If your council is paying for some or all of your care but you’d like to move somewhere that costs more than they’ll pay, you might be able to make up the difference with a top-up fee.
What is a top-up fee?
If your council is contributing towards your care home fees, they must tell you how much they think your care should cost. They will work out how much you will have to pay in a financial assessment. The total amount – including their contribution and yours – is called your personal budget.
The council must show there is at least one place available at a care home in your area that meets your care needs and is within your personal budget. 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 your personal budget. This is a top-up fee.
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:
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 and how any annual increase in costs will be shared.
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.
Is your personal budget high enough?
The council will have carried out a care needs assessment to make sure your personal budget is high enough for you to 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.
Your relative or friend mustn’t be asked to pay a top-up fee if your personal budget isn’t high enough to pay for a care home that meets your needs. Instead, the council must increase their contribution to your personal budget to cover the extra costs. For example, if your needs assessment states that you need to be near to your family, the council must cover the additional cost of this if it means you need a care home place in a more expensive area.
Sometimes, the council may only increase your personal budget temporarily until a suitable cheaper care home place becomes available.
Care home fee increases
Care home fees usually increase annually but the council may not increase its contribution to your personal budget, so be aware that your top-up fee could increase.
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 your personal budget to cover the care home fee increase. Check for information about fee increases in the contract with the care home.
What happens if I can no longer afford to pay a top-up fee?
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. For more information, call us on 0800 319 6789 to speak to an adviser.
Challenging a request for a top-up fee
You might be able to challenge a top-up fee request on a number of grounds. For example:
you weren’t offered a suitable care home within your personal budget
your care needs assessment didn’t record all your needs
the council has refused to increase your personal budget to meet your assessed care needs.
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.