Care Home Top-Up Fees Explained

Care home top-up fees can be one of the most confusing and risky parts of paying for care. Many families first hear about them during a stressful moment: a parent is ready to leave hospital, a care home has been found, the local authority has agreed to contribute, but there is a gap between what the council will pay and what the preferred care home charges.

That gap is often called a care home top-up fee. It may sound like a small extra payment, but it can become a long-term financial commitment. Top-up fees can continue for years, increase over time, and cause serious problems if the person paying can no longer afford them.

This guide explains what care home top-up fees are, when they apply, who can pay them, when they should not be requested, what to check before signing, and what happens if a top-up fee can no longer be paid.

If you are paying for care privately or trying to understand how self-funding works, read our full guide to self-funding a care home. You may also find our guides to care home fees and social care funding in the UK useful.

What is a care home top-up fee?

A care home top-up fee is an extra payment made when the care home someone chooses costs more than the amount the local authority is willing or able to pay for their assessed care needs.

For example, a local authority may agree that a person needs residential care and set a personal budget of £900 per week. If the family chooses a care home that charges £1,100 per week, there is a £200 weekly shortfall. That £200 may be treated as a top-up fee.

Top-up fees are usually paid by someone other than the person receiving care. This is why they are often called third-party top-up fees. The third party is commonly an adult child, another relative, a friend or occasionally a charity.

Simple example of a top-up fee

Here is a simple example:

• The local authority assesses your mother as needing a care home.
• The council calculates that it can pay £950 per week towards a suitable placement.
• You prefer a care home that costs £1,150 per week.
• The difference is £200 per week.
• That £200 per week may be requested as a third-party top-up fee.

At first, £200 per week may sound manageable. But over a year, it is £10,400. If the fee rises to £250 per week, that becomes £13,000 per year. If the placement lasts several years, the total can become very large.

When do care home top-up fees usually apply?

Top-up fees usually apply when all of the following are true:

• the person has been assessed as needing a care home;
• the local authority is contributing towards the cost;
• the council has calculated a personal budget for the person’s care;
• the preferred care home costs more than that personal budget;
• a third party agrees to pay the difference.

Top-up fees are most common when families choose a home because it is closer to relatives, has a larger room, has better facilities, provides a preferred environment, or is considered a better fit than the care homes available within the council’s budget.

When should a top-up fee not be requested?

A top-up fee should not be treated as automatic. The local authority should be able to show that the personal budget is enough to secure at least one suitable care home placement that can meet the person’s assessed needs.

In other words, if the council says, “We will only pay £900 per week,” there should normally be at least one suitable care home available at that amount. If every suitable care home costs more, the issue may not be that the family has chosen a more expensive preference. The issue may be that the council’s budget is not enough to meet the person’s assessed needs.

This is a very important distinction. A top-up fee may be appropriate when the family chooses a more expensive home for preference. It is much more questionable if the top-up is needed simply because there is no suitable care home available at the council’s rate.

If you are told a top-up is needed, ask the local authority:

• Which suitable care home is available within the personal budget?
• Can that home meet the person’s assessed needs?
• Is there a real vacancy?
• Is the home in a reasonable location?
• Has the person’s dementia, nursing, mobility, communication or cultural needs been considered?
• Is the higher-cost home genuinely a preference, or is it the only suitable option?

Who usually pays a care home top-up fee?

Top-up fees are usually paid by a third party. This is often:

• an adult child;
• a spouse or partner in some circumstances;
• another relative;
• a friend;
• a charity or benevolent fund.

The person living in the care home usually cannot pay their own top-up fee from their regular income or capital once the local authority is funding their placement. There are some exceptions, but the usual position is that a top-up is paid by someone else.

Possible exceptions may include situations involving a 12-week property disregard, a deferred payment agreement, or certain other arrangements where the person has access to disregarded income or capital. Because this area can be complicated, ask the local authority to explain the rule in writing if someone says the resident can pay their own top-up.

What is the difference between self-funding and a top-up fee?

Self-funding and top-up fees are often confused, but they are not the same thing.

Self-funding means the person pays for their own care because they do not qualify for local authority financial support, usually because their capital is above the relevant threshold.

