Date of decision: 09 Jun 2025
Summary
A son challenged steep annual fee increases at a private Bupa care home where his father lived. He argued the compounded rises amounted to over 85% in six years, exceeding inflation and norms, creating financial strain and uncertainty in planning long-term care. He sought explanation, reduction, and a halt to further increases.
What happened
Mr X’s father, Mr Y, was resident in a privately funded care placement at a Bupa care home. Over a six-year period, the Care Provider applied annual fee increases that together compounded to more than 85%.
Mr X, responsible for managing his father’s financial arrangements, grew concerned at the escalating fees, which he said were well above the Consumer Prices Index and higher than many other providers.
The LGSCO said that there was a contract for the care and the terms and conditions of its care, and explained that it will increase fees in January each year. The report implies that the terms said that the Care Provider ‘aims’ to give at least 28 days’ notice before it increases the fee and will explain its reasons.
This particular year, it considered it necessary to increase its fees above its standard 7 percent and had given its reasons. [This will have been because of the ENIC change and change to the national living wage, we expect]. The Care Provider wrote to Mr X with enough notice before it imposed the increase for him to decide if he wanted to continue with the service. It responded to Mr X’s complaint with further explanation for the increase.
Mr X complained, raising that the steep increases placed a heavy financial burden and created anxiety about funding his father’s ongoing care. He asked the Care Provider to: provide a better justification for the exceptionally high increases; reconsider or halt the most recent rise; and commit to no further increases.
The Care Provider responded by referring Mr X to the written terms and conditions originally supplied, which confirmed annual increases would occur, with notice provided. It added explanation regarding the 2025 increase and maintained its position.
Dissatisfied, Mr X escalated the matter to the Local Government and Social Care Ombudsman (LGSCO).
What was found
The Ombudsman considered the complaint and the Care Provider’s correspondence, alongside the Ombudsman’s Assessment Code.
The review included the Care Quality Commission’s regulations, in particular Regulation 19 of the CQC (Registration) Regulations 2009, which requires providers to give clear information about fees and notify service users promptly of changes.
The Care Provider was found to have complied with these requirements: it had explained its terms, given sufficient notice, and provided reasoning.
The Ombudsman noted that, while Mr X disagreed strongly with the increases, he had over five years continued to accept them by retaining his father’s placement at the home and paying the revised fees. The Ombudsman emphasised its remit did not extend to deciding what constituted a fair price for care or to prevent providers from raising fees. Strict contractual interpretation and the legitimacy of the rises could only be determined by the courts. It would be reasonable for Mr X to pursue these issues at court because it is the body which can consider them, the Ombudsman said.
The Ombudsman found the provider complied with legal and contractual duties, including giving advance notice and reasons for fee rises under Regulation 19 of the CQC (Registration) Regulations 2009. The provider responded to concerns in writing, and redress was not warranted. The Ombudsman highlighted that it cannot decide what constitutes a fair care fee or enforce limits on private fees.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
Regulation 19 of the CQC (Registration) Regulations 2009 requires providers to give clear written information about the cost of care, including any planned increases and adequate notice before these take effect. Providers must ensure that service users, or their representatives, are given enough time to consider such changes and decide whether to continue with the service.
The Unfair Contract Terms Act and the Competition and Markets Authority emphasises the need for transparency and procedural fairness in care charging.
Where charges or fee uplifts are being imposed, providers—and commissioning councils when involved—must evidence that their communications and contractual terms are genuinely accessible and meaningful, not simply a technical compliance. Fee notices and explanations should be sufficiently detailed to allow people to make informed choices about ongoing care arrangements.
On fee increases, the CMA Guidance is firm:
In this sector notice of a change and a right for the resident to end the contract without penalty before it takes effect is unlikely ever to be enough to offer sufficient protection. Residents are often reluctant to move homes even when unhappy or dissatisfied because of the stress and inconvenience involved and the potential negative impact on their health.
… You should ensure that any term that may allow you to change your terms or service after the resident has agreed to move into your home
- Clearly, accurately and unambiguously specifies the circumstances in which you can make changes, which should be limited to valid reasons. Terms are more likely to be fair where they allow only very minor changes non fee related changes that are necessary to give effect to new laws or regulations changes that benefit residents or an annual increase of fees in line with inflation;
- Is transparent so that residents and their representatives can foresee and understand how the changes might affect them before they accept the offer of a place. Simply saying that any change will be reasonable is not enough as the resident will not be in a position to understand and evaluate what sort of changes you may make and in what circumstances;
- Requires you to give advance written notice of the change to residents and their representatives before it takes effect so that residents who do not wish to accept it can in theory end the contract and avoid it. The period should be sufficient for the resident realistically to be able to escape the effects of the change and be no less than the period of notice that the resident must give to end the contract further when the resident has given notice within this. The changes should not apply to the resident during their notice. Periods of less than 28 days are unlikely to be fair;
- Allows the resident to obtain a pro rata refund of prepayments for use of their room or services not yet provided if they decide to move out before the variation takes effect…
Terms which give you in effect an unlimited right to increase the price of your service after it has been agreed are likely to be unfair under consumer law, especially where the resident has no choice but to pay the higher price or leave.
Simply stating that one’s fees may go up as a result of increased costs, local market conditions or the wider national economic picture will not make the provider’s terms fair. A term which merely states that any increases will be cost reflective or reasonable or limited to unexpected changes is unlikely to be fair as the resident will be unable to foresee what sort of changes such wording allows and in what circumstances.
Terms which seek to cap an annual fee increase but which still give the provider a very broad discretion to increase its fees or without setting out clearly the circumstances in which a change may occur, are also likely to be unfair.
“Whilst it is not the only way to comply with the law we consider that care homes are more likely to ensure compliance where they review existing residence fees on an annual basis by reference to a relevant objective and verifiable published price index clearly specified and explained in the contract.”
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Bupa Care Homes (GL) Limited (24 022 037) report.
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