Two in five (41%) residents in UK independent care homes are now paying the full cost of their own care - an increase of almost a third (28.5%) in the last 10 years (from 130,000 in 2005 to167,000 in 2014). This rise is a result of the state-funded system declining while demand from our ageing population continues to rise.
The new report from Age UK ‘Behind the headlines: ‘Stuck in the middle – self funders in care homes’ is based on actual calls to Age UK’s information and advice line and highlights the real challenges many face in getting a fair deal.
The decision to move into a care home is very difficult and often made in a rush following a spell in hospital. At such an emotional time scrutinising the fine print in a care home contract and negotiating rates is probably the last thing on anyone’s mind – but the terms set at this point will have a huge impact not only on an older person’s quality of life but also on their finances too.
Older people and their families feel powerless
Unfortunately calls to Age UK’s information line show just how powerless many older people and families feel when they are trying to arrange and manage care. The calls expose the problems people face navigating a complex market and the difficult position they can find themselves in when terms change suddenly or in ways that they don’t think are fair.
The report also reveals the extent to which ‘self-funders’ are ultimately paying the price for a care system under severe pressure. Care home providers have been increasingly financially squeezed, above all by big cuts in public funding for social care that in turn are forcing local authorities to drive down prices. As a result many care homes are struggling to balance the books and turning to self-funders to make up the shortfall to keep their homes open. Self-funders now on average pay between £603 and £827 a week depending on the area, compared to councils paying between £421 and £624 a week.
Self-funders lack equal rights
Self-funders are still largely unprotected when it comes to being able to remain in their care home as they have no security of tenure.
In addition, there are no specific measures to ensure fair contracts in care homes and older people who pay for their own care do not enjoy the protection of the Human Rights Act, whereas those whose care is organised by the State do. 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 being asked to leave.
Caroline Abrahams, Charity Director at Age UK’s commented: 'More and more older people are paying their own care home fees and they are increasingly at risk of a raw deal because they are propping up a system that is seriously underfunded. They not only often face eye wateringly high weekly rates, calls to our helpline show that in some care homes they are being asked to pay even more through various extra charges as proprietors struggle to balance the books.
'Older people and their families deserve greater legal protection from care home contracts that are one-sided and extra charges that are over the top. It also seems incredibly unfair that a care home resident can be evicted if they or their family are seen to "rock the boat" by complaining. Surely the time has come to give these vulnerable older people their proper legal rights.
The Government needs to tackle the care crisis
Caroline Abrahams continued by highlighting the wider problems the care system faces. She said, 'A big underlying problem is that our care system is financially terribly shaky. The cost of running a care home has risen but the money councils have to buy care has fallen: isn’t it inevitable in these circumstances that many providers will look to fill as much of the gap as they can from self-funders? And isn’t it equally unsurprising that so many care homes are going to the wall?
'Sadly we are seeing more and more rationing of social care and in this instance it looks like Peter is being robbed to pay Paul. It’s an awful situation for everyone, most of all for older people in need of a care home place and their families. The Government needs to grasp just how much of a crisis our care system is in and work with others, including Age UK, to address it.'
Real life stories
The stories below reflect just some of cases outlined in the report and are representative of calls Age UK has received. Names, gender and certain details and characteristics have been changed to preserve our callers’ confidentiality.
Relatives asked to guarantee care fees: Yvonne’s mother is 89 and now lives in a residential care home. However Yvonne is not happy with the contract, which says that both her mother and the so called, 'notifiable person' (which is stated as being Yvonne) accept 'joint and several liability' to pay all fees and charges claimed by the care home, 'on demand'. To Yvonne’s astonishment the contract also states that the care home's ability to do this will not be affected by the failure of the client to sign the agreement!
Unexpected or arbitrary fee increases: Lisa’s grandmother is 92 and pays for her own residential care home place. In April the care home increased fees by 5%. The care home has now contacted Lisa and told her there is a further increase of £40.00 a week. Lisa has challenged this because it has been less than 3 months since the previous increase. Lisa has been told that the second increase is because the home has reviewed residents who have high dependency needs. Lisa does not think that her grandmother is ‘high dependency’.
Charges for ‘extras’: Elizabeth is a self- funder in residential care. She has Alzheimer’s disease. Her daughter deals with her care home bills. Elizabeth has been billed for an entertainer. Her daughter doesn’t think that Elizabeth actually wanted or received this service. It is not covered in the contract. When concerns were raised, the care home said that this was a one off, but Elizabeth has been recently billed again for an entertainer.
Long notice periods: Eileen moved into a care home as a self-funder. However, she was very unhappy with the quality of care being provided and moved out again after 3 days. The care home is demanding payment for 4 weeks care - several thousand pounds.
Call Age UK for free advice
The charity argues that older people who pay their own care home fees need more legal protection, especially as the shortage of money in the care home sector risks exposing them to increased risk of financial exploitation as proprietors struggle to survive.
Age UK offers a free advice service for older people who are affected by any of these issues. People can call Age UK Advice free of charge on 0800 169 2081, read our online advice on care homes or contact their local Age UK for further information.