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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Commissioning, Contracts and Resident Agreements Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} establishes, maintains and reviews robust, transparent and legally compliant systems for commissioning arrangements, placement agreements, resident contracts, service specifications and contractual relationships connected with the operation of its care home services in England. This includes contracts and arrangements with local authorities, NHS bodies, Integrated Care Boards, self-funding residents, representatives, deputies, attorneys, advocates, and relevant third-party providers.

This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the Care Quality Commission (Registration) Regulations 2009, the Care Act 2014, the Mental Capacity Act 2005, the Equality Act 2010, UK GDPR and the Data Protection Act 2018, and relevant consumer protection requirements applying to care home contracts.

The policy is designed to ensure that contractual arrangements promote safe, effective, caring, responsive and well-led services; protect residents’ rights, dignity, safety and wellbeing; support transparent fees and charges; and provide clear evidence for CQC that the service has effective governance, risk management, quality monitoring and accountability arrangements.

2. Scope

This policy applies to all commissioning, contracting, placement, admission, funding and contractual review arrangements relating to residents living in {{org_field_name}}’s care home service(s) in England.

It applies to arrangements with:

• local authorities;
• Integrated Care Boards;
• NHS England where relevant;
• NHS trusts or other NHS commissioners;
• self-funding residents;
• residents’ representatives;
• attorneys appointed under a Lasting Power of Attorney;
• Court of Protection deputies;
• advocates;
• appointees;
• families involved with the resident’s consent or lawful authority;
• and third-party providers or contractors involved in delivering or supporting care, accommodation, nursing, therapy, catering, maintenance, transport, equipment or other services affecting residents.

This policy applies before admission, during contract negotiation, at admission, during any change in assessed need or funding status, at contract review, when fees or terms change, when services are varied, and when a resident’s placement ends, including planned moves, emergency moves, hospital admission, death, safeguarding concerns, or service closure.

3. Related Policies

• CH04-Good Governance
• CH07-Person-Centred Care Policy
• CH09-Consent to Care Policy
• CH11-Safe Care and Treatment Policy
• CH13-Safeguarding Adults from Abuse and Improper Treatment Policy
• CH14-Receiving and Acting on Complaints Policy
• CH18-Risk Management and Assessment Policy
• CH36-Initial Assessment and Care Planning Policy

4. Principles of Commissioning and Contract Management

Legal and Regulatory Compliance

All commissioning, placement and contractual arrangements entered into by {{org_field_name}} must comply with applicable legislation, regulatory requirements and statutory guidance in England. This includes, but is not limited to, the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the Care Quality Commission (Registration) Regulations 2009, the Care Act 2014, the Mental Capacity Act 2005, the Equality Act 2010, UK GDPR and the Data Protection Act 2018.

Contracts and placement arrangements must support compliance with the CQC fundamental standards, including Regulation 9 person-centred care, Regulation 9A visiting and accompanying, Regulation 10 dignity and respect, Regulation 11 consent, Regulation 12 safe care and treatment, Regulation 13 safeguarding, Regulation 16 complaints, Regulation 17 good governance, Regulation 18 staffing, Regulation 19 fit and proper persons employed, Regulation 20 duty of candour and Regulation 20A display of performance assessments.

{{org_field_name}} will not enter into, continue or vary a contract where the terms would prevent the service from meeting residents’ assessed needs, compromise safety or dignity, unlawfully restrict rights, create an unmanaged safeguarding risk, or prevent compliance with CQC registration conditions.

Clear, Fair and Transparent Contracting

Before admission, and before any contract is signed, {{org_field_name}} will provide the resident and/or their lawful representative with clear, accurate and accessible information about the service, accommodation, care to be provided, fees, what is included in the weekly fee, what may be charged separately, payment arrangements, deposits or advance payments, NHS or local authority funding arrangements where applicable, third-party top-ups, review arrangements, notice periods, complaints processes, termination provisions and circumstances in which fees may change.

Resident contracts and service agreements must be written in plain English and must not contain unfair, misleading or unclear terms. Any important or unusual terms must be brought clearly to the attention of the resident or their representative before the contract is signed. The resident or representative must be given sufficient time and support to read, understand and ask questions about the contract.

