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The CMA must widen its investigation into care homes

Care homes

We’ve been investigating care home websites and contracts. We weren’t happy with what we found. Many providers weren’t upfront about charges, and some could be breaching consumer protection laws with unfair terms.

Last month, the Competition and Markets Authority (CMA) published its mid-year update of its year-long market study into the care homes market, and its findings were bleak.

But we weren’t surprised because during this time we’d been doing our own investigations into care homes. For months, people have been telling us their stories about the troubles they’ve faced while dealing with care homes, either for themselves or on behalf of a loved one.

Lacking information

While it certainly isn’t the case for everyone, many people told us that going into a care home or having to find care for a relative can be an emotional and stressful time. At these times, It’s unlikely you’d be thinking about ‘shopping around for the best deal’, but rather the most appropriate care setting.

And yet our investigations found that during a time when you need vital information to make these important decisions, such as the cost of rooms, how many staff will be available at any one point, or what the visiting rights are for family and friends, care home providers are making it needlessly difficult to find out these details.

And on analysing the small sample of care home contracts we were eventually able to get our hands on (even these were a struggle to find), we found a number of terms and conditions that could be potentially breaching consumer protection laws.

Unfair terms

The CMA has already opened up a consumer protection case to investigate whether care home providers really are breaching consumer law. But we’ve heard about the traumatic impact unfair contracts can have on people, often when they’re at their most vulnerable.

One relative of a care home resident told us:

’…the contract that we signed said that at whatever point in the month a resident dies, there will be no refund for the rest of that month. Even though we were prepared to fully clear his room that day, we never received a penny back. Upset from just losing Dad, I was not in a fit state to challenge​ this.’

Another said:

‘I paid for 1:1 care but within 24 hours I was asked to remove my husband as they could not cope with him. I had asked what would happen if they couldn’t cope and they just said, ‘Don’t worry about that’. I was not informed I may have to remove him. My GP and social services told me to report them to the Care Quality Commission as they did not give him a chance and they should not have asked me to remove him.’

Stamping out poor practice

We’re pressing the CMA to widen its investigation and take action against providers breaching consumer protection laws to stamp out poor practice and ensure people entering the care setting are properly protected.

We will continue to feed in your experiences to inform the regulator’s work, which concludes at the end of the year, so please share your story with us using our care home reporting tool.

Sheiila says:
4 October 2017

3 of my elderly friends experienced so-called community care. One example – lunch was a cream cracker scraped with cheese. No one would have wanted to eat it. Another 90 year old was visited at 3 pm to be fed and 11 pm to be put to bed. He had ulcerated legs amongst other things. Because of what I saw I have moved into a retirement village, which isn’t perfect but is a whole lot better than that.

Gordon. says:
4 October 2017

The majority went through a World War, rationing and long working lives and yet in this day and age,
there is no guarantee they will be cared for with respect and compassion.
In the 21st Century we are a third world nation when it comes to caring for OUR elderly.
(That is of course unless you are rich)

I have an email from Which, asking for support, based on Fred’s story. It looks legitimate but the ‘Show you care’ button links to a site on the domain ‘bsd.net’ (whichcouk.bsd.net/…) I erred on the side of caution – that it was a phishing scam – and came straight to Which site to (successfully) find Fred’s story. Surely Which are not using third party domains in their mailings. Anyone following Which’s phishing advice would ignore the email I received (which may be a pretty good genuine scam, or a poorly constructed genuine Which mailing.)

Hi Steve, thanks for your comment and I understand your concern. The Care website does indeed include three links to separate pages where you’ll find a form to share your care story with us – these are legitimate pages that are created by us. We are hoping to include a form itself on the site so that you don’t have to click off anywhere else, we’ve just had some technical difficulties with the form styling.

We have indeed published Fred’s story in full here: https://conversation.which.co.uk/health/care-homes-provision-service-cma/

Thanks for your response. I’ve obviously pledged my support via the website. I just wanted to ensure you were aware. 🙂

I am 80 and in good health. I have done all I can to make my flat suitable if I become ill. I have a good sum available from the sale of my house and will use it if necessary to buy high quality care, either at home or in a care home. My family agree with this. I have helped them when needed rathe than them hanging on for an inheritance when they are middle aged. I see no reason why the government should be expected to provide for me unless I have a real medical condition when I would hope theNHS will oblige. My money comes entirely from my husband and I working, paying into pension s chemes from our income and still managing to live busy, fulfilled lives. This may sound pious and complacent but there are millions like me who should stop winging and spend their money to ensure a comfortable end. If we paid a proper wage and organised training for care staff and made it a proper career then homes would improve


My father died after being admitted to Norfolk & Norwich Hospital from St Nicholas Home East Dereham Norfolk. The proximate cause of his death was his desperation, occasioned by pain and suffering from a urethral blockage, on being told that its removal was being delayed by surgical concerns with his low blood pressure without any palliative procedures being [offered or available?]. He pulled the tube out himself for relief.. subsequent complications soon led to his death, the cause of which only referenced, in effect, ‘misadventure’ or similar. No fault was ascribed, proximate nor ultimate. Clearly the ultimate cause was the fact that his urethral catheter had not been periodically changed by the carers in St Nicholas Care Home according to clinical requirements. In the ICU where I have worked this is required within every 21 days and also requires management in care homes. I know that his had not been replaced for several months prior to his difficulty passing water and the great pain he reported that led to the discovery that the tube was adhering. The home admits to no wrong doing even though this would appear to be a clear case of manslaughter along with several failings of a professional nature.