A top-up fee usually applies when the local authority is already contributing towards care, but the chosen care home costs more than the local authority’s personal budget.

For example:

• If your father has savings above the upper capital limit and pays the full care home fee himself, he is self-funding.
• If your father qualifies for council support, but you choose a home that costs more than the council will pay, the extra payment may be a top-up fee.

For a full explanation of private payment, read our guide to self-funding a care home.

Why do top-up fees happen?

Top-up fees happen because there can be a gap between the local authority’s personal budget and the actual fee charged by a preferred care home.

This gap may arise because:

• the chosen home is more expensive than other suitable homes;
• the chosen room is larger or has better facilities;
• the home is in a more expensive area;
• the family wants a home closer to relatives;
• the person wants to stay in a particular home after self-funding;
• the care home charges private rates above local authority rates;
• the person needs specialist dementia or nursing care;
• there are limited vacancies locally.

Some of these reasons may justify a top-up. Others may mean the local authority needs to reconsider whether its budget is enough to meet the person’s needs.

Top-up fees and personal budgets

When the local authority agrees that someone has eligible care needs, it should calculate a personal budget. This is the amount the council says is needed to meet the person’s assessed needs.

The personal budget should be realistic. It should not simply be an arbitrary amount. If the person has dementia, nursing needs, mobility problems, behavioural distress, communication needs, cultural needs or other specific requirements, the budget should reflect what is needed to find suitable care.

If the council sets a personal budget too low and no suitable care home is available at that price, families should challenge this. A top-up should not be used to cover an inadequate personal budget.

Top-up fees and choice of care home

Families often want to choose a particular care home for good reasons. It may be close to family, have better dementia care, feel calmer, have a room available quickly, or seem more suitable for the person’s personality.

The local authority should normally allow some choice, but it does not have to pay unlimited fees if a suitable care home is available within the personal budget. If the family chooses a more expensive home for preference, a top-up may be needed.

The key question is whether the higher-cost home is a preference or a necessity.

Ask:

• Is there another suitable home available within budget?
• Can that home meet the person’s assessed needs?
• Would that home be reasonable for family contact?
• Does the preferred home offer something clinically or practically necessary?
• Is the person already settled in the preferred home?
• Would moving cause distress or risk?

Can a family be forced to pay a top-up fee?

A family member should not be forced to pay a top-up fee. A top-up is meant to be a voluntary agreement by someone who is willing and able to pay.

If nobody is willing or able to pay a top-up, the local authority must still meet the person’s eligible care needs. That may mean arranging a suitable care home within the personal budget. If no suitable home is available at that amount, the council may need to increase the budget.

Families should be cautious if they feel pressured with statements such as:

• “You have to pay this if you want your parent to be safe.”
• “There are no other options, so you must pay the difference.”
• “Just sign now and we will sort the details later.”
• “Everyone pays top-ups.”

If you feel pressured, ask for the local authority’s position in writing and consider getting advice before signing anything.

Can the resident pay their own top-up fee?

Usually, the person receiving care cannot pay their own top-up fee from ordinary income or capital once the local authority is financially supporting the placement. This is because their income and capital have already been considered through the financial assessment.

However, there are limited situations where a first-party top-up may be possible. These may include:

• during a 12-week property disregard;
• where there is a deferred payment agreement;
• where the person has certain disregarded income or capital.

Do not assume this applies. If the care home or council suggests the resident can pay their own top-up, ask for a written explanation of the legal basis and how long the arrangement can last.

Top-up fees during the 12-week property disregard

When someone moves permanently into a care home, their property may be included in the financial assessment unless a disregard applies. In some cases, the value of the property is ignored for the first 12 weeks. This is often called the 12-week property disregard.

During this period, the person may be able to pay a top-up from their own resources if they choose a home that costs more than the local authority’s budget. However, the rules are specific, and the arrangement may change after the 12 weeks.

Ask the local authority:

• Does the 12-week property disregard apply?
• Can the resident pay their own top-up during this period?
• What happens after the 12 weeks end?
• Will a third party need to take over the top-up?
• Is a deferred payment agreement being considered?

