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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.


It is too long ago now to do much about it, but the care home where my mother resided the last 6 months of her life, from age 98.5, :-
a) treated everyone as if they had dementia – which she did not
b) Did nothing when money was taken from her handbag
c) Never returned her nightwear
d) Failed to spot she had pleurisy although they knew she had cracked ribs from a fall and a previous episode of the problem – and when she persistently complained of pain in the chest and needing to sit up. When she finally had another fall and went into hospital for the last time, one lung was completely full of fluid.
e) When informed by me that she had died earlier in the evening, and I would be collecting her belongings the next day, did nothing to collect them or find the missing nightwear.

I have worked in Care homes and supported housing all my life and I find many of the campaigns that are mounted against staff and companies are either unfounded or exaggerated.
The example you give in your email about a woman being charged till the end of the month even though they were ready to clear the room that day is a good example of not understanding the case.
If you lived in rented accommodation and decided to leave it wouldn’t matter how quickly you leave the Lamdlord would still charge you to the end of the month.
Care homes are not hotels. When someone passes away or moves out the manager can’t just move someone in the next day.
In order to give proper care care plans have to be formulated and written likewise Risk assessments have to be completed.
If the client is being partly or wholely funded by Adult Services a Care Manager has to agree to the cost and to the care plan and risk assessments.
I am the first to admit that there are problems with Care Homes but the majority of organisations and their staff to a great job and yet face constant criticism from the “Redtop” press and other forms of media.

I am an occupational therapist, recently retired, with 20 years experience working with older people who have dementia and I know that the demand for beds in care homes is so high that social services will place a person into a vacant bed ASAP. Most homes, nursing and residential, in the area where I worked had waiting lists. It was rare for a vacant bed to be left more than a couple of days, if that. The crisis in the NHS general wards is greatly due to the lack of beds in nursing and care homes to discharge people too, that is why A&E departments have patients laid out on trolleys for hours as hospital beds are blocked by patients who cannot be moved out to community care due to the lack of beds. Your experience is not the norm.

This comment was removed at the request of the user

Well said Gerry it has to work for everyone in the home when you take in a new resident. Some clients can be very disrupting and display behavioural problems the Social Worker /Hospital staff never mentioned .
Obviously those care homes who fall below the standard hit the news and sell newspapers – good care homes are never mentioned.

I have worked in a care home where there was no refund to the relatives when I queried saying what about the food the patient had not eaten I was told to be quiet.

When Dad was first released from hospital in November 2016, he was sent to a Nursing Home (1) by the Council. Because the hospital said he needed a pureed diet he had a lunch that was all minced up, which was not too bad but for the evening he was just given a mug of soup. When he recovered enough he then said to us that he was not getting enough to eat. When he went into the dining room they always sat the same lady across from him, she would put her hands in the food to eat and when the staff came to take it away she would not take her hands from the plate and the uneaten food went onto the tablecloth. The second Care Home the Council put him in was January 2017, after another stay in hospital. They said that the staff would pop in and see him through out the day (no they did not) We asked if they could get him out of bed and into a chair (no they did not). We asked if they could make arrangements for an eye appointment, hearing aid appointment and to have his toe nails cut (no they did not). We gave them a £100 for his pot, so if he needed anything they would have the money to buy it for him. I did not get a receipt for this either. He went there as a 6 week planning bed, we told the home when we had a meeting with the manager at the end of the first week that we wanted to move him. The Manager would not make herself available to take phone calls and would not speak to the Home we chose for him, so we had to ask the Hospital to give the Home the information they needed. So he was moved at the end of the 6 weeks. The day Dad was leaving the Home my Sister was asked if she would have a word with the owner of the Home for her views. We had a phone call 3 weeks ago from the Council saying that as we had not given the Home (2) notice that Dad was leaving and wanted a months money. I personally delivered the letter to the Staff in the Home 3 weeks before he left. The Home he is now in is very good and the staff are lovely all the girls come and say good bye before leaving their shifts, we are very pleased we made the move.

