/ Health, Home & Energy

Is the care home sector working well?

elderly care

The Competition and Markets Authority is undertaking a thorough review of the care home sector to make sure it works in the best interests of those who rely on it, as Douglas Cooper of the CMA explains.

We launched our market study in December last year to look at issues affecting the 430,000 older people in care and nursing homes across the UK.

As part of this study, we’re looking at a range of issues including:

  • How people find the experience of choosing a care home
  • How care homes compete to attract residents
  • How well care homes are complying with their obligations under consumer law
  • Whether the current regulation and complaints systems give residents adequate protection

We want to be sure that the care homes sector is working well for residents and their families.

Home to care home

Care homes can provide a safe, warm and caring environment for older people to be looked after when they’re no longer able to cope at home.

But choosing a care home is a big decision, which often needs to be taken in stressful or upsetting circumstances, and can have a huge financial impact on families.

In particular, we want to know that residents and their families can get the information they need, when they need it, that they understand any contracts they sign once a home is chosen, and that they are treated fairly by the home during the time they need it.

We’re also looking very closely at reports of potentially unfair practices and contract terms being used by some care homes.

We will assess how widespread these concerns are, how they’re affecting residents, and whether they are likely to breach consumer law.

Playing fair

We’re now a few months into our study and have already received a wealth of useful information and well-informed opinions.

We’ve heard from consumer groups and charities about various concerns around potentially unfair practices and contract terms being used by some care homes, including:

  • Hidden charges where residents face additional fees for services they didn’t know weren’t covered within the weekly fees. Examples might include charges for accompanying residents to medical appointments or entertainment.
  • Fees being increased at very short notice and without clear explanation.
  • Care home residents being charged large deposits/upfront payments without being clear what these cover.
  • Unreasonably long notice periods to leave the home.
  • Residents in receipt of local authority funding being asked directly for top-up payments for additional services by the care home, but it may not always be clear what they are being charged for.

We’re also looking at complaints and redress systems to assess whether these work effectively for residents and their families or if they are difficult to use and deter people from complaining, for example through fear of retaliation against them.

We’re taking a detailed look into how common these practices are.

We haven’t yet formed any view about whether they break any consumer law or other regulations.

But if we do find there are problems, we can take action, including launching enforcement cases or making recommendations for changes in the rules that protect residents and their families.

Help needed

We want to gather further information and that’s why we welcome the launch of the Which? care home reporting tool, where your comments will be treated confidentially.

We want to hear about the experiences of residents and their families who feel they may have been treated unfairly by a care home.

This will feed into our study and help inform our conclusions when we publish our final report by the end of the year. We’ll also be ready to publish our interim report in May this year.

This is a guest contribution by Douglas Cooper of the CMA. All views expressed here are the CMA’s and not necessarily those shared by Which?.

What’s your experience of the care home sector? Have you or an older relative/friend ever been treated unfairly by a care home’s practice, contract or complaints procedure? Or, if you’ve ever worked in the sector, what sort of problems did you encounter?

If you’d like to share sensitive personal experiences in the comments below, please choose to do so using an alias, and omit anything identifiable.

Alan Smith says:
31 March 2017

In my opinion and observations . Care homes are only making vasts amount of money for very little care , I had arranged to take a person out , I had given plenty of notice and asked to have this person ready and shoes on due to an appointment time , I also phoned 30 mins before my arrival time , when I got there the person was waiting to be dressed and no shoes on , his medication had not been given , When I spoke with the manager she phoned my company to complain , Managers feel they are a power on themselves and staff are often scared to speak openly . This person told me that the staff was rude , refused a cup of tea and given a glass of water . Lunch consisted or soup and toast for breakfast with cerials and evening meals was mince .
People in care homes are often verbally abused if they ask for help and assistance . but always very nice to visitors and family , Personally I would rather die before I go into a care home ,


That last sentence of yours Alan–I echo that. This shows up to the world what type of people we really are , while countries with GDP,s a fraction of ours treat their old folk with respect even poverty restricted countries this country is put to shame for its basically inhumane treatment of old people , a fast buck comes first , its not easy to make me ashamed of the country I was born in but this cruel behavour I will never accept people think more of being PC than they do of human dignity and human life –it stinks in my view , tell me posters where,s the PC in looking after old people , I am actually embarrassed and believe me nothing else in life can make me embarrassed I have seen it all , its the pits morally.

