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Competitions and Market Authority (CMA) – Care Homes Market Study – Update paper, June 2017

The Competitions and Market Authority (CMA) has published the initial findings of its care homes market study. MHA has taken an active part in the CMA inquiry and supplied comprehensive information on our care home provision.

We currently have 88 care homes with a further two in development. We care for 4,686 residents in residential, nursing and specialist dementia care settings.

Key concerns the CMA has raised in its initial findings include:

People are struggling to make decisions about care: the CMA’s initial findings suggest that many people find it difficult to get the information they need, are confused by the social care system and funding options, and do not know how to find and choose between homes.

We agree that social care and associated funding system is difficult to navigate, particularly at times of personal, individual crises and believe that work is needed to make it easier for people.

At MHA we work very hard to provide as much information about our care homes as possible.  

We do this online, where you can search our range of care homes using different criteria, such as type of care (e.g. residential care, nursing care, dementia care) and geographical location. Each care home webpage includes an information brochure, plus its Care Quality Commission inspection rating and independent reviews from carehome.co.uk   In addition all our homes are also listed on Carehome.co.uk and NHS Choices.

Our individual care homes also work hard to raise awareness of the services we provide in local communities, for example, many are now on Facebook and run community and open days to make information available about our services locally. We believe local relationships and word of mouth recommendations are also very important – such as through local GPs, hospital discharge teams, local authorities, local community groups, local church groups, our ‘Live at Home’ schemes, etc.

All our homes provide an application pack for prospective residents and their relatives, which include an explanation of the types of care provided, the range of fees in the home and information about funding routes.  But we will always encourage people to come and visit the care home they are considering. A personal visit is very important to experience the ‘feeling’ of the home, the sense of the community within the home and understand the overall picture of life with us. It also enables us to have a really thorough conversation about what we can and can’t offer and it enables them to meet the staff team who will provide their care.

We also recommend the use of  ‘taster’ days, so prospective residents can come and spend the day with us well as respite care options.

Complaints procedures are not functioning well: The CMA’s findings indicate that redress systems (range of feedback and complaints’ systems)  often do not work well, and residents can find it very challenging to make complaints.

While it may be the case that some providers do not encourage feedback from residents and relatives, at MHA we encourage as much feedback as possible, so that we can continue to improve our services and the way we do things.

It is important to us, that if a resident or a relative is not happy with any aspect of our service, they are able to tell us quickly and easily.  That’s why our complaints procedure and policy is available to residents and relatives, within their application pack and online.  All our homes have posters on display explaining about our compliments, comments and complaints policy which encourages feedback. Feedback forms are available throughout our homes to help people tell us what they think. In the year to March 2017, we had 5,478 compliments, 223 comments and 1,089 complaints showing that we really do value listening to our residents and relatives.

All complaints are audited and reported to MHA’s Quality Committee and Board, quarterly to identify and address trends. 80% of complaints involving care homes, were resolved within 15 days. The majority which took longer were often due to their complexity ore referrals to outside agencies.

MHA is also an active member of the Your Care Rating consortia, which was established so that all residents living within a care home are given the opportunity to provide views and feedback via an annual, independent, confidential and standardised survey. This feedback, along with our quality inspections, enable us to make sure we are providing the best care and quality of life we can for our residents.

The CMA acknowledges that many care homes offer a good service, but they have concerns that some might not be treating residents fairly and that certain practices and contract terms might break consumer law, such as large upfront fees and fees charged after death, a lack of information about prices on care home websites, and care homes’ contracts giving homes wide-ranging discretion to ask residents to leave, at short notice.

We do not charge a deposit.

We would never ask a resident to leave at short notice and we only charge residents up to the point when they leave us, including the notice period. When a resident passes away, the fees stop. We would only continue a charge if the relatives wish to keep the room for some time afterwards.

We have clear standard Terms and Conditions.  Our Residential Care Agreement and Resident’s Terms and Conditions explain that the first eight weeks with us are a trial period, so a resident only needs to provide only a week’s notice to leave within that first eight weeks. (After that, four weeks’ notice is required.) 

We include details about our fees in our care home application packs and display them within each home. We have a matrix of prices, based on the level of care needed (standard, medium and high) and the types of care we can provide in the home n offer (residential, nursing etc). which are set depending on the care needs of the individual. For example, someone in one of our specialist nursing dementia care homes would expect to pay more for the services as their needs and levels of care are higher and more complex than someone within a residential care place.  We do not publish our fee matrix online, as it’s important to us that we are able to fully assess the needs of the potential resident prior to setting the fee for the care they need. We also believe that its more helpful for potential residents and their relatives to have a conversation with us about fees, so we can help them to understand the complexities of funding rather than simply publishing the fees. 

The sector is not positioned to attract the investment necessary to build greater capacity needed for the future: At present, short-term public funding pressures and uncertainty mean the sector is not incentivized to undertake the investment necessary to meet future demand.

In our response to the CMA we highlighted concern at the wider fragility of the sector, highlighted by the ongoing social care funding crisis, workforce pressures and red tape. We would agree that short-term public funding pressures and uncertainty are really not helpful for the sector.

We have already welcomed the intention announced by the then-Government in the March 2017 budget to publish proposals for the future funding of social care. We hope the newly-elected Government will honour this commitment.

We are one of the most well respected not-for-profit care providers in the sector. As a charity we aim to provide good quality services which represent excellent value for money and since we are not for profit, all of our surplus income is reinvested into providing services for older people now and into the future.

This approach has enabled us develop our ten-year strategy published in April 2015, which includes our ambition to increase the number of our care home places from 4,500 to 6,000 people. Oak Manor in Shefford is due to open in Autumn 2017, along with a home being built in Middlesborough – Stainton Manor – due to open in 2018.

At MHA we build connections with residents, their families and the wider community, as we believe it is important in helping our residents live happily in later life. Examples of how we do this include, our focus on the spiritual wellbeing of our residents, which is just as important as their physical and mental wellbeing. This is provided for free through our chaplaincy service, with 140 Chaplains who are a source of counsel, advice and guidance. They are there for people of all faiths or none at all.

We also provide free, dedicated music therapy service for our residents who are living with dementia in our dementia care settings. We employ a team of 21 qualified music therapists who deliver both group therapy and weekly 30-minute individual 1:1 sessions for residents with dementia who have severe difficulties in communication, behaviour or wellbeing.

We are able to offer both of these services free of charge to residents as they are fully funded by voluntary income from our generous supporters.

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