C&SW CHAIR RESPONDS TO CMA FINDINGS
Len Collacott reviewed the initial findings of the market study and responds to each in turn below
1. People are struggling to make decisions about care: Prospective care home residents and their families need to be able to make informed choices, often under stressful and time-pressured circumstances. However the CMA’s initial findings suggest that many people find it difficult to get the information they need, are confused by the social care system and funding options, and do not know how to find and choose between homes.
LEN says: I think there is a lot of information out there about care homes. There are a number of ‘trip advisor’ type sites (NHS Choices, Care Home UK) and most care homes have a website of their own that can easily be found via google. Funding options are confusing- mostly the LA role. The service user element of LA fees varies hugely and families are often not told about it. Furthermore the financial assessment is often door well after admission and if a service user contribution is large it is left to the home to collect the shortfall.
2. Complaints procedures are not functioning well: It is not realistic for many residents to move home if they are dissatisfied with the care they are receiving, as to do so would be distressing and harmful to their health. It is therefore essential that effective systems are in place for them to be able to complain and, where necessary, have these concerns acted upon. Our initial findings, however, indicate that redress systems often do not work well, and residents can find it very challenging to make complaints.
LEN says: I can’t see why complaints systems don’t work. It is one of the elements examined by CQC. I agree that changing placements is a last resort. We should police our complaints procedures thoroughly and CQC should be doing the same to ensure they are unfit for purpose. This does, of course, need to be balanced as problems can go both ways. Some families can be unrealistic, unreasonable, and difficult.
3. While many care homes offer a good service, there are concerns that some might not be treating residents fairly and that certain practices and contract terms might break consumer law. As well as the issues on large upfront fees and fees charged after death, which we are investigating in the consumer protection case, we are concerned about other consumer protection issues such as a lack of information about prices on care home websites, and care homes’ contracts giving homes wide-ranging discretion to ask residents to leave, at short notice.
LEN says: The only large upfront fees that I am aware of is when families pay in advance to secure a good discount. I can’t see any other good reason for large upfront fees to be charged. There does need to be a reasonable time after death to allow for the room to be cleared and re-let. Our own contract allows for 14 days. If the room can be cleared , turned around and re-let before that we refund the fees on a daily pro rata basis. Some families leave furniture and possessions in the room for a long time (understandable sometimes when it is emotionally difficult) so the room cannot be offered to the next resident and there is a cost to that. Again it is about finding a balance.
4. The sector is not positioned to attract the investment necessary to build greater capacity needed for the future: Demand for care home services is expected to increase substantially, with the number of people aged 85 and over projected to more than double by mid-2039. The level of care they require is also expected to increase as, having spent longer in their own homes, they will be more frail when they do move to a care home. At present, short-term public funding pressures and uncertainty mean the sector is not incentivised to undertake the investment necessary to meet future demand.
LEN says This is true- in part. Investment can only be attracted if the product at the end earns enough money to pay for it. There is a two tier system. Those private funders who can afford it have encouraged the development of ‘next generation’ homes that are well speced, and comfortable if not luxurious. LA fees have been so far below the market rate for so long and continue to be so. There is a market of poorer quality older homes who can operate on much lower cost but it is not possible to charge low fees and invest in higher quality. Years of raising this issue and pointing out the facts have done nothing to change things.