Top-up fees and deferred payment agreements

A deferred payment agreement is an arrangement where the local authority helps pay care home fees and the money is repaid later, usually when the person’s property is sold or after death. It is often used when someone has most of their wealth tied up in their home.

In some cases, a top-up may be included as part of a deferred payment arrangement, but this depends on the local authority’s rules, the value of the property, affordability and whether the arrangement is sustainable.

Before relying on a deferred payment agreement to cover a top-up, ask:

• Will the deferred payment cover the full care home fee?
• Will it cover the top-up amount?
• Is there enough equity in the property?
• What interest is charged?
• What administration fees apply?
• What happens if the care home increases its fees?
• What happens if the property takes a long time to sell?

Who should the top-up agreement be with?

Top-up arrangements should be clear and written down. In many cases, the agreement should involve the local authority, the care home and the person paying the top-up.

The agreement should explain:

• who is paying the top-up;
• how much will be paid;
• who the payment is made to;
• how often it is paid;
• when the amount can increase;
• what happens if payments stop;
• what happens if the care home fee rises;
• what happens if the resident’s needs change;
• what notice is required to end the agreement.

Do not rely on a verbal arrangement. If you are paying a top-up, you need a written agreement that you understand.

Should the top-up be paid to the council or the care home?

Top-up fees may be paid to the local authority or directly to the care home, depending on the arrangement. However, it is usually safer for the agreement to be clear and formally recorded, especially where the local authority is arranging the placement.

Ask:

• Who invoices me for the top-up?
• Who do I pay?
• Who do I contact if the amount changes?
• Does the council know about and approve the arrangement?
• What happens if the care home asks for extra money directly?

Be cautious about informal side agreements with a care home that are not properly recorded or understood by the local authority.

How long do top-up fees last?

A top-up fee may last for as long as the person remains in the more expensive care home and the local authority continues to pay only part of the fee.

This could be months, years or the rest of the person’s life. Nobody can know exactly how long a care home placement will last, so the person paying the top-up should think carefully about long-term affordability.

Before agreeing, ask yourself:

• Can I afford this weekly amount now?
• Could I afford it for one year?
• Could I afford it for three years?
• Could I afford it if the fee increases?
• Could I afford it if my own income changes?
• Would this affect my mortgage, rent, retirement, children or savings?

Do not agree to a top-up based only on short-term emotion or pressure. It is a real financial commitment.

Can top-up fees increase?

Yes. Top-up fees can increase if the care home raises its fees, if the local authority does not increase its contribution by the same amount, or if the resident’s needs change and the care home charges more.

For example:

• The care home fee is £1,100 per week.
• The council pays £950 per week.
• The top-up is £150 per week.
• The care home later increases the fee to £1,200 per week.
• If the council still pays £950, the top-up may rise to £250 per week.

Before signing, ask how fee increases are handled. The agreement should say how much notice you will receive and what happens if you cannot afford the increase.

What happens if you cannot pay the top-up anymore?

If the person paying the top-up can no longer afford it, the local authority should review the situation. The outcome depends on the circumstances.

Possible outcomes include:

• the care home agrees to reduce or remove the top-up;
• another family member takes over payment;
• the local authority increases the personal budget if the current home is now necessary to meet needs;
• the resident moves to another suitable care home within budget;
• there is a dispute about whether moving would be appropriate.

The local authority should not ignore the person’s wellbeing, needs and best interests. If the person is settled, has dementia, is frail or would be harmed by a move, this should be considered. However, if another suitable home is available within the council’s budget, a move may be proposed.

If you are struggling to pay a top-up, tell the local authority early. Do not wait until arrears build up.

Can a resident be moved if the top-up stops?

Possibly. If the top-up stops and the care home will not accept the local authority’s rate, the council may look for another suitable care home within the personal budget.

However, any move should consider the person’s assessed needs, wellbeing, mental capacity, emotional distress, dementia, family contact and whether the alternative home is genuinely suitable.

If you are worried about a proposed move, ask:

• Has the person’s care needs assessment been updated?
• Has the impact of moving been considered?
• Is the alternative home suitable?
• Can it meet dementia, nursing, mobility or communication needs?
• Has the person’s mental capacity been considered?
• Has family contact been considered?
• Can the decision be reviewed?