Contracts must clearly set out:

• the parties to the agreement;
• the resident’s room or accommodation arrangements;
• the care and support included;
• nursing input where applicable;
• agreed start date;
• trial or settling-in arrangements;
• fees and payment frequency;
• what happens during hospital admission or temporary absence;
• arrangements following death;
• review dates;
• changes to assessed need;
• changes to funding status;
• how fee increases are calculated and communicated;
• complaints arrangements;
• safeguarding escalation;
• termination rights;
• notice periods;
• safe exit planning.

Where the resident lacks capacity to enter into a contract, {{org_field_name}} will identify whether there is a legally authorised person able to sign or agree the contract, such as an attorney under a valid Lasting Power of Attorney or a Court of Protection deputy. Where no such person exists, best interests decision-making will be followed under the Mental Capacity Act 2005, and the resident’s rights and interests will be protected.

Person-Centred Approach to Commissioning

We work collaboratively with commissioners and the people we support to ensure the service specification reflects their individual needs, choices, cultural preferences, and circumstances. Each package of care is based on a comprehensive needs assessment and a person-centred care plan. We do not accept or enter into contracts that conflict with the preferences or best interests of the person receiving care.

Before accepting any placement, {{org_field_name}} will confirm that the care home can safely and lawfully meet the resident’s assessed needs, preferences, communication needs, cultural needs, religious needs, dietary needs, disability-related needs, visiting and relationship needs, and any needs arising from dementia, mental health conditions, sensory impairment, learning disability or autism. The decision to accept a placement must be based on the resident’s needs and the service’s ability to meet those needs safely, not solely on room availability or funding.

Due Diligence, Admission Suitability and Risk Assessment

Before entering into a commissioning, placement or resident contract, {{org_field_name}} will complete proportionate due diligence and risk assessment. This will include consideration of the resident’s assessed needs, dependency level, mental capacity, consent, safeguarding risks, moving and handling needs, medication needs, nutrition and hydration needs, clinical or nursing needs, behavioural or distress-related support needs, infection prevention and control risks, equipment requirements, environmental suitability, staffing skills and staffing numbers.

For third-party providers and contractors, due diligence will include confirmation of identity, role, qualifications where relevant, professional registration where required, insurance, safeguarding arrangements, data protection arrangements, health and safety compliance, CQC registration where the subcontracted activity is a regulated activity, and evidence that workers are fit and proper for the work they will carry out.

Risks must be recorded in the contract risk log or admission risk record, allocated to a responsible manager, reviewed at agreed intervals, and escalated without delay where a risk could affect resident safety, continuity of care, regulatory compliance or contractual viability.

Monitoring of Contracts, Placements and Quality Performance

All contracts and placements will be monitored to ensure that contractual obligations continue to support safe, effective, caring, responsive and well-led care. Monitoring will include, where relevant: resident outcomes; resident, family and representative feedback; complaints and compliments; safeguarding concerns; incidents and accidents; falls; medication errors; staffing levels; agency use; staff training and supervision; dependency changes; hospital admissions; infection prevention and control issues; nutrition and hydration risks; contract variations; fee disputes; delayed payments; and any concerns raised by commissioners, professionals or CQC.

Contract and placement review meetings will be held at agreed intervals and sooner where there is a significant change in need, risk, funding, mental capacity, safeguarding concern, complaint, deterioration in health, or concern about the suitability of the placement.

The Registered Manager or nominated senior manager will ensure that learning from contract monitoring is included in governance meetings, quality assurance audits and service improvement plans.

Managing Changes and Variations

Any changes to care packages, pricing, or contractual terms must be formally agreed and documented in writing. We maintain a variation log and ensure that staff are notified of updates through the care planning and rota systems. Where changes impact the person’s wellbeing or needs, we update their care plan and carry out a risk reassessment.

Where a resident’s needs change, the care plan, risk assessments, dependency assessment, staffing considerations and contractual arrangements must be reviewed together. Any proposed change to fees, services, accommodation, funding responsibility or contractual terms must be explained clearly to the resident and/or lawful representative before implementation, unless urgent action is required to protect the resident’s safety or wellbeing. Evidence of discussion, agreement, best interests decision-making where applicable, and any commissioner approval must be retained.

