They have responded stating their minimum support hrs for the unit is 25 hrs week and anything on top will be costed as an addition. And that the balance of 5 hrs are for background support.
Q1. Is there a minimum support hrs prescribed by any regulations for nursing homes?
A: No there is not. It is all left to the professional judgement of the care planner from the Council or ICB, or if the person is privately funding their care, from the nurse manager, who is always a registered nurse. CQC requires management of care homes to consider their overall staff ratios and the dependency levels of all residents, because all are owed a duty of care.
But that does not mean that a care home cannot have a costing model whereby they translate their core offer to people – the room, the personal and social care, the nursing care that is ancillary or incidental to social care, and the food and activities, etc – into a model, which then translates into hours, with various dependency levels. That is because all homes need to factor in the cost of running the home, of regulation, of land acquisition costs, maintenance, development of new offers, marketing, and paying staff salaries plus oncosts. Some even factor in the cost of legal advice to get things right rather than wrong, but it all then gets divided into the room price, sometimes with one to one hours on top.
Q2. Are they breaking the Care Act?
A: You’ve not said whether the person is funded by a council under the Care Act. If so, the thing to hold their care plan up against would be the council’s own care plan which is a legal obligation which should have been provided after assessment to your relative or anyone supporting their involvement. That care plan is likely to be very woolly, these days, as councils leave it up to the care home’s planning, much of the time, but your relative’s rights come from that care plan, if she is publicly funded.
If she is privately funded, then no, the Care Act is not relevant, unless and until someone says that safeguarding should be called in for abuse or neglect concerns. I don’t think you’re at that stage as yet, from what you say.
Q3. Are dependency levels a national guideline or the Nursing homes criteria?
A: They are not a national ‘thing’. They tend to emerge from the way councils and ICBs structure their contracts when procuring willing providers for a given rate, or asking what providers would want to charge IF they were given clients of this that or the other raw profiles of anonymised need.
Or they sometimes tend to be used by canny care homes with their own contracts, when they are looking after mainly private clients. The good ones appreciate that they need a justification for raising the fees, in line with the Competition and Markets Authority’s guidance about fair fees in care homes – here’s the link to that document: https://assets.publishing.service.gov.uk/media/61b09fbde90e070448c520f0/CMA_care_homes_consumer_law_advice_—-.pdf
You can see this Guidance in practice in a report from the ombudsman about banding of dependency rates here: https://cascaidr.org.uk/2025/05/18/christadelphian-care-homes-was-not-transparent-about-care-fees-and-nor-did-it-give-adequate-notice-to-a-private-client/