It usually goes something like this. Your mother has been in hospital for eleven days. On a Thursday afternoon someone says she is medically fit for discharge and the ward needs the bed. A care home has a vacancy. Could you come in and sign the paperwork today?
Everyone in that conversation is under pressure and most of them are being perfectly reasonable. But the pressure is real, the documents are binding and the decisions made on discharge day are the ones families most often regret.
Here is what you are actually entitled to.
You do not have to sign anything that day
Start here, because everything else follows from it.
A care home contract is a consumer contract. Nothing obliges you to sign it at the moment it is presented. You are entitled to take it away, read it and return it signed. A home that is unwilling to allow that is telling you something useful about the home.
Two or three days is a reasonable and normal request. The sentence that does the work:
“We are proceeding with the placement and will return the signed contract within two working days. Please confirm in writing that admission is not conditional on signing today.”
Consumer protections apply to the care home contract from the point of admission, not from the point of signature, so the placement itself is not at risk while you read.
Discharge is a process, not an eviction
A hospital cannot simply put someone out. There has to be a discharge plan, and where ongoing care is needed there should be an assessment of what that care should be.
You are entitled to be told in writing what is proposed. If the person lacks capacity to make the decision, any decision must be made in their best interests under the Mental Capacity Act 2005, with the family consulted. If there is no one appropriate to consult, an independent mental capacity advocate should be involved.
You are also entitled to ask whether NHS Continuing Healthcare has been considered. If the person’s needs are primarily health needs, the NHS may be responsible for funding the whole package, and that assessment is much harder to obtain once someone has been discharged and settled into a privately funded placement. Ask about it before discharge, not after.
Discharge to assess models mean the full assessment sometimes happens after leaving hospital. That is legitimate, and it makes it more important to be clear about what is temporary and what is permanent, because the funding consequences differ.
The three things to check in any care contract
If you read nothing else, read these.
1. Who is liable, and for how much. Are you signing as a representative of the resident, or in your own name? A guarantor clause makes you personally liable for the fees. If the council is contributing, does the contract cap your liability at the top-up amount or leave you exposed to the full private rate?
2. Fee increases. How much notice is given, how often can fees rise and is there any cap? Annual increases well above inflation are common and they compound over a placement lasting years.
3. Notice and what happens on death. How much notice is required to leave, what happens if the person’s needs change and the home says it can no longer meet them, and how long fees continue to be charged after a death. That last clause varies enormously between homes and it lands on the estate.
Also check what is included. Chiropody, hairdressing, escorted appointments and incontinence products are frequently extras, and they add up.
The guarantor clause, specifically
The single most consequential thing you can sign on discharge day.
Signing as guarantor means that if the fees are not paid, from any cause, the home can pursue you personally. Not the estate. You.
Never sign one under time pressure. If a home insists, that alone is reason to take the contract away and get it looked at. Age UK’s factsheets cover care home contracts in detail and a solicitor will review one for a modest fixed fee.
What to do on the day itself
Say clearly that you are willing to proceed with the placement. Ask for the contract to take away. Ask for the discharge plan in writing. Ask whether Continuing Healthcare has been assessed. Ask what is temporary and what is permanent. Write down who you spoke to and when.
Then go home and read it.
If you are not in England
Care funding is devolved and the differences are substantial rather than cosmetic. Scotland provides free personal and nursing care as flat weekly payments regardless of income or assets, and its capital limits are more generous than England’s. Wales uses a single capital limit and caps the weekly charge for care at home. Northern Ireland runs its care system through Health and Social Care Trusts rather than councils. Everything below describes England. If you are elsewhere, start with Care Information Scotland, the Welsh Government social care pages or nidirect, because the thresholds quoted here will not apply to you.
Where FamilySafe fits
Discharge day generates paperwork at exactly the moment nobody can absorb it, and it usually lands with whichever family member happened to be there. FamilySafe keeps the contract, the discharge plan and the record of who said what in one place the whole family can reach, so the decisions made in a difficult week are not held by one person’s memory.
Sources
- Consumer Rights Act 2015 and the Competition and Markets Authority guidance on care home consumer law
- Mental Capacity Act 2005
- NHS England guidance on hospital discharge and discharge to assess
- Age UK factsheet 29: finding, choosing and funding a care home
This is general information, not legal advice. If you are under pressure to sign something you are unsure about, speak to a solicitor or contact Age UK before you do.