Linda says:
4 October 2017

Hi Pam
Really glad to hear at last your dad is getting the care that he deserves.
My mum was taken into hospital (unnecessarily ) for a bowel overflow in May 2016 which should have been dealt with at her gp’s as it had been before. Unfortunately she was taken to our local hospital and was there until August 2016. She had vascular dementia and Alzheimer’s but when went into hospital could walk make a drink and snack. When leaving hospital the lady couldn’t do a thing. She couldn’t sit up hold a drink, spoon and never walked again. After a lot of hard work I was determine that she was to go home to her husband who also has vascular dementia and Alzheimer’s . She was loaned a hospital bed where she initially just laid there. CCTV was put in there home to monitor there safety. The first care provider they had were awful even knowing cctv was there some carers didn’t care. Holding mum down, swearing at her playing on theirs phone whilst she was trying to get a drink.
At that point mum had a change of social worker (what a blessing) who arranged for a lovely lady who was a care and handler to see her. Within days mum was out of bed in a comfy chair, within weeks she was feeding herself and could hold a beaker. Weekly visits to the hairdressers what a difference good caring people can make.
We are now on our fourth care company for dad , mum passed away in August.
My point is that hospitals are not the right place for dementia sufferers they are just left. Care can be provided at home with the correct care company and like care homes there are a lot of bad ones .

Based on the horrible experience I and she had when my mother was in care I prepared a note on what to look out for when choosing a care home. I should be happy to contribute this to current Which research etc

Hi Jenny,

Thanks for your comment. Your research into what to look for when choosing a care home sounds really interesting and is definitely something we’d love to see. Would it be possible to email it to conversation.comments@which.co.uk?

We look forward to reading it.

My husband was resident in an excellent care home for approximately eighteen months. He died in December 2014. However, although the care he received was excellent, he was admitted to hospital on several occasions, usually being hospitalized for four weeks each time. We were still expected to pay the full amount for his care even though he was absent from the care home. When I questioned this I was told that this was to keep his room available for him to return to. I thought that this was unfair. I would have expected to pay a reduced amount for the time when he was not actually at the home, but we had to pay the full cost (£2500 per month).

Although it’s in the contract, my wife was in a care home for 10 days before she died and I’d paid a month in advance. Normal notice to leave is 4 weeks but on death that’s reduced to 2 weeks (less 10% as not taking food). Still a lot of money when weekly rate in excess of £1450.

J Howarth says:
13 July 2017

I had no such problem with my mother’s account. When she was dying we were allowed to stay all the time with her and when she died I felt we had to clear her belongings the next day purely because I wanted to get it dealt with whilst we couldn’t do anything else immediately. The end of life was the only time the NHS covered her care, and they were the ones who dallied about payment, and we were charged as per the contract to the day the room was cleared. We did have to discuss when the NHS period was, but it was resolved satisfactorily.

We also need to call for greater transparency and accountability for those who choose to pay for a residence in a retirement villages. Older people who often spend huge amounts purchasing delux homes find that if they develop dementia or some other “disruptive” long term condition are strongly encouraged to leave, often with little knowledge that as home owners they have rights. I have in my research about care provision for older people with dementia come across 3 large providers who have a practice of making life so awkward that the person with dementia has to leave to go into a home or acute hospital care on the grounds of the disruption to others living there. Domicillary care services are not encouraged to provide extensive care so the person hits crisis point. I think older people need to have real independent advocates who can advise and provide full legal help to avoid this appalling practice. If we value older people that means supporting them in their home for as long as possible and residents not living in fear of their dementia being known to others. Please Which consider this as these places are not CQC checked at all.

