‘Stuck in the middle’ – Self funders in care homes


If you’ve ever made a massive purchase like buying a home or taken out a large loan or mortgage, as you picked up the pen to sign on the dotted line, you might well have had your doubts about whether you’d really read and understood all the small print. Moving into a care home is another one of those huge decisions, with major consequences if you get it wrong. So it’s just as vital to understand what you’re signing.

Yet moving into a care home is frequently a hurried and pressurised decision, which for many comes after a spell in hospital. People are often ill, facing the stress of living with new levels of disability and confronting the reality of losing their home, community and identity. Some will also have reduced mental capacity. At times like these reading the small print is often not a priority and, in any case, many people are faced with limited options so can feel they have no choice but to agree to the home’s terms and conditions.

It is therefore vital that contracts are fair and easy to understand, but all too often this is not the case. Age UK’s new report, Behind the Headlines: Stuck in the Middle, published today, highlights the challenges many older people and their families face in trying to get a fair deal in a complex and failing care system.

The report, based on enquiries to Age UK’s information line, raises real questions about contracts that are either unclear or unfairly weighted against the care home resident.

We see examples where homes demand large ‘up front’ payments or deposits, sometimes running to several thousand pounds. By the same token, when residents move out they are often required to pay for long notice periods – in one case the family were asked to give (and pay for) a 30 day notice period after their loved one had died after just 6 days in the home.

It’s easy to see why the prospect of losing a large deposit, and paying a long notice period, would deter a resident from trying to move if they felt they’d made a mistake in choosing a home.

Many contracts give the care home free reign to increase fees as and when they wish, and charge for ‘extras’. Relatives can find themselves faced with a much higher bill all of a sudden, or extra bills for care which the home says is not included in the contract – for example escorting the resident to hospital or doctor’s appointments or for the cost of ‘entertainment.’

Yet ultimately the report reveals the extent to which ‘self-funders’ are paying the price for a care system under severe financial pressure.

It is easy to overlook the fact that a failing public care system has ramifications beyond the public sector, however local authorities are a major purchaser and they therefore have a huge impact on the shape the care market for us all. Big cuts in public funding for social care are forcing local authorities to drive down prices meaning care home providers have been increasingly financially squeezed and struggling to balance the books. This in turn has meant care homes are increasingly looking to self-funders to make up the shortfall and keep their homes open.

Self-funders now on average pay between £603 and £867 a week depending on the area, compared to councils paying between £421 and £624 a week. And we are now hearing of contracts which ask the person and their relatives not to approach the local authority for funding even when they are entitled to, since this will result in lower payments to the home.

Self-funders are also still largely unprotected when it comes to being able to remain in their care home (security of tenure), measures to ensure fair contracts and the protection of the Human Rights Act. Indeed older people can be evicted at short notice and with little reason. As long as this is the case many residents and their families will understandably be reluctant to complain or to challenge apparently unfair actions by care homes, for fear of jeopardising their accommodation at a time when good, affordable care home placements are hard to find.

This is an awful situation for everyone, most of all for the older people and their families, and it shows how important it is that the new Government grips the crisis in care and works urgently to address it.

Read the full report: Behind the headlines: Stuck in the middle 

You can find information and advice to help you and your family on the Age UK website 

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