Financial Clarity, Fees, Invoicing and Payment Disputes

{{org_field_name}} will ensure that fees and charges are transparent, accurate and clearly explained before admission and throughout the resident’s stay. The resident contract or placement agreement must state the weekly fee, what the fee includes, what is excluded, any additional services or optional charges, payment frequency, invoicing arrangements, deposit or advance payment requirements, fee review process, notice of fee increases, non-payment process, and arrangements during temporary absence, hospital admission, end of placement and death.

Invoices will be generated according to the contract or placement agreement and will be based on the agreed fees and services provided. Any billing discrepancy, fee query, non-payment issue or funding dispute will be handled promptly, sensitively and fairly, taking account of the resident’s wellbeing and the need to avoid disruption to care.

Where a resident is funded by a local authority, NHS body or Integrated Care Board, {{org_field_name}} will maintain clear records of funding approvals, purchase orders, agreed rates, resident contributions, top-up arrangements and any correspondence relating to fee disputes or changes in need.

Contractors, Subcontractors and Partnership Agreements

Where {{org_field_name}} uses contractors, subcontractors, agency staff, visiting professionals or partner organisations to support the delivery of care, accommodation or services to residents, the Registered Manager or nominated senior manager must ensure that appropriate checks, agreements and monitoring arrangements are in place.

Before work begins, {{org_field_name}} will confirm, as applicable, the contractor’s identity, competence, qualifications, professional registration, DBS status where required, insurance, safeguarding arrangements, health and safety compliance, infection prevention and control arrangements, confidentiality obligations, data protection compliance, complaints process and escalation route.

Where a contractor or subcontractor carries out a regulated activity, {{org_field_name}} must confirm that the provider is appropriately registered with CQC for that regulated activity. Contractual arrangements must require contractors to comply with the home’s safeguarding, confidentiality, infection prevention and control, health and safety, equality, dignity and respect, complaints and incident reporting requirements.

Contractor performance will be reviewed proportionately according to risk. Any concern about safety, competence, conduct, safeguarding, quality or contractual compliance must be escalated to the Registered Manager and acted on without delay.

Contract Termination and Exit Planning

We include clear terms in each contract about how services may be ended, whether by the person receiving care, their representative, a commissioner, or {{org_field_name}}. Our exit planning includes a safe transition process, handover of records, and continuity of care to prevent disruption. Where notice periods are waived due to safeguarding or critical needs, emergency protocols are followed.

Where {{org_field_name}} is considering ending a placement or resident contract, the decision must be approved by the Registered Manager and provider representative, except in an emergency. The decision must be based on clear evidence, must be proportionate, and must consider the resident’s safety, wellbeing, mental capacity, safeguarding risks, equality and human rights, and the availability of suitable alternative care.

The service will not terminate a placement in a way that places the resident at avoidable risk. Where a resident’s needs can no longer be safely met, {{org_field_name}} will work with the resident, their representative, commissioners, health and social care professionals and safeguarding teams where relevant to arrange a safe transition.

Where a placement ends because of death, fees, room clearance, belongings, records, notification, invoicing and communication with relatives or representatives will be managed sensitively and in accordance with the resident contract, applicable law and good practice.

Record-Keeping, Confidentiality and Evidence for CQC

All contracts, resident agreements, placement agreements, funding approvals, top-up agreements, pre-admission assessments, mental capacity assessments, best interests records, correspondence, meeting notes, service specifications, fee notices, contract variations, risk assessments, complaints, safeguarding records and termination records must be accurate, complete, securely stored and accessible to authorised staff.

Records must show who agreed the contract, the legal authority relied upon where the resident lacked capacity, what information was provided before admission, what fees and terms were explained, what risks were identified, what actions were agreed, and how the resident’s rights, choices and safety were protected.

Records will be retained and shared in accordance with UK GDPR, the Data Protection Act 2018, confidentiality requirements, safeguarding duties, contractual obligations and CQC requirements. Records must be available for CQC inspection where lawfully requested.

Resident Contracts, Self-Funders and Third-Party Top-Ups

Where a resident is self-funding, partly self-funding, or subject to a third-party top-up arrangement, {{org_field_name}} will ensure that the financial responsibility of each party is clearly documented before admission wherever practicable. The service will not rely on verbal agreements for fees, top-ups, deposits, additional services or notice periods.

