Summary: We found fault with Ridge House Residential Home Limited (the Care Provider) for the way it ended its residential care contract with Mr X. The Care Provider’s failure to provide information about the possibility and procedure for ending the contract due to the change of residents’ needs caused injustice to Mr X and his daughters. The Care Provider agreed to apologise to Mr X and his daughters, make a symbolic payment for Mr X’s daughters to recognise their distress and amend its residential care contracts.

The complaint

1. The complainant’s representatives (Ms Y and Ms Z) say the way Ridge House Residential Care Home (the Care Home) ended a residential care agreement with their father (Mr X) caused him and them injustice. They say the Care Home failed to:
• provide a termination notice;
• respond to their request for information and a termination policy;
• refund care fees paid for the month in which the agreement was ended.
2. Ms Y and Ms Z say their father was distressed not to be able to return to his home at the Care Provider’s after being discharged from the hospital. Ms Y and Ms Z spent much time communicating with the Care Provider's staff about the end of Mr X’s residency and any refunds due. The Care Provider’s actions also resulted in the need to urgently find a new residential care home, to look after distressed Mr X and to relocate his possessions. Ms Y and Ms Z also had costs associated with the move.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused injustice, or could have caused injustice, to the person complaining. I have used the term fault to describe this. (Local Government Act 1974, sections 34B and 34C)
4. If an adult social care provider’s actions have caused injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
5. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
6. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

7. I spoke with Ms Z and considered the information she and Ms Y provided.
8. I made enquiries with the Care Provider and considered the information it provided.
9. Ms Y, Ms Z and the Care Provider had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Legal and administrative framework

10. Providers must give people information in writing about the terms and conditions of their care, treatment or support, including the expected costs and the requirement to pay for their care, treatment and support. (Care Quality Commission (Registration) Regulations 2009 paragraph 19)
11. The Competition and Markets Authority (CMA) has published an updated guidance for care homes to help them comply with their consumer law obligations. The guidance applies specifically to care homes for people over 65 and covers the whole of the United Kingdom. The guidance states it is relevant for all care homes, irrespective of whether residents pay their own fees or are state funded.
12. The CMA guidance states care homes should provide residents with detailed information about how they or it may end the contract. It says care homes should include terms in its contracts that give both it and the resident legitimate reasons for ending it.
13. The legitimate reasons for terminating a resident’s contract include:
• The need for the resident to move to accommodation that can better meet their care needs, even though care providers have made reasonable adjustments to try to meet those needs;
• The need for the resident to move to extra care or supported accommodation, and the care provider does not provide this.
14. Normally when terminating contracts care homes are expected to provide residents with a written notice of at least 28 days. In certain circumstances, however, such as where a resident’s health rapidly deteriorates care homes may need to take immediate action to safeguard residents and staff.

What happened

Residential care contract

15. The Care Home’s contract for providing residential care includes two references to the termination of the contract. It states:
• The agreement remains in force unless terminated with written notice by either party one month before the intended date of termination.
• If the resident at any time is absent for a hospital treatment or for any other reason for more than three days, the Care Provider will not use the room for any other resident on payment of a retainer of 90% of the full fee for a period of four weeks. Thereafter the normal fee may be charged or notice of termination assumed.

Termination of Mr X’s contract

16. Mr X was receiving residential care in the Care Home when he was taken to the hospital at the end of March 2023. Ms Z kept regular contact with the Care Home. A member of staff from the Care Home visited Mr X at the hospital two days after his admission.
17. From the beginning of April Mr X’s daughters were discussing with the Care Home any adaptations necessary for Mr X’s return. With Mr X’s reduced mobility, the Care Home was concerned how to get Mr X to his room upstairs and afterwards how to take him downstairs to participate in various activities. Several times the hospital transport to take Mr X back to the Care Home was booked and then cancelled for the following reasons:
• First time - Mr X’s potential inability to sit in a chair lift at the Care Home. An Occupational Therapy (OT) assessment followed. The OT assessment found Mr X was not able to sit in a chair lift;
• Second time - the need for the Care Home to carry out Mr X’s assessment;
• Third time – the Care Home’s decision they could not meet Mr X’s needs and continue providing care for him.
18. On 6 April 2023 the Care Home cancelled the hospital transport for Mr X before telling his daughters they could not continue providing residential care for Mr X. Ms Y and Ms Z said a member of the Care Home’s staff had not been able to answer their questions about a refund policy, notice period applicable and reasons for their inability to meet Mr X’s needs.
19. Ms Y and Ms Z contacted the Care Home again the next day as they were unhappy with the termination of Mr X’s contract. They thought some people receiving residential care at the Care Home had similar needs, so questioned the Care Home’s reasons for ending the contract. The following day Ms Y and Ms Z asked the Care Home for its refund policy. The Care Home failed to respond.
20. On 8 April Mr X was offered a place in another Care Home.
21. The next day Ms Z made arrangements for clearing Mr X’s room at the Care Home. This happened on 10 April. Ms Z received information she would receive a refund of fees from the day she emptied Mr X’s room.

