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Choosing a care home is a very important and often emotional decision. Moving to a different care home if the first one isn’t right for you could be a big upheaval, so you need to be confident that you have all the information you need to choose the right home for you.
You have consumer rights regardless of whether you pay all the costs of your care or whether some or all of the costs are paid for by the local authority, Health and Social Care Trust or NHS. Knowing these rights will help you, and anyone assisting you, get the information you need to make an informed decision when choosing your care home. Your consumer rights can also help ensure you are fairly treated and protected if things go wrong.
This guide gives an overview of your rights under consumer law. You also have other protections relating to safety and standards of care, which are enforced by the following national regulators who are responsible for inspecting care homes:
- The Care Quality Commission (England)
- The Care Inspectorate (Scotland)
- Care Inspectorate Wales
- The Regulation and Quality Improvement Authority (Northern Ireland)
Choosing a care home
When you, or anyone helping you, first contacts a care home, the home must give you certain key information. This should be clear and easy to understand and is necessary to help you decide, for example, whether to shortlist that home, arrange a visit or make further enquiries.
This key information includes:
- whether the care home accepts people who will be paying their own fees and also those whose fees will be paid for by the local authority, Health and Social Care Trust or NHS
- an overview of the types of care, facilities and activities available
- a brief description of the staffing arrangements
- where applicable, the regulator’s latest inspection rating or grade for the home and where to find the most recent inspection report
- any especially surprising or important terms and conditions that may apply to you, such as where the home requires you to prove that you can pay for your own care for a minimum period of time and how your fees might increase during your stay, if you are paying for your own care
- how much you will pay to stay in the home. This will include an indication of how much the weekly fees will be if you are paying for your care (the exact amount will depend on an assessment of your care needs and the type of room you choose) and any other payments you may have to make upfront, such as deposits
- what services are included in the weekly fees and whether there are any additional fees (for example, for being accompanied by staff to hospital appointments) or optional ‘extras’, such as for hairdressing
This key information should be prominently highlighted on the care home’s website and in any information packs or other materials you are given (for example in a ‘key facts’ sheet) and explained to you, upfront, on your initial telephone call and at the beginning of your first visit.
To also help you choose a home, the home should provide you with important additional information (including information about any trial period offered, and the circumstances in which you could be asked to leave).
This information should be easily accessible to you from the start of your search and the care home should actively provide it to you in sufficient time for you to be able to consider it before you agree to have a care needs assessment.
The additional information should be easy to find on the care home’s website, included in information packs they give you, and explained to you on any follow-up enquiry. The home should also provide you, upfront, with a copy of the standard terms and conditions that you will be asked to sign (if you pay for your care).
Once the home has assessed your care needs and you have chosen the services you want, it must confirm the final amount you’ll have to pay, including the final total weekly fee rate.
You should be given enough time to consider the final offer before you accept it.
Terms and conditions
If you’re paying for your own care, there will be a contract between you and the care home. The terms and conditions in that contract must be written simply and clearly, avoiding jargon, so that you can easily understand your rights and responsibilities.
Terms must be written and agreed with you in a fair and open way.
If a term in a contract is unfair, it will not be valid and the care home cannot hold you to it. Unfair terms include those which put you, or the person who signs the contract on your behalf, at an unfair disadvantage (for example, because they give the care home more rights than you).
Terms which may be unfair include those that:
- hold you to ‘hidden’ terms that you have not had the chance to read and understand
- do not hold the care home responsible if things go wrong and it is their fault.
- require fees to continue to be paid for extended periods after a resident has died
- allow the care home to make unexpected changes to your fees
- require any upfront payments, unless it is a fair deposit or an advance payment of the regular residential fees
What if something changes when I am in the care home?
You should receive the service you have agreed with the care home and not something significantly different.
If the contract allows the care home to make lots of changes to benefit itself, this is likely to be unfair. There should only be very limited situations where the terms of your contract or the service provided by the care home may need to change.
Where there are changes, you should usually be given at least 28 days’ notice of them. If you’re unhappy, you should be able to leave the home without penalty before the change takes effect.
The terms of your contract should also clearly explain the circumstances in which your fees may change and how the changes will be calculated. This includes where there is an annual review of the fees or where your care needs change significantly.
If your contract gives the care home an unlimited right to increase your fees or make unexpected changes, this is likely to be unfair.
Being asked to leave a care home
The care home should clearly explain, upfront, the reasons why it might need to ask you to leave and set these out in your contract.
These must be valid reasons, for example:
- the care home cannot meet your care needs anymore, even after making reasonable adjustments
- you have repeatedly not paid your fees and you have large arrears
The care home should not ask you to leave without first consulting you, anyone assisting you, and other relevant independent professionals.
You should be given at least 28 days’ written notice to leave.
Level of service
The care home’s staff must act with reasonable care and skill and provide the service they said they would. If they don’t, you may be able to claim compensation for breach of contract.
For example, they must ensure that the care home’s buildings and equipment are suitable and safe, and you must be treated with dignity and respect. If they claim to provide a particular type of care (such as palliative care), they should do so competently.
What can you do if something goes wrong?
You always have the right to complain about your care or how you’re being treated.
The care home must make it easy for you to complain and deal with your complaint quickly and fairly. They should direct you to people who may be able to support and assist you, such as advocacy, interpreter and advice services.
The staff at your care home must never discourage you from making a complaint. They must not threaten to restrict or ban your visitors or ask you to leave if you make a complaint.
The care home’s procedure for dealing with complaints must be in writing and should:
- be easy to find on their website, in their service guide and in the care home itself
- be easy to understand and use, and clearly explain what concerns and issues it covers
- be available in different languages (in so far as possible) and formats such as large print, braille and audio
- set out clear and reasonable timescales if a complaint requires further investigation
- protect your anonymity, as far as possible
- explain how you can escalate your complaint to someone more senior in the care home if you don’t think it has been dealt with properly
- explain where you can go (for example, to the Ombudsman, or the Care Inspectorate in Scotland) if you’re unhappy with how the care home has dealt with your complaint
As a resident of a care home, you have consumer rights.
Care homes which don’t meet their obligations might be in breach of consumer law and could face enforcement action by local Trading Standards Services or the CMA.
If you don’t think you are being treated fairly, or think a care home is breaking consumer law, you can contact the Citizens Advice national consumer helpline on 03454 04 05 06 (or contact 03454 04 05 05 to speak with a Welsh-speaking advisor), or visit the Citizens Advice website. As well as giving you advice, the consumer helpline can pass information about complaints on to Trading Standards. In Northern Ireland, you can contact Consumerline on 0300 123 6262, or visit the Consumerline website.