Are care homes delivering a good deal to residents? Age UK report looks at the care crisis



New report from AGE UK highlights the challenge of getting a ‘fair deal’ faced by older people who pay way their own way in care homes 

Just under a half (41 per cent) of all residents in UK independent care homes are now paying for their own care. This is an increase of almost a third (28.5 per cent) in the last ten years (from 130,000 in 2005 to 167,000 in 2014[i])[i].

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 on an older person’s quality of life and finances.

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 £867 a week depending on the area, compared to councils paying between £421 and £624 a week[ii].

Self-funders are 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. 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.

Caroline Abrahams, Charity Director at Age UK’s said:

We are worried that too many older people who pay for their own care home fees are getting a raw deal and are unfairly being asked to pay the price for a failing care system. They not only often face eye wateringly high weekly rates, calls to our helpline show that some are being asked to pay even more in ways that most of us would regard as ‘sharp practice’ as care homes struggle to keep the lights on.

“There is no doubt in our view that self-funders deserve greater legal protection from unfair care home contracts and charges that are over the top. It also seems crazy that a hale and hearty thirty year old who rents a flat enjoys more security of tenure than an eighty five year old with dementia and diabetes who lives in a care home. Surely the time has come to give these vulnerable older people their proper legal rights

“There is no justification for poor charging practice in any care home, but what these calls to our helpline reveal above all is a care system that is not really financially sustainable. The cost of running a care home has risen substantially but the money councils have to buy care has fallen: isn’t it inevitable in these circumstances that 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?

“The problem is that in such a cash-strapped system we are seeing more and more rationing and in this instance it looks like Peter is sometimes being robbed to pay Paul. 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 with others, including Age UK, to address it.”

The stories below reflect just some of cases outlined in the report and are representative of calls 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”. 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.

The charity argues that self-funding older people in care homes 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 are currently running a campaign Don’t Cut CareClick here for information






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