In addition I am very familiar, from testimony of a very close relative working in a rural Worcestershire care home for two years, that the same lack of properly managed and administered care of the elderly would appear to be endemic at the same and very much worse levels of dereliction of the duty of care on the part of the owners of these establishments. I place the finger of blame where it belongs. These homes are endemically squeezed in resource availability, operating restrictions and in all operational aspects which may lead to the incurring of expenses which may affect profitability. This is not that they would not be profitable if the property cost were limited to the depreciation charge required to maintain the property in a good state of preservation and asset value. It is because the owners require the business to be profitable at a ‘commercial’ rate of return on capital invested that is over and above the servicing costs of a mortgage that paid for the development of the property as well as the depreciation charge to maintain its asset value… and before accounting for any capital appreciation arising from the ‘holding’ of that property.

Looked at from another way.. one might argue that it is maximising the legally available ROI of the owners’ investments in these businesses which is the business with which they are concerend and upon which their attention is focussed. The people, as individuals, passing through the doors of their facility, whether working or dying, are incidental to their principle purpose as far as owner’s are concerned whatever their public protestations, and whether or not they actually believe what they say. Simply because the motivations by which the business arrangements of our society require them to act no differently.

Until all people who utilise what we call ‘capital’ are seen as, and see themselves as, providers of the service of employing capital within society for all of our mutual benefit, and see their services as no more and no less important and requiring of integrity and professional application and focus on the social importance of what they do as are the services provided by the refuse removal men, the firemen and the medical clinicians then we can expect no more from these ‘care clinicians’ who refuse to take their place in the society upon which they rely no more or less than does any other member of it.
Rob Jarvis, FRSA,

I was a nurse for over 30 years. On occasions when I was between jobs I do occasional shifts in various homes. In most of them the unqualified staff were not adequately supervised, so they simply did things the easy way instead of the correct way. Having an easy shift was more important than doing the right thing. I would not put someone I love into any of the homes I worked in. However the best one was a Masonic Home, things were a lot better there as they spent more money on services and were not looking for a profit. Homes should be not for profit businesses .
Thrift is a good attribute and waste is bad, But not providing enough basic items like bedding, wipes and towels to do the job adequately is disgusting.
I don’t have time to list all the things I experienced. None of them were shocking but even little things matter.
Im afraid I will have to ask that this be posted anonymously.

The system is broke. It’s not fit for service, and as its costs money ( alot of money) the advertising standards
agency should get involved because simply “care” and “nursing care” are words that should not in my opinion be allowed to be used. Its false representation. Strong words some will say, over the top others and in some areas I might agree. However I say this because so many people pat themselves on the back, pay themselves large salaries and bonuses, the regulator does the same, and Governments DO NOTHING. Abosultely NOTHING, not a single mention today in Manchester, because today, this week, this crisis the Young ones are in the spotlight. The Old are not important (until the next election) … so things will get worse. Pay rises will rob funding even more, housing will rob money away from care, it just gets worse.
Every day every week for the next year … Thats just 365 .. personal stories should be published, in the papers, on bill boards, all over social media, in print, and as in the way of polictical parties a 3 minute slot on TV just before the news. This will highlight The woeful assistance the authorities give, the utter waste of time many of the “packages are”, the profits made and the employment records and practices of the care home owners, the sheer lack of funding and shameful practice of preventing the correct assesments for continuing heathcare, are the cause of much of this. Oh and a regulator that couldn’t run a party for 6 yrs olds. Until a wider audience get more than soundbites mentioned breifly on the news only those that have loved ones in homes will know just how bad it can be and often is.

Blanche says:
5 October 2017

I did try and share this debate on Facebook but it did not share when I clicked on the share facility even though I tried several times. I think it is an important subject so please tell me when the ‘share’ facility works.

IMHO there are two significant problems facing the Care Home Industry (because that is exactly what it is now) with private Companies putting profit before care and Local Authorities paying too little. The consequences are staffing and care quality. There are many people who work in Care Homes who are wonderful and caring but there are those who are not. Caring has to begin at the top of each organisation. The drive to meet occupancy targets suggests that the business models are skewed and lease-back of premises rather than asset ownership suggests that many Care Home Operators businesses have no value other than “vendre commerce”. Unfortunately good homes suffer from the bad reputation of poor homes. CQC has failed very many who are no longer with us and many are suffering in silence if they do not have relatives who can speak for them.

My father-in-law went into a care home early last year. We had to find a place for him in a great hurry and there wasn’t much choice. Luckily there was a place available in a residential home run by the council. The deputy manager showing us round said that she’d been there 32 years and that most of the staff had been there for ages too which is a good sign. Having worked in a social care team I knew that LA- run homes are usually very good, with well-trained staff and no profit motive [though of course times are hard with the government cuts]. My father-in-law moved in and was cared for extremely well until his death nine months later. He was treated as an individual and as a fellow human. They also provided us with lots of support and were extremely helpful.
The financial situation is so unfair now…. people without money have to have their fees fees topped up by relatives who may have little themselves, people with capital have the dual bad luck of suffering ill health and using up their hard-earned savings. At present Mrs. A and Mrs. B have the same amount in the bank….. Mrs. A. is ill, goes into a home for 2 years and uses up all her savings apart from the last £23000. Mrs. B. next door remains healthy and lively until a short hospital stay before her death and has the pleasure of passing on her savings to her grandchildren.
I have no objection to paying towards care but feel very strongly that everyone should pay a little towards possible care rather than only the ones unfortunate enough to need it. When will the politicians be brave enough to bring in a National Care Service ? Or at least a tax on everyone’s estate after their death? They are scared to even discuss this but should explain how it would provide financial security in old age just as our NI payments means we don’t worry about the cost of hospital care.