Moving

If you are funding your own care

Yes, of course. You can choose your care home in the same way as you might choose any other type of home.

Not all care homes are the same, though, so it is important to think about what you will want from your new home. It can help to make a list and see which homes best match your preferences.

Try not be be dazzled by fancy facilities that you are not likely to use. For instance, you probably don't want to pay for a specially adapted gym if you don’t have the range of mobility to benefit from it.

There are other considerations to think about, too. For example, room size is important if you use a wheelchair and you want to make sure that bathroom facilities are easy for you to get to.

It's worth treating this home move as a chance to think about what you want and need. That way you can look for specific care and assistance with activities that are important to you.

Thinking about costs

Even if you don’t have sufficient money to fund your care in the long term, you can still choose a more expensive home that might become funded by the local authority at a later date. However, in this scenario, there is a chance you might have to move again once your funds run out.

Under the Care Act, while you are fully funding your own care, you should never be asked to restrict your funds.

If you are getting support from the local authority for your care

Even if you are getting support to fund your care from the local authority, you can still choose the care home you want to live in. Under the Care Act’s statutory guidance on Care and Support, Annex A, you have the right to choose your own home.

As long as your chosen home mets your needs, is within your budget, or there is someone available who can top up fees, then you should be able to move into your home of choice.

However, it is more complicated where the local authority is part funding your care (under the Care Act) or fully funding your care (under the Mental Health Act s117).

Your budget will be set against your eligible needs, so it is important to ensure that your care and support plan is correct. The plan considers your needs and your wellbeing holistically and sets out your preferences and needs that are eligible for funding. It should include your budget, set so as to be sufficient to meet those needs.

The local authority must be able to show that your budget is sufficient by providing ‘at least one’ care home option that can meet your needs.

Going into care after hospital

Moving out of hospital after an illness can be traumatic and a confusing time.

If you feel put under pressure to leave, it is worth knowing that your discharge plan must focus on meeting your needs. And you, or your representative, if you are unable, must be involved in this care planning.

Regardless of your finances, if you or your carer feel unable to make arrangements, you can ask for a social worker to help you plan care arrangements so that they are ready for you when you leave.

If your preferred choice is not available, then you may need to move into a temporary setting until it becomes available.

Assessing your needs

Your hospital discharge planning should ensure that your needs are met safely in the agreed place of discharge, whether this is at home, in your current care home or a new care home. If necessary, a more in depth needs assessments should be carried out as soon as possible after leaving hospital, if this was not done before leaving.

You may also be entitled to a period of intensive support for up to six weeks after leaving hospital. This is called 'intermediate care’, and you should not be charged for this.

This intermediate care could include a placement in a care home or more extensive home care.

Any progress or improvements you are expected to make should be discussed with you and recorded, including how it may be achieved. For instance, if you need support to stand and to become more mobile before being ready to going home, your discharge plan should include written details of the specific help you will get to achieve this. The plan should go beyond just saying something general like 'working with a physiotherapist’ and instead provide some detail on how you will be supported to carry out any exercises.

Unless you were previously living in a care home, or wish to move into one permanently, moving into a care home upon discharge from hospital should be temporary measure. If it looks as though it may be going on for longer than six weeks, then you must have a further needs assessment to evaluate and discuss your needs, as well as the options open to you.

Again, at this stage, you are entitled to choose your care home. However, if you need specific rehabilitation support, the availability of specialist services might limit your choice.

If you choose a home, but it doesn’t have a vacancy, then you may need to move to another home until one becomes available.

It is important that you are happy in your care home. It is, after all, your home. If you are not happy with the care you receive and wish to move, then you should be free to do so.

Have you considered making a complaint?

If you are unhappy or have concerns because of the low quality care, or have been subject to abuse by staff or another resident, then you might consider one of these options before making plans to move:

• raising a complaint with the provider

• making a referral to safeguarding

• contacting the regulator, the Care Quality Commission (CQC).

If you have any concerns about your care or someone else’s, or want to discuss a move, please speak to one of our Helpline advisors.

Giving notice

If you pay for all of your fees and have entered into a contract with the home for your care, you will need to give notice that you wish to terminate your contract.

It is a good idea to check the notice period in your contract. The notice period can be shortened in some cases, for instance, if the home cannot safely meet your needs.

If you leave before the end of your termination period and the provider contracts the room to someone else, you should be refunded for that period. They should not be taking two fees for the same service.

You may also want to find a home that you prefer before giving notice, so that you are not under pressure to find a placement in a specific amount of time.

Involving the funder

Bear in mind that if part or all of the care fees are funded by the local authority or the NHS, then you need to involve them in any decision to move, since they manage the contract for care. They will assist you to through the process and help you find a suitable alternative.

If you are making a decision for someone else

If you are making a decision for someone else, provided you are able to enter into a contract on their behalf, you should be able to move the person you are concerned about if you believe it is in their best interests.

However, even as their Power of Attorney for Health and Welfare, your decision can be challenged if, for some reason, it is believed to be unsafe or not their best interests. It is a good idea to check that the people involved in assessing or providing the care are in agreement before you attempt to move someone.

The people you consult could include the Best Interests Assessor (if there is a Deprivation of Liberty authorisation in place), the present care home manager and the local authority. You can let them know via a shared email, stating your intentions and why you believe it is in the best interests of the person you are representing. Your email should ask that they contact you by a specific date if they have any concerns.