Top-up fees after a self-funder runs out of money

Top-up fees often become an issue when someone has been paying privately for a care home and their savings fall below the local authority threshold.

For example, your mother may have been self-funding a care home that costs £1,300 per week. When her savings reduce, the local authority assesses her and agrees to pay only £950 per week. The care home may then ask for a £350 weekly top-up if she is to stay.

This is why self-funders should plan early. If money is likely to run down, contact the local authority before savings are nearly gone. Ask the care home in advance whether it accepts local authority-funded residents and whether a top-up may be needed.

For more detail, see our guide to self-funding a care home.

Top-up fees and dementia care

Dementia care can make top-up decisions more sensitive. A person with dementia may become distressed by a move, especially if they are settled, recognise staff and rely on familiar routines.

If a top-up is requested for a dementia care home, ask whether the higher-cost home is needed because of the person’s dementia needs or whether it is simply a preference.

Important questions include:

• Can the lower-cost home safely support dementia?
• Can it manage distress, wandering, night-time confusion or personal care resistance?
• Would moving cause significant distress?
• Has the person’s mental capacity been assessed?
• Has best interests decision-making been followed if the person lacks capacity?
• Is the current home now the most suitable option because the person is settled?

You may also find our guide to dementia care homes in the UK helpful.

Top-up fees and nursing care

If someone needs nursing care, the local authority budget should reflect the cost of meeting those nursing-related needs where the council is responsible for arranging care. The person may also be assessed for NHS-funded nursing care or NHS Continuing Healthcare.

Before agreeing to a top-up for a nursing home, ask:

• Has NHS-funded nursing care been considered?
• Has NHS Continuing Healthcare been considered?
• Is the top-up needed because the chosen home is more expensive, or because the council budget is too low?
• Is there another suitable nursing home available within budget?
• Does the preferred home provide specialist nursing that the person needs?

If the person may have a primary health need, read our guide to NHS Continuing Healthcare.

Top-up fees and hospital discharge

Top-up fee pressure often happens during hospital discharge. Families may be told that a relative is medically fit for discharge and needs a care home quickly. In that situation, it can be hard to slow down and ask financial questions.

Before agreeing to a top-up during discharge, ask:

• Is this a temporary or permanent placement?
• Has a care needs assessment been completed?
• Has a financial assessment been completed?
• Is the local authority arranging the placement?
• Is there a suitable home available within the personal budget?
• Is the top-up only temporary?
• Who is asking for the top-up?
• What happens if I refuse?
• Can I see the agreement before signing?

Do not sign a long-term top-up agreement just because the discharge process feels urgent. Ask for written information and, if necessary, request time to get advice.

Top-up fees and care home contracts

Top-up fees should be considered alongside the care home contract. Families can accidentally take on more liability than they realise.

Before signing anything, check whether you are signing:

• a top-up agreement;
• a care home contract;
• a guarantor agreement;
• a third-party payment agreement;
• a local authority agreement;
• a direct agreement with the care home.

Ask directly:

• Am I personally responsible for unpaid fees?
• Is my liability limited to the top-up amount?
• Could I be liable for the full care home fee?
• Can the top-up increase?
• Can I end the agreement?
• What notice must I give?
• What happens if I die, lose my job or cannot pay?

If you do not understand the contract, do not sign it until you have had advice.

Common top-up fee mistakes families make

Assuming the top-up is short term

A top-up may continue for as long as the resident remains in the care home. Always plan for the possibility that it may last years.

Agreeing verbally

Never rely on a verbal understanding. The amount, duration, payment route and consequences of non-payment should be written down.

Not asking whether a suitable lower-cost home exists

The local authority should be able to identify at least one suitable option within the personal budget. If it cannot, the budget may need reviewing.

Forgetting about fee increases

A manageable top-up can become unaffordable if the care home increases its fees. Ask how increases are handled.

Signing as guarantor by mistake

Some families think they are only confirming paperwork but may be accepting financial liability. Read every document carefully.

