If your council assesses you as needing to move into a care home, they must ensure this need is met. If they're contributing towards your care home fees, they must tell you how much they think your care should cost. At your financial assessment, your council will work out how much you will have to pay towards your care, and whether you are entitled to financial help from the council. For more information, read our guides Paying care home fees in England and Wales and Paying care home fees in Scotland. 

In England and Scotland, the council must show there is at least one place available at a care home in your area that:

• meets your care needs, and
• does not cost more than the cost of your care (in England, this total amount is known as your personal budget).

In Wales, the council must give you at least 2 different care homes that fit this criteria, so you can decide which one you would prefer.

If you’d prefer a different, more expensive home, you may still be able to move there if someone pays the difference between the fees and the cost of your care. This is a top-up fee.

For more information on choosing care homes, see our webpage Choosing the right care home.

You can’t usually pay your own top-up fees; they’re generally paid by a third party, such as a friend, relative or charity. If you’ve agreed to pay a top-up fee for someone else, you’ll be asked to sign a contract, preferably with the council who will then pay the care home. The council must be satisfied that you’re willing and able to pay the top-up fee for as long as it’s needed.

You can only pay your own top-up fees in one of the following situations:

• you've just moved permanently into a care home and are in the 12-week property disregard period 
• you have a deferred payment agreement with the council
• if, in Scotland, you are better off as a result of receiving personal or nursing care payments from the council and have capital over the upper capital limit (currently £32,750). You can only top-up the difference between what you are paying towards your accommodation costs, and what you would be paying if you hadn't qualified for those payments.
• if, in England, your accommodation is being provided under section 117 of the Mental Health Act 1983 as aftercare.

The contract for the top-up fee must explain important points, including:

• how much the top-up payments will be
• how often they’ll need to be paid
• what might happen if you or your chosen third party can no longer afford the top-up
• how any annual increase in costs will be shared (in England and Wales)
• what will happen if your care needs change (in Scotland).

If you’re unclear about, or disagree with, any aspect of the top-up fee agreement, do not sign it and get advice instead. Call our Helpline on 0800 319 6789 to arrange to speak to adviser.

If your chosen home is more expensive than the cost of your care

This is when you may need to arrange top-up fees. However, before asking for a top-up, the council must be able to show that:

• there is another care home within the cost of your care that can meet your needs, and
• a place is currently available in the home they have found.

Only after this can they say you have chosen a more expensive home and will need to arrange a top-up to be able to move there. Our Helpline can help if you’re unsure which care home to choose.

If you were paying all your care home fees, but your money is running out

If you’re already living in a care home and paying your own fees, and your capital falls below a certain amount (£23,250 in England, £32,750 in Scotland or £50,000 in Wales), you’ll usually qualify for some help from your council to pay the fees. However, it may be that your care home charges more than the amount the council thinks is required to meet your care needs.

If this is the case, and there are other suitable care homes available which are less expensive, the council may either:

• ask you to move to a cheaper home, or
• ask you to pay a top-up fee so you can stay in your chosen care home.

Before making this decision, the council would first need to consider how this might impact your care needs and wellbeing. For more advice, call our Helpline.

The council will have carried out a care needs assessment to assess your care needs and to decide the cost of your care. This needs to be enough money to ensure you get the care you need. The assessment must consider what your care and support needs are and the impact of these needs on your physical and mental health, emotional and social wellbeing, and personal relationships, among other things.

If your care needs change, it may mean that it will cost more to meet your needs. In this case, the council must consider increasing the amount it is prepared to pay – for example, they may agree that:

• you need to move to a more expensive part of the country to be nearer to family
• the cost of your care is higher because of your particular care needs. For instance, if your first language isn’t English, your council may need to pay more for a care home where they can talk to you in your first language
• your eligible needs can only be met in a specialist care home, such as one that caters for the needs of someone who is deafblind or that can meet your special dietary needs.

Sometimes, the council may only temporarily increase the amount they’re paying towards your care, until a suitable cheaper care home place becomes available.

Care home fees usually increase annually. Your top up agreement with the council should set out if the council will share the cost of these increases with you.

If your top up fee increases and you no longer wish to pay it, you can ask the council if there is another, cheaper care home in the area that can meet your care needs. If there is, you will have the option to move to this care home.

However, if there isn’t a cheaper care home available that can meet your care needs, the council will have to increase its contribution to the cost of your care, to cover the care home fee increase. Check for information about fee increases in the contract with the care home.

If the person paying the top-up fee can no longer afford to pay it, the council has to carry out a new care needs assessment before deciding what to do.

They won’t be able to just move you to a cheaper care home to resolve the need for the top-up fee. First, the council must consider whether the new care home can meet all your care needs and the impact the move might have on your health and wellbeing. In the meantime, the council would be responsible for covering the fees. For more information, call us on 0800 319 6789 to speak to an adviser.

You might be able to challenge a top-up fee request on a number of grounds. If, for example:

• you weren’t offered a suitable care home within the cost of your care
• your care needs assessment didn’t record all your needs
• the council has refused to increase the cost of your care, and you feel your care needs aren’t being met.

To challenge the request, you can use the council’s complaints procedure or seek legal advice. There is a time limit for using each of these procedures, so it’s important not to miss these deadlines. See our page Complaints about care and health services for more information.

If you’ve been asked for a top-up fee and don’t think you should have been, call us on 0800 319 6789 for advice.