don jones says:
1 April 2017

care home, i am not sure what this means to me, it looks very much like wear housing’ pack um high sell um cheep, CQC again expensive organisation but a toothless tiger , politicisation just did not get it for many years , sold the dream to the electorate, cradle to grave we will be there, ?? now its time to pay the piper . BIG QUESTION HOW ?? . some families like to visit members of there family in care home if this becomes to often care home do not like it heavens forbid should you complain your family member is convicted , yes this is a care home . what is needed an open discussion about shared support a good look at profit and see if it meets value , it is an ugly subject but needs to be thoroughly arid,
this is my observation based on just visiting

Blue2 says:
8 April 2017

I worked in the NHS for 40 yrs and heard many horror stories from nurses who had worked in “care” homes. Your case is, sadly, typical of many of these homes, but the government is uncaring as well.
My sister and I care for our 101 yr old mother ourselves, and will never subject her to the abuse (physical and verbal) meted out in many of these homes. It costs a lot and retricts our freedom, but she cared for us when we were babies, and now the role is reversed – it’s our turn to care.
Naturally, if my mum was “cared for” by the local authority, it would cost far, far more than the laughable allowance paid for her care by her family. My sister and I have only our state pensions, and we just about manage. Meanwhile the owners of these places are raking in the takings.
My sister and I are childless and the future is bleak.

Vexed says:
1 April 2017

I have worked in Adult Social Care for over 35 years, over this time I have seen many very well run care home’s and met many very compassionate care staff, I have of course seen many poorly run home’s and met some dubious staff.
In my view there are some key issues that are very wrong with the care sector at this point in time.
* We have a growing population of older people and severe cuts to public spending
* Over the last 30 years the sector has gone from one mainly run by council’s and the voluntary (not for profit) sectors to one where care is either privately purchased or commissioned by councils from the independent for profit sector. This makes old and vulnerable people a commodity. Many of these companies very genuinely want to provide good quality care but many are run for the sole purpose of making a profit for their owners of share holders.
* Due to the above, the wages, terms and conditions of the workforce have been eroded, staff are working long hours, doing very demanding work, with minimal numbers of staff, often 2 or 3 staff having to care for 20 to 30 vulnerable people. Most care staff are on minimum wage.
* The knock on effect of all this is that the care sector now has such a poor reputation that who would want to work in it, when the pay is so bad and the work so undervalued.


Very good summary, Vexed.


I would agree with all that you say and add, that the independant ‘not for profit’ charities are positively encourage, for tax purposes, to become limited companies. And of course it was only a short step before the charity became ‘for profit’ organisation.

The question comes down to whether money is governoring us or if we are governing money. By that I mean, there is a moral and social question regarding how ‘we’ as a society is going to address this major issue of the numbers of elderly people. That is the social and moral situation. So we find the money to address that situation.

Or we can do what is usually the case, declare it’s going to cost too much money so ‘we’ as a society we do nothing.


I have a cousin who has been sectioned and lives in a ‘care’ home. Throughout her stay there, they have treated her appallingly. They are literally punishing her for being mentally disabled. They use methods which prison guards are not permitted to use on convicted murderers. Why is it that there are laws to protect murderers but no laws to protect residents in ‘care’ homes ? There should be at least the same protection. Whenever she complains, they order her to withdraw the complaint or else they will have her locked up in a mental hospital. The appalling food has caused her (and some of the other residents) to become diabetic – but they won’t provide a diabetic diet for them. They are continually robbing her – they help themselves to money from her account. For example – although she has a free bus pass covering herself and carer, the carer calls for a taxi and takes money from her account to pay for it. They have got all of them hooked onto nasty addictive drugs which mean they spend most of their time doped like zombies. They do experiments on the residents – e.g. give them a drug which makes them thirsty, refuse to allow them a drink and watch what they are driven to do by the thirst. Then punish them for doing it.