Although the money aspect is important, the sad tales of neglect and mis-management that litter these pages here, on the subject, are of even more concern. For around fifty thousand pounds a year, one can find villages that cater for the elderly, providing flats and facilities for dementia care. At this level, the brochures aim their content at the stockbroker belt. For the rest of us, a decent room, good food, adequate medical and domestic attention, social activity and friendly staff are what is required. These, too, are expensive, but, worryingly, they are obviously not always available. Since these are the basics for good care, this is simply not good enough. It should not be a lottery whether one ends up in a care home or a hell hole. It should not be a lottery that the only way to judge the provision is by personal inspection. So often, it seems, promises made are not kept. We know that our population is aging and this time bomb will explode at some point, when demand (already stretched) exceeds supply. If the private sector is not able to regulate itself, and if provision costs lead to home closures, or worse, inadequate staffing and poor accommodation, then the state has a duty to investigate and intervene. There is little sign of this happening at present. When the government decided to make it an election issue, they got hammered. So who is to pick up the tab is still a hot topic.
The uncertainty of the quality of homes available, makes my sister and I continued carers, but one day, in the not too distant future, we shall be in need of this provision, and, in my case, no one else is around to do the research for me.

We found the care went down at the weekends when more expensive agency staff were employed. And bank holidays when the normal staff were absent. Sad, but true. They didn’t dress my fil properly, attend to his urine bag properly etc. so he got more infections than should have.

Please don’t stop with care homes. What about the care agencies who supply care in the home – they also need more investigation than they are currently getting, CQC are a joke !!

Most care homes are run as a business |||Most businesses are there just to make money Some will make money in any way they can legally ,illegally or using any way they think they can get away with by getting people to sign contracts without thinking about just what they are signing when upset at having to find a care home for a loved one AS USUAL DODGY BUSISINESSES ARE EVERYWHERE IN ALL AREAS They need investigating and some closing down paying compensation to the ones affected by the closure and owners banned from the care home business for life GET TOUGH WITH ALL WRONG DOERS

[wikiwand is a prettier wikipedia]

A campaigner on the subject for many years and one with real practical knowledge of the issues. Links to the active sites are in the article and she has a Youtube presence.

lstartrek says:
14 July 2017

My Grandmother was in a care home, during one visit we could not identify what she was being given to eat it just looked like slop. She was given hard biscuits & basically left to her own devices. I feel the system is in major need of reform, criminals in prison are kept in better conditions than our elderly population.

I worked as a consultant in many care homes in Scotland. There isn’t much I don’t know about the scams in care homes. It’s disgusting !!!!

Allan Cooke says:
14 July 2017

We had an old uncle living in a care home in Bedford, my mother(his Niece) was housebound and heard that he was in hospital in a bad way. My brother drove down overnight from Glasgow and hours after arriving in Bedford my uncle passed away but THANKFULLY not on his own? My brother went back to the Care home to carry out my uncles dying wish and to give my mum his last possessions, the care home had already discarded everything, photos, letters. THEIR EXCUSE WAS, they didn’t think he had anyone left to pass them onto, presumptuous, untrue and it put doubt into our minds of how he had been treated in his stay there???

My father spent time in a nursing home. he had Alzheimers and his food was just left on a small table beside him. he needed feeding-so I would go every mealtime to do this. After a short time I realised the only way he would be properly looked after would be to nurse him at home–which I did for 5 exhausting years..
If you really care- you have little option

David says:
14 July 2017

Though I understand the grief people are experiencing I am not sure that it is necessarily ‘sharp practice’ for the home to seek costs for that month. My own father died in early June and I quite understood that care costs should not end on the day he died or I cleared his room. As for the wider issues, you have to be proactive in ensuring care provision for your family member matches their needs. My father was generally well cared for, well fed and enjoyed his final years in a supportive home. And yes, it was a private care home and yes, he had to pay for it from his savings.

Ailsa says:
14 July 2017

My father suffered with dementia. He resided in a care home until his death in 2014. The conditions were not up to standard and I complained to the CQC who investigated and were very helpful. They eventually closed the home.