Waiting until arrears build up

If you cannot afford the top-up, contact the local authority immediately. Waiting can create debt and reduce options.

Questions to ask before agreeing to a top-up fee

Before agreeing to pay a top-up fee, ask these questions:

• Why is a top-up fee needed?
• What is the local authority’s personal budget?
• What is the care home’s weekly fee?
• What is the exact weekly top-up?
• Is there a suitable care home available within the personal budget?
• Has that home got a real vacancy?
• Can it meet the person’s assessed needs?
• Is the preferred home more expensive because of choice or necessity?
• Who is expected to pay the top-up?
• Can the resident pay it, or must it be a third party?
• How long could the payment last?
• Can the amount increase?
• How much notice will be given of increases?
• What happens if I can no longer pay?
• Could the resident be moved?
• Who is the agreement with?
• Can I take the agreement away before signing?
• Am I being asked to act as guarantor?

What should be included in a top-up agreement?

A proper top-up agreement should include:

• the name of the resident;
• the name of the care home;
• the local authority contribution;
• the care home’s full weekly fee;
• the weekly top-up amount;
• who is paying the top-up;
• who receives the payment;
• payment frequency;
• how increases are handled;
• what happens if payment stops;
• what happens if care needs change;
• what happens if the care home fee rises;
• review arrangements;
• notice periods;
• signatures from the relevant parties.

If any of these points are unclear, ask for clarification before signing.

How to challenge a top-up fee

If you think a top-up fee is unfair or wrongly requested, you can challenge it.

Reasons to challenge may include:

• no suitable care home is available within the personal budget;
• the council has not properly assessed the person’s needs;
• the personal budget is too low;
• the person needs specialist care that costs more;
• the family has been pressured to pay;
• the agreement was not explained properly;
• the top-up has increased without proper notice;
• the resident may be harmed by moving.

Steps you can take include:

1. Ask the local authority for a written explanation of the top-up.
2. Ask which suitable care home is available within the personal budget.
3. Request a review of the care needs assessment.
4. Request a review of the personal budget.
5. Put your concerns in writing.
6. Use the local authority complaints process.
7. Seek advice from Age UK, Citizens Advice, a care fees adviser or a solicitor if needed.
8. If unresolved, consider whether the Local Government and Social Care Ombudsman may be relevant.

What if the care home asks for extra money directly?

If the local authority is arranging the placement, be cautious if the care home asks you directly for extra payments that have not been agreed through the proper process.

Ask:

• Is this a top-up fee?
• Does the local authority know about it?
• Is it included in the written agreement?
• Is it optional or required?
• What service is the extra charge for?
• Can I refuse it?

There is a difference between optional extras, such as hairdressing or outings, and an ongoing top-up fee required to keep the placement. Make sure you know which one you are being asked to pay.

Are top-up fees the same as extra charges?

No. A top-up fee is usually the difference between the local authority’s budget and the care home’s core weekly fee. Extra charges are separate payments for additional goods or services.

Extra charges may include:

• hairdressing;
• chiropody;
• newspapers;
• private phone lines;
• premium activities;
• trips;
• toiletries;
• clothing;
• escorts to appointments.

Ask the care home for a written list of what is included in the weekly fee and what is charged separately.

Should you pay a top-up for a better room?

Sometimes families choose to pay a top-up because the resident wants a larger room, an en-suite bathroom, a garden view or a specific part of the home. This may be reasonable if the family can afford it and understands the commitment.

Before agreeing, ask:

• Is the top-up only for the room?
• What happens if the resident later moves rooms?
• Does the top-up reduce or stop if the room changes?
• Can the room fee increase?
• Is there a suitable standard room available without a top-up?

Make sure the agreement explains exactly what the top-up is paying for.

Should you pay a top-up to keep someone close to family?

Many families choose a more expensive care home because it is close enough for regular visits. This can be very important. Family visits can support wellbeing, help staff understand the resident, and make it easier to notice changes or concerns.

However, affordability still matters. If the top-up is too high, the arrangement may break down later.

Ask the local authority whether location and family contact have been considered as part of wellbeing. If the only affordable home is far away and would seriously reduce family contact, this may be relevant to whether it is truly suitable.