Where a local authority or NHS body commissions or funds the placement, {{org_field_name}} will ensure that the contract or placement agreement confirms the assessed care needs, agreed funding, resident contribution where applicable, any lawful top-up arrangement, review responsibilities, invoicing arrangements, dispute resolution process and escalation route if the resident’s needs change.

Third-party top-up arrangements must be transparent, voluntary, properly documented and reviewed if the resident’s needs, placement suitability or funding status changes. Staff must not pressure relatives or representatives to agree to payments where they do not have legal responsibility or where the arrangement has not been properly explained.

CQC Assessment Framework and Evidence

{{org_field_name}} will ensure that commissioning and contractual arrangements support CQC’s current assessment framework and the five key questions: safe, effective, caring, responsive and well-led. The service will maintain evidence showing that contracts, placement decisions and resident agreements are person-centred, lawful, transparent, risk-assessed, monitored and reviewed.

Evidence may include pre-admission assessments, care plans, contract review records, resident and representative feedback, quality audits, commissioner feedback, safeguarding records, complaints and learning, staffing reviews, training records, meeting minutes, improvement plans, and records of action taken in response to identified risks.

The Registered Manager will ensure that contract-related governance information is included in quality assurance processes and is available to demonstrate compliance with Regulation 17 good governance.

Learning Disability and Autism Training in Contracted Arrangements

Where a resident has a learning disability, is autistic, or may require support from staff with specific knowledge of learning disability or autism, {{org_field_name}} will ensure that staff involved in assessment, admission, contracting, care planning and service delivery receive learning disability and autism training appropriate to their role.

The service will have regard to the Oliver McGowan code of practice on statutory learning disability and autism training and will maintain records showing how relevant staff training has been planned, delivered, monitored and reviewed. Contractors and agency providers involved in direct care or support must provide assurance that their workers have appropriate training for the role they undertake.

Visiting, Family Involvement and Accompanying

Resident contracts and placement arrangements must not unlawfully restrict visiting, contact with family or friends, advocacy, or support from people who are important to the resident. Any visiting arrangements must comply with Regulation 9A where applicable, the resident’s rights and preferences, safeguarding requirements, infection prevention and control requirements, and any lawful restrictions based on individual risk assessment.

Where a resident wishes family members, friends, advocates or representatives to be involved in reviews, contract discussions or decisions, this will be supported unless there is a lawful reason not to do so.

5. Staff Responsibilities and Training

The Registered Manager is responsible for ensuring that commissioning, placement and contractual arrangements are lawful, transparent, person-centred, risk-assessed and properly monitored. The Registered Manager must ensure that staff understand their responsibilities under this policy and that concerns about contracts, placements, fees, risk, safeguarding, mental capacity, complaints or quality are escalated through the governance structure.

Managers and team leaders involved in commissioning, admissions, contract management, resident agreements, fee discussions or placement reviews must receive training and support appropriate to their role. This may include training in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, CQC requirements, Regulation 17 good governance, Regulation 18 staffing, Regulation 19 fit and proper persons employed, safeguarding, Mental Capacity Act 2005, equality and human rights, consumer law principles, complaints handling, confidentiality, data protection, record keeping and contract escalation.

Staff providing care under commissioned or contractual arrangements must be briefed on the resident’s assessed needs, care plan, risks, communication needs, preferences, contractual service expectations and escalation routes. Staff must not agree changes to fees, contractual terms, funded hours, placement status or service withdrawal unless they are authorised to do so.

Where agency staff, contractors or subcontractors are used, the service must obtain assurance that they are competent, suitable, appropriately trained and safely deployed. This includes assurance that workers are fit and proper for the work they undertake.

6. Policy Review

This policy will be reviewed at least annually and sooner where there are changes in legislation, CQC guidance, CQC assessment methodology, commissioning requirements, consumer law guidance, contractual practice, safeguarding learning, complaints themes, serious incidents, service changes or organisational learning.

The Registered Manager and provider representative will ensure that any changes are communicated to relevant staff and embedded into practice through supervision, team meetings, training, audits and governance review.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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