What a care home fee includes, and what costs extra

The Competition and Markets Authority requires care homes to be clear about what the fee includes before you sign, so a good home will hand you a list. It will usually contain:

• Your room, furnished, with heating, lighting and cleaning
• All meals, drinks and snacks
• Personal care: help with washing, dressing, medication, eating and moving
• Laundry of your own clothes and bedding
• Activities run by the home
• Nursing care, in a nursing home (part paid by the NHS: see NHS funded nursing care)
• Incontinence products where prescribed
• Insurance for the building and a limited amount of cover for your belongings

Typical fees on record across England are £1,350 a week for residential care and £1,586 for nursing. Your council area page has the local figure.

Extras are not wrong, but they add up. A hairdresser once a fortnight and a chiropodist once a month can be £150 a month. Ask for the extras price list and ask how they are billed: monthly in arrears is normal, cash to the hairdresser is common, and a “personal allowance account” the home tops up from your money should come with statements.

If a home cannot give you a written list of what is and is not included, treat that as information.

Most homes have a range, and the figures published on this site show it where the home does. A standard room with a shared bathroom is the base. An en suite, a larger room, a ground floor room, a garden view or a room in a newer wing each add to the weekly price, often by £50 to £200 a week. Higher care needs also move you up the range: a home may quote one fee for residential care and a higher one for dementia care in the same room.

When you visit, ask to see the room that is actually available and its price, not the show room. If the only vacancy is a premium room, ask whether the fee will drop when a standard room comes free, and get the answer in writing.

Councils negotiate a rate with homes for the residents they fund, and it is usually well below what the home charges a person paying their own way for the same room. The gap is often £200 a week or more. Homes say the council rate does not cover their costs and self-funders make up the difference. Councils say that is a matter for the homes.

Whatever the rights of it, two things follow. If the council is likely to fund you in future, tell it early, because once it contracts with the home the fee for your room may fall to its rate. And if you are self-funding you can ask the council to arrange your care anyway; it is entitled to charge an arrangement fee, but the home’s rate through the council contract can be lower. See who pays.

Nearly every home reviews its fees once a year, usually in April, when staff pay, the minimum wage and the NHS nursing contribution all change. Increases of five to ten per cent have been common in recent years. The contract should say how the rise is calculated and how much notice you get; four weeks is typical. A home can also raise the fee if your care needs increase, which should follow a reassessment you are told about.

• The weekly fee, for the named room, and the date it starts
• What is included and the extras price list, attached to the contract
• How and when fees rise, and the notice given
• Any deposit or admission fee, and when it is returned
• The notice period to leave, and what is charged after death (the CMA says a home should not charge for more than a few days once the room is cleared)
• What happens if you are in hospital: most homes charge the full fee to hold the room
• The trial period, usually four weeks, and who can end it
• Whether the home will accept the council rate if your money runs down

Most contracts are fair and most homes are straightforward about money. The point of reading it is not suspicion; it is to make sure the number you have in your head is the number that will arrive on the invoice.