Care home top-up fees

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. The total amount – including their contribution and yours – is called your personal budget. The council must show that at least one care home place available in your area meets your care needs for that amount of money. 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.

For more information on your rights around choice of care home accommodation, read our factsheet Paying care home top-up fees.

Who can pay top-ups?

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 have 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 have entered into a 12-week property disregard period
you have a deferred payment agreement with the council
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 the frequency of the payments and how much you’ll have to pay. If you’re unclear about, or disagree with, any aspect of the top-up fee agreement, do not sign it and seek advice. Call us on 0800 319 6789 to arrange to speak to an adviser.

Is your personal budget high enough?

The council must make sure that your personal budget is high enough for you to get the care you need according to the care needs assessment they carried out. 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 mustn’t be asked to pay a top-up fee if your personal budget isn’t high enough to pay for a care home to cover your care 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 proportionally, so be aware that the top-up fee could become disproportionately higher. Check for information about fee increases in the contract.

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 simply to 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 arrange to speak to an adviser.

Challenging a request for a top-up fee

You might be able to challenge a top-up request on a number of grounds. For example:

you weren’t offered a care home within your 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. See our factsheet 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 to arrange to speak to an adviser.