1. Staying Alive: Service User Contracts, CQC and Commissioners
Mei-Ling Huang, Royds Withy King
Health & social care team

2. Our services for care providers
CQC inspections and enforcement
litigation
HR and employment
safeguarding and inquests
mental capacity and DOLS
service user contracts
contract negotiations and disputes
business sales and acquisitions
property development, construction and finance
immigration law

3. Overview CMA market study and service user contracts
CQC enforcement action
Commissioning

4. Service User Contracts
The Competition and Markets Authority, (CMA) has done a market study of care home contracts.
Main issue: service user contracts in care homes often do not comply with consumer law.
A new area of vulnerability for providers.

5. Service User Contracts
Nursing Home A charged a top up on CHC funding. The contract made clear that the top up was a room amenity fee. Sea view and balcony.
Nursing Home B charged a top up on CHC funding. The contract described the top up as covering the gap between the actual cost of care and what the NHS would pay.

6. Problem areas Information Upfront fees and deposits
Charging fees on death
Fees increases
Guarantors
FNC payments
Fees when a person is absent
Third-party top ups

7. Service User Contracts
The goalposts have been moved. Revise your contracts to avoid future problems.
This is an easy (affordable) win.

8. CQC Main issues: Easy to fall into “requires improvement”;
Heavy compliance action when a provider is rated RI, re-inspected and doesn’t improve;
Harsh compliance action more generally.

9. CQC Guidance on repeated ratings of RI:

10. CQC Compliance action Cancellation of registration when rated RI.
Criminal enforcement for failing to have a registered manager and other breaches of the regulations.
Demands for the production of information.
Conditions being placed on registration, such as audits and action plans.

11. Commissioners
CCG’s trying to cut FNC and CHC costs.

12. Questions?