Care top-up fees

    Care top-up fees

    When a relative is financially assessed to determine if they should fund their own care, whether at home or in a care home, relatives may be asked if they are prepared to pay a top-up.

    Firstly it is important to remember that no questions should be asked about a person’s ability to fund their own care before they are assessed for their care needs using a Continuing Healthcare Checklist.

    If this has been correctly carried out and care needs are determined to be social care, a financial assessment may be carried out to assess ability to fund care.


    If you have savings/assets over the threshold of £23,250, you will be self-funding and there is no need to disclose your personal financial affairs to the Local Authority, even if they request you to do so.

    They will still be obliged to ensure that your care needs are correctly assessed and, if an intermediate package of care is required, arrange for this to be put in place. Often families feel abandoned when a relative has the means to pay for care above the threshold but no one is interested in assisting them with care and support providers.

    What is an Intermediate Care Package?

    An Intermediate Care Package is a specific type of short term care that can be offered without charge, generally for a maximum period of 6 weeks.

    It is available to anyone aged 18 or over but more usually offered to older people, with the aim of:

    • avoiding unnecessary hospital admission, or
    • avoiding long term or permanent care home admission
    • helping you remain living at home if due to illness or disability, you are having increasing difficulty with daily life, or
    • allowing time to recover before any decision is made regarding long term care.

    Third-party top-up fees

    If you have been assessed as requiring Local Authority Funding, family may be asked if they are willing to pay a top-up to meet the additional cost of care. Relatives must be very careful when entering such an arrangement. They will have to be willing to meet the additional cost for the likely duration of the arrangement, recognising that this may be for some time into the future.

    Third-party top-ups should only be used after taking advice on the contract, particularly in relation to what happens if/when:

    • The person in care’s needs increase and the weekly fee is increased
    • The fee is increased each year
    • They can no longer afford the top-up

    If you have a need, rather than a preference, to live in a particular care facility that is more expensive than the Local Authority will agree to fund, it is important to seek legal advice as Social Services may increase the funding contribution and thus lower the top-up requirement.

    Should you be paying top-up fees?

    Top-up fees are usually associated with the additional costs of accommodation. It is very important to understand the difference between assessed clinical health needs and social needs as this is vital to determine whether top-up fees should legally be charged.

    If a person is already receiving NHS Continuing Healthcare Funding, the care home should not charge top-up fees. NHS Continuing Healthcare Funding is supposed to be provided free at the point of when you need it. All of the costs required to meet care needs should be met by the NHS where a person has primarily healthcare needs. The National Framework is clear about this:

    “NHS care is free at the point of delivery. The funding provided by the CCGs in NHS Continuing Healthcare packages should be sufficient to meet the needs identified in the care plan. Therefore, it is not permissible for individuals to be asked to make any payments towards meeting their assessed needs”.

    Do you need help and advice with funding issues?

    To find out whether you may be eligible for funding, please do not hesitate to contact our team who will be happy to help.

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