Refund of Mr X’s residential care fees

22. At the end of April Ms Y, Ms Z and their sister (Ms A) complained to the Care Home about the way the Care Home ended its contract with Mr X and its actions which followed. Mr X’s daughters asked for a full refund of the residential care fees for April 2023.
23. After a request for an update from Mr X’s daughters, the Care Home provided its response to the complaint later in May. The Care Home said:
• Its refund policy provides for refunds from the date personal belongings of a resident are removed from his room;
• There was no notice for ending the contract as due to the decline in Mr X’s health the Care Home could not provide with the level of care he needed.
24. Ms Y, Ms Z and Ms A were not happy with the Care Home’s response. They also pointed out some factual inaccuracies in the complaint response.
25. At the end of May the Care Home told Ms Y, Ms Z and Ms A that it had not received a payment for April 2023 from Mr X. An extensive correspondence took place throughout June, July and August with both parties seeking advice from their banks. At the end of August the Care Home’s bank stated three cheques had been paid in at the same time which meant that these payments had not been identified as a monthly residential care fee. The Care Home apologised but explained this situation was outside its control. It offered a refund of Mr X’s residential care fees from 10 April.
26. The Care Home provided Mr X with the refund of his fees from 10 April in mid-September 2023.

Analysis

27. After completing an assessment following deterioration of Mr X’s health, the Care Home decided it could not meet his increased needs without a risk to him, other residents and the Care Home staff. As explained in paragraph 14 of this decision care providers can legitimately end care contracts on these grounds and a notice would not be required.
28. I found, however, that the absence of the required information in Mr X’s residential care contract as well as some of the Care Home’s actions at the time of ending Mr X’s contract caused injustice to Mr X and his daughters, which is fault. Specifically the Care Home failed to:
• Include in the residential care contract a possibility of ending the contract when the resident’s needs change;
• Provide Ms Y, Ms Z and Ms A with the Care Home’s refund policy when they had asked for it;
• Address Mr X’s daughters’ concerns about the lack of a written notice to end the residential care contract.
29. I do not think the Care Home’s actions negatively affected Mr X’s finances for the following reasons:
• There were only four days between ending the contract and clearing Mr X’s room of his possessions;
• It is reasonable to expect to pay for the room in a care home which cannot be used for another person.
30. The lack of communication from the Care Home and its failure to provide information as requested by Mr X’s daughters caused distress to them and Mr X. It happened at the time when Mr X’s health deteriorated. In view of Mr X’s dementia his daughters were concerned about the effect of the change in Mr X’s living arrangements on his well-being as he consistently asked to go back home. Ms Y, Ms Z and Ms A spent much time seeking clarity on Mr X’s rights in relation to his contract with the Care Home.
31. There was a confusion with one monthly payment for Mr X’s residential care, which delayed the Care Home’s refund for Mr X. The Care Home’s bank eventually found reasons for the non-identification of this payment. As it was outside the Care Home’s control I would not criticise it for this delay.

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Agreed action

32. To remedy the injustice caused by the Care Provider’s actions, the Care Provider agreed to complete within four weeks of the final decision the following:
• apologise to Mr X, Ms Y and Ms Z for the injustice caused by its actions. When making an apology the Care Provider will follow our guidance;
• pay Ms Y and Ms Z £150 to recognise the distress caused to them by the Care Provider’s failure to provide sufficient information on ending residential care contracts due to a change in the residents’ health.

The Care Provider will send the evidence that this has happened.

33. The Care Provider also agreed within three months of the final decision to amend its residential care contract, adding terms of ending the contract when residents’ needs change. The Care Provider will send the evidence that this has happened.

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Final decision

34. I uphold this complaint. I found fault with the way Ridge House Residential Home Limited ended its residential care contract with Mr X. The Care Provider’s actions caused injustice to Mr X and his daughters. The Care Provider has accepted my recommendations, so this investigation is at an end.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman