones that look good to the untrained eye. Everywhere I have been, they work on skeleton staff to cut back costs. Carers are paid diabolical money & can work 12 & 15 hr shifts. You can get home at 11pm & be up at 5am next morning. Carers are skilled, they have to be to put up with how there job treats them, unless they have a very good heart, & oddles of patience, they are mostly trained to some nvq level so why does the pay not reflect this. My grandfather of nearly 101 years, passed last year & I never let him go in a care home until a few months before he died. I always reckoned that when you saw 3 members of staff with 40 odd rooms what the ratio was. I am so pleased. I would hand on heart personally not recommend it to anyone. I guess; if you ask any carers if they would want to be a resident of a care home you will get your answer. But by the will of God I will ensure that all the people I love would not end up in one. It would be cheaper to pay for a carer to be in a person’s home from 8am till 8pm or something? Regarding emi care, they really need to employ a lot more carers on those wards, you need it to be able to handle the situations that arise on those wards. To put it bluntly, I only ever worked at 1 care home that I would recommend, & i used to go to a lot of different places on a daily basis.

Stephen Cooper says:
29 November 2017

Very sorry to learn that Barnet is bottom of the ratings table. Have the CQC any views on this? My wife was well cared for at Clovelly House in North Finchley for about two years, and on the strength of this her sister followed. While frail and physically disabled she is still completely compos and is well contented


My Mother-in-Law spent several years in a Council run Care home – Weaver’s Court – in Diss, South Norfolk, with 24 hour help on call.
She had her own 4 room flatlet, with pull cord alarm points in every room.
She also had (although she had to pay for installation and all calls) her own telephone.
Her rooms opened out into a small, private, garden area.
She had to provide her own breakfast, her Lunch was cooked and served to her in the communal Dining Room and the produced fresh sandwiches which Residents could purchase for their tea. Naturally my wife obtained all the cereal and other food and groceries for her.
My wife, and my wife’s sister, had no complaints whatsoever about the care provided to their mother.


I know that residential home, John, and have heard very good reports about it. It’s actually operated by Norse Care which is a trading subsidiary of Norfolk County Council. They run about 20 highly-regarded homes throughout the County, so it can be done.


I cared for my mother for many years before very reluctantly moving her from her own home to a care home. I visited my mother every day both at home and whilst in two different care homes and in two temporary homes whilst we were on holiday.

My conclusion is that if you do not have a relative close by, residents are at risk from the main cause of problems – poor management that is not held to account, rather than lack of funding. Like a failing school the cause is a weak head teacher not a shortage of exercise books and pencils. The same school can be turned round by a change of leadership in the same building, with the same teachers and the same children, yet often the “failed institution” is closed down and the building abandoned as if it is the building itself that is at fault.

This is what happened to us; the care home concerned, that we helped close, is still empty after three years . There were plenty of staff – many were temporarily contracted at great expense but arrived at the home and stood around doing nothing waiting to be told what to do. My mother was left in bed with the window open and room temperature below 60 degrees Fahrenheit because the cleaner was told that the window had to be opened for airing after cleaning. We complained, but the manager still left other residents in the same situation until we complained on their behalf. There were many other issues – too many to list.

When the Local Council convened a meeting because of so many complaints, the second in command of the very large company that operated the home, and still operate many homes, gave her seat up to someone and left the room never to return.

In contrast the next home my mother stayed in was excellent – a caring responsible manager that interacted with her staff and listened and acted on any comments made.

It has to be said that the CQC has changed – at one time if you made a complaint it was just dismissed with comments like “you are the first one to complain – we will talk to someone when we next visit..” but did nothing and refused to register a formal complaint. At least now they do record complaints.

My recommendation is for relations of residents if possible to get together to form a “monitoring” group to share concerns and apply pressure when needed. Care homes are no different to many other institutions – hospitals, doctors surgeries, domiciliary care companies – they all have the best of intentions but need honest feedback and action to work as they should.