Making Cents: Guidelines for contract of care at residential homes

‘The decision to move into residential care is usually taken in stressful circumstances.”

This comment was made recently by chairperson of the Competition and Consumer Protection Commission (CCPC) Isolde Goggin as her organisation published guidelines for contracts of care in long-term residential care services for older people.

As she highlighted, the decision to move to a nursing home can be highly emotional for the individuals involved and their families, making it far from an ideal time to be making decisions with long term consequences.

“For many people, there are limited options to choose from and moving to another nursing home, if you are not happy, is not feasible,” Ms Goggin said.

“This means residents are particularly vulnerable.

If there is a lack of transparency in contracts of care, residents and their families are at risk of being tied into terms and conditions that they don’t understand or that they would never knowingly agree to.

The new guidelines are aimed at providers but the CCPC also want to educate consumers on what they mean for them and how they can be their own (or in many cases their elderly relatives) best advocate.

To help, they have an explanatory booklet detailing what older people and their families can expect when they first begin looking at nursing homes.

It highlights what is required of nursing home providers and gives pointers to families on what to do if they feel their provider has not dealt with them fairly.

Once you’ve decided on a care home, you will be required to commit to a contract of care, a legal document setting out the rights and responsibilities both the nursing home provider and the resident will be bound by.

It deals with topics such as; the costof the services, payment schedules, details of the service that will be provided and terms attached to the service such as visiting rights, liability and the circumstances in which a contract can be ended.

In most cases the residents will be asked to commit to a standard contract of care, where terms have been drafted in advance and there may be little or no opportunity for the resident to negotiate or change the terms.

Nursing homes must use simple and clear language in their contracts of care, so that you can assess the consequences of what each term means and the extent of the obligations that you are committing to.

You shouldn’t be provided with a contract of care which contains unexplained legal jargon, or where there are legal/ technical words or phrases not explained. If you feel something is ambiguous ask for clarification. Under new guidelines, providers have been told by the CCPC any ambiguity could lead to the terms being challenged on the grounds of fairness.

In some cases a nursing home will require not just the prospective resident but another family member to sign the contract of care, as a guarantor. Here, the responsibilities of the guarantor should be clearly explained in advance so whoever signs fully understands the practical implications for you and in particular how much they could end up paying.

The booklet, available from www.ccpc.ie, explains fees, any absences, visiting rights and how other important details should be handled in the contract of care.

The Commission also has a template letter on its website that can be used if an individual or family wishes to make a formal complaint to a nursing home. .

“It is vital that nursing homes are fair and transparent in how they draw up residents’ contracts,” Ms Goggin added.

It is now up to each nursing home provider to review their standard form contracts of care to ensure that they are in compliance with consumer protection law.

It is important to note that the CCPC’s guidelines specificallyrelate to the contract of care and the terms under which a resident is being cared for.

If you have a complaint regarding the care a resident is receiving, or any other issue, you should contact Hiqa or the Office of the Ombudsman.