If your decision is challenged, there will need to be a best interests decision under the Mental Capacity Act. This must include all those involved in the care, including you, led by adult social care services. If you do not agree with their decision, then you can challenge it in the Court of Protection.

The short answer is, yes! It is common for people to want to live closer if their health or the health of someone they care about deteriorates.

Moving closer to family, can mean you can see each other more often, be more involved in their lives and give and receive support more easily.

However, moving closer to family isn’t always the answer. Busy lives and commitments mean that you may not see as much of them as you might have hoped, while you also may leave behind friends and a community that have been a great source of enjoyment and support.

It’s worth talking it through as a family so that everyone understands what is involved and to make sure that everyone’s expectations are aligned.

The importance of relationships is recognised in the law, not least the Human Rights Act, Article 8, which protects the right to private and family life.

The fundamental basis of the Care Act is to support people’s wellbeing. This includes local authorities supporting your need to maintain relationships as part of the eligibility criteria and outcomes. If you must move to a different area to maintain key relationships then, under the Care Act, you should be supported to so.

If you are unable to express your desire to move, then, similarly, under the Mental Capacity Act, care professionals are legally required to act in your best interests, which can sometimes mean enabling you to move closer to family where you can get more support.

Likewise, you should not be moved away from family due to funding, if the move hampers your contact with people you rely on or value.

If you are eligible for financial support under the Care Act or the Mental Health Act (s117), it's worth remembering that maintaining family relationships is treated as an eligible need. If the move helps achieve this need, then any additional costs to your care should be met by the local authority.

Looking for support from your local authority because you have run out of funds can be a stressful time. Particularly if you are not familiar with how the funding works or your rights under the Care Act. Your local authority should never set your budget for your care without assessing your needs first. For instance, you should never be told by the local authority that they ‘only pay £xxx for this type of care and if you want to stay where you are you will need someone to top up the rest’.

Your budget must reflect your needs:

Your budget set for your care must be able to meet your eligible needs. This means the local authority should carryout a social care needs assessments in the same way as anyone else approaching them for support. As part of the assessment, they must assess the risk to your health and wellbeing should you move from your current care home. They must speak to all relevant people involved in your care, including specialist medical staff.

Risk Assessment:

If the risk of moving you is considered too high and may have a lasting impact on your health and wellbeing, then the local authority will need to take this into account when setting your budget for your care. Effectively, this means that the only home that can meet your needs is your current home, and your budget will need to reflect the fees at this home.

For example, Doris’s Parkinson’s specialist nurse advised the local authority that if she was moved from the home she was settled in who were managing her condition well, it would most likely lead to a serious deterioration of her condition. Due to the nature of Parkinson’s disease, she could not recover from the impact of the move, so it was considered too dangerous to move Doris. The local authority had to set her personal care budget to match that of her current home.

Where the risk has been assessed as not being significantly high or permanent, then it may be determined that you are able to move to an alternative home. As a result, your care budget set by the local authority may be less than your current care home fees. However, they must be able to provide at least one care home option, that has a vacancy and meets your needs at the same cost as the budget set. To find out more, see our Money and Costs page. In these situations, then the local authority can request that a third party meet the difference between your budget and the cost of the fees in order to stay there.

If you disagree with risk assessment, or feel that the identified home does not meet your needs, you may wish to challenge this. You can find out more from our Making a complaint page or speak to one of our helpline advisors.

Under the Care Act, you will need to contribute towards the cost of your care, to find out more about this see Money and Costs.

Receiving notice to leave your care home can bring about a range of emotions. Terminating your placement should only happen as a last resort after all efforts have been made by the provider to meet your care needs and to resolve any conflict. This is highlighted in the Competitions and Marketing Authority (CMA) guidance for care home providers on Consumer Law.

“You (provider) should not ask a resident to leave the care home without first consulting with them and their representatives, and any other relevant independent professionals, and after efforts have been made to meet the resident’s care needs”.

Any termination must also follow the terms of your contract, and, unless it is unsafe for you to stay, should give you a minimum of 28 days’ notice.

Self-funders

If you hold the contract for your care, and you believe that any notice given has not followed the terms of your contract, you may challenge the notice setting out why it is in breach of these terms.

If you believe that the provider is acting unlawfully or unfairly, and you do not want to leave, then you may want to seek legal advice as it is likely that the provider will need to take you to court and prove that they have followed the contract before an order can be given for your removal as stated in the CMA’s guidance:

4.97 “Furthermore, most care home residents in England and Wales are legally entitled to a minimum of 28 days’ written notice to vacate a care home under the Protection from Eviction Act 1977 (or the period set out in your contract, if longer). Where the resident is unwilling to leave the home once notice has expired, you must apply to court for an order to evict. Similar provisions may apply for residents in Scotland.” Page 121

If you are supported by the local authority

If you do not hold the contract for your care as this has been arranged by the local authority, you can seek the support of the local authority to resolve the matter for you and challenge the termination. If the local authority is unwilling to do this, and believe are not acting in your best interests, then you can make an official complaint to the local authority setting out why you believe that the termination is unfair and unreasonable, and request that they do not accept the termination on those grounds.

If you have received notice to leave, you may want to contact our Helpline to discuss your situation in more detail. You can book a call with an adviser here.