What to do when a care home will not take someone back after hospital

Start with one question: is the home waiting for more information, or has it decided to end the placement? These need different next steps.

• If an assessment is outstanding, ask who will arrange it and what information the assessor needs.
• If the home says needs have changed, ask which needs it cannot meet and how it reached that view.
• If it is ending the placement, ask for the decision, reason, proposed end date and relevant contract terms in writing.

Keep a dated note of each conversation. Ask for unclear points to be confirmed by email or letter. Independent Age explains the documents to gather when a care home asks someone to leave.

Ask the hospital and home whether they are working from the same current information. A previous placement does not, by itself, establish that the home can meet needs after an illness or injury.

Ask which assessment supports the decision, whether a reassessment is needed and what support or adjustments have been considered. Where the council or NHS arranges or funds the placement, ask its relevant care coordinator to be involved.

The person should be involved in decisions about their care. Ask how they want family or carers involved. If their ability to make the particular decision is in doubt, ask the team how capacity and the appropriate decision making process will be addressed. Being a relative does not automatically give someone authority to make every decision.

Our residential and nursing care guide explains the different services. The assessment must establish what the person needs.

Tell the ward team promptly that the care home has not agreed to the return. Ask for the named discharge contact and a discussion involving the home and relevant health or social care staff.

Ask these questions:

• What care setting is being considered, and has it agreed it can meet the assessed needs?
• Is the arrangement temporary, for recovery or assessment, or intended to be longer term?
• Who will arrange care, equipment, medicines and transport?
• Who is responsible for payment, and when will the arrangement be reviewed?
• Who should be contacted if the plan changes or support is missing?

If a proposed discharge leaves essential support unresolved, tell the ward manager or discharge team which support is missing and ask how it will be addressed. Read our general hospital discharge guide for the wider planning checklist.

Ask the discharge team what information a prospective home needs and who will share it appropriately. Useful questions cover the current care plan, mobility and transfers, medicines, nursing input, eating and drinking, communication and support overnight.

Ask the prospective provider to confirm which needs it can meet, any outstanding assessment and the earliest date it could accept the person. A vacant room alone does not confirm a suitable placement.

Use our guide to choosing a care home when considering alternatives. If you need to search, find care homes by area and confirm suitability and availability directly with each provider.

Get a copy of the contract and ask the home to set out its position in writing. Request the date it considers the placement ended, the clause it relies on, an itemised calculation of any charges and how it has treated payments made in advance. Agree how belongings can be collected.

Consumer law requires fair terms. The CMA guidance addresses ending a contract when needs change and the treatment of advance payments. A disputed fee needs to be considered against the facts and contract; do not assume that a standard notice charge is always valid.

In an Ombudsman decision dated 14 October 2024, a home that could no longer meet a resident's needs agreed to refund fees. That decision concerned the particular contract and circumstances. It does not establish an automatic refund in every case.

If the council or NHS is paying, ask it to clarify the funding arrangements. For a disputed personal bill, seek independent consumer or legal advice before deciding how to respond.

For the immediate discharge plan, speak to the ward manager or discharge team. The hospital's Patient Advice and Liaison Service, known as PALS, can help with concerns about the hospital process.

For the home's decision or fees, ask for its complaints procedure and send a clear account of what you want it to address. Raise council assessment or funding concerns with the council involved.

The Local Government and Social Care Ombudsman can consider adult social care complaints, including privately arranged care, after the relevant organisation has had a chance to respond. Check its guidance on eligibility and timing. A complaint does not replace the immediate work of arranging appropriate care.

Independent Age explains options for advice and challenging a decision. Ask about advocacy if the person needs help to make their views heard.