Some families end up subsidising elderly relatives‟ care home fees because councils do not give them the advice and support they‟re legally obliged to provide, says a new report, launched today (17 July 2013) by older people‟s charity, Independent Age.

Councils are required to check that so-called „top-up payments‟ – paid by relatives to improve the quality of council-funded care - are voluntary and that families can afford to pay them. But the new report, Care home top-up fees: the secret subsidy, based on Freedom of Information requests to all 152 English councils, has found that most councils do not carry out these checks properly. Independent Age says it receives one call every working day from relatives concerned about top-up fees – which can amount to several hundred pounds a week.

The report also voices the concerns of care homes that top-up payments are being paid by relatives because the care home fees paid by councils are too low.

“This report demonstrates a real concern that top-up fees are becoming a „secret subsidy‟ by which some underfunded councils limit the amount they spend on care,” says Independent Age chief executive Janet Morrison. “But because councils are not keeping records of the payments, no one can be sure about the true level of top-up fees – or whether they are really voluntary. Many families are being given no information, no support – and no choice.”

Of the 129 councils that responded to the Freedom of Information requests, three quarters (72%) did not know about all top-up fee payments in their area – and so cannot have made sure that all relatives were „able and willing‟ to pay them, as they are legally required to do. Only 36 councils – the „good‟ councils, according to the report – said they knew about all top-up fee contracts in their area but 36 – the „bad‟ ones - said they had no information at all. Meanwhile, 57 „ugly‟ councils – had only incomplete information.

The report found that only 1 in 4 councils signposted families to independent advice prior to signing top-up agreements and only 1 in 5 councils carried out annual checks to ensure that relatives can still afford top-up fee payments. This is despite councils being legally responsible for the full amount of top-up fee contracts should relatives be unable to pay.

Martin Green, Chief Executive of the English Community Care Association, which conducted a survey of care homes in England for the report, says, “This is an extremely comprehensive and helpful reminder of the need for councils to be better aware of their responsibilities around „top-ups‟. It demonstrates yet again the concern around inadequate fees paid by councils to care homes and most importantly, that individuals and their families need independent financial and other advice and support when a move to a care home is being considered. We urge that the report‟s recommendations are closely studied by all parties and addressed, in order to ensure the law is followed and individuals receive consistent and high quality advice on their rights and responsibilities regarding top-up payments.”

Notes to editor

For media enquiries, contact Rebecca Law on 020 7605 4291 or 07545 209 589, or email

About the report

Care Concerns 2013

Care home top-up fees: the secret subsidy

In addition to data and case studies from the Independent Age Advice Service, the report draws upon two completely new pieces of research:

- a Freedom of Information request to all 152 local authorities in England, asking them about the extent and level of top-up fees in their area and their policies and practices for handling them. 129 councils responded.

- a survey of care homes in England, kindly facilitated by the English Community Care Association (ECCA), asking homes for their experience of top-up fees.

About Independent Age

Founded 150 years ago, Independent Age is a growing charity empowering older people across the UK and Ireland through the „A, B, C‟ of advice, befriending and campaigning. We offer a national telephone and email advice service focusing on social care, welfare benefits and befriending services, which is supported by a wide range of printed guides and factsheets. This is integrated with on-theground, local support, provided by a network of over 1,500 volunteers offering one-to-one and group befriending.

For more information, visit our website Speak to one of our advisers for free and confidential advice and information. Lines are open Monday to Friday between 10am - 4pm. Call 0845 262 1863 or email

About ECCA

ECCA works to ensure that care services are commissioned fairly, efficiently and on a properly funded basis, to meet the true costs of providing appropriate care. Visit

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