Nursing homes warned about imposing unfair terms on residents

Consumer watchdog to issue guidelines on potentially unfair clauses in contracts of care

Private nursing homes have been criticised for “top-up” fees for social and occupational therapy programmes, with claims some charge  for wound dressings, prescription painkillers and bedsore creams. Photograph: John Stillwell/PA
Private nursing homes have been criticised for “top-up” fees for social and occupational therapy programmes, with claims some charge for wound dressings, prescription painkillers and bedsore creams. Photograph: John Stillwell/PA

Almost 600 nursing homes nationwide are to receive a warning from the State’s consumer watchdog about imposing potentially unfair terms on vulnerable residents.

The action by the Competition and Consumer Protection Commission (CCPC) follows controversy over some nursing homes imposing additional charges on residents for so-called “additional” activities.

The CCPC, which has identified a number of potentially unfair terms currently being used in nursing home contracts, says the providers of care should now review these contracts to ensure they are legally compliant.

In some homes, contracts allowed for significant changes to the contract with no prior consultation with the resident or their family, the commission found.

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Decisions to move into residential care are often made in stressful circumstances, CCPC chairwoman Isolde Goggin pointed out.

“For many people, there are limited options to choose from and moving to another nursing home, if you are not happy, is not feasible. This means residents are particularly vulnerable. If there is a lack of transparency in contracts of care, they are at risk of being tied into terms and conditions they don’t understand or would never knowingly agree to.”

Dressings and painkillers

Private nursing homes have been repeatedly criticised for charging “top-up” fees of €100 and more a month for social and occupational therapy programmes. Sinn Féin TD Imelda Munster has claimed private homes are also charging residents for items such as wound dressings, prescription painkillers and bedsore creams.

Nursing home owners say the fault lies with the Health Service Executive for not funding care packages under the Fair Deal scheme sufficiently to allow for such services to be included.

The commission will this week send new guidelines to all nursing homes warning against the inclusion of potentially unfair clauses in contracts of care. Examples cited in the document include unfair restrictions on visiting rights of family members; the charging of excessive interest on fees; catch-all clauses on terminating the contract; transferring financial obligations to others; and changes to contracts.

Additional fees

In relation to additional fees, the commission says: “All fees should ideally be included in the upfront fee for the services to be provided.” Where this is not possible, information on all fees, whether mandatory or optional, should be provided to any prospective resident.

“Where the additional fee is genuinely optional then this has to be communicated clearly to the resident and the resident should be afforded the opportunity to either agree or otherwise to availing of the service concerned.”

The commission’s review found the language used in contracts was often technical and difficult to understand. In some cases, important information was not provided.

The review was to be based on a sample of 10 per cent of nursing homes, but only one-third of those selected responded and some told the commission they were unwilling to provide information.

The guidelines have legal standing and apply to both public and private homes, but the commission cannot force individual homes to alter unfair contract terms.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.