Should you pay a top-up for a better-rated care home?

Families may prefer a care home with a stronger inspection report, better reputation or more positive atmosphere. That is understandable. But the local authority may say that another home is still suitable if it can meet the person’s assessed needs.

Before agreeing to a top-up, compare:

• CQC reports;
• staffing;
• dementia or nursing capability;
• location;
• family visiting;
• room suitability;
• resident wellbeing;
• long-term affordability.

For quality signs to look for, read our guide to what a good care home looks like.

Can top-up fees be backdated?

Families should be cautious about backdated top-up requests. If someone asks you to pay a top-up for a period before you agreed to it, ask for a written explanation.

Ask:

• When was the top-up first discussed?
• When was it agreed?
• Was there a written agreement?
• Who signed it?
• Why is backdated payment being requested?
• Did the local authority approve the arrangement?

Do not pay large backdated sums without understanding the basis for the request.

Can a top-up fee be reduced?

Sometimes. A top-up may be reduced if the care home agrees to lower its fee, if the local authority increases the personal budget, if the resident moves rooms, if care needs are reassessed, or if the agreement is renegotiated.

If the top-up has become unaffordable, ask for a review. Explain the financial change clearly and provide evidence if needed.

Do not simply stop paying without telling anyone. Contact the local authority early so it can review the placement and consider options.

Top-up fee checklist before signing

Before signing a top-up agreement, make sure you can answer all of these questions:

• Do I understand why the top-up is needed?
• Has the local authority identified a suitable home within budget?
• Is the preferred home a genuine choice or the only suitable option?
• Do I know the weekly top-up amount?
• Do I know how and when it is paid?
• Do I know whether it can increase?
• Can I afford it long term?
• Do I know what happens if I cannot pay?
• Do I know whether the resident could be moved?
• Have I read the written agreement?
• Am I signing only for the top-up, or am I guaranteeing wider fees?
• Have I had advice if I am unsure?

When to get advice about top-up fees

Consider getting advice if:

• you feel pressured to pay;
• the top-up is large;
• the agreement is unclear;
• you are asked to sign as guarantor;
• you cannot afford the top-up long term;
• the council has not identified a suitable home within budget;
• the person has dementia and moving may cause distress;
• the care home is requesting extra payments directly;
• there are arrears or threats of moving the resident;
• family members disagree about payment.

Sources of help may include Age UK, Citizens Advice, a specialist care fees adviser, a solicitor experienced in community care law, or the local authority complaints process. The Local Government and Social Care Ombudsman may be relevant if a complaint about council handling is not resolved.

Final thoughts

Care home top-up fees can give families more choice, but they can also create long-term financial pressure. Before agreeing to pay one, make sure you understand why it is needed, whether a suitable care home is available within the local authority’s budget, who is legally responsible, how long the payment may last, whether it can increase and what happens if you can no longer afford it.

Do not agree to a top-up fee because you feel rushed, guilty or frightened. Ask for written information. Read the agreement carefully. Check whether you are being asked to act as guarantor. Think about long-term affordability, not just the first few months.

A top-up fee may be reasonable when a family chooses a more expensive home for preference. But it should not be used to cover an inadequate local authority budget when no suitable care home is available at the council’s rate.

If you are still working out how care fees fit together, read our guides to self-funding a care home, care home costs by region, care home fees and social care funding in the UK.

Frequently asked questions

What is a care home top-up fee?

A care home top-up fee is an extra payment made when the chosen care home costs more than the amount the local authority has agreed in the person’s personal budget. It is usually paid by a third party, such as a relative or friend.

Who pays a care home top-up fee?

Top-up fees are usually paid by someone other than the resident or local authority. This is often an adult child, another relative, a friend or sometimes a charity. The person receiving care usually cannot pay their own top-up except in limited circumstances.

Can I be forced to pay a top-up fee for my parent?

No. A family member should not be forced to pay a top-up fee. If nobody is willing or able to pay, the local authority must still meet the person’s eligible care needs. It may need to identify a suitable care home within budget or review the personal budget.

When should a top-up fee not be charged?

A top-up fee should not normally be requested unless the local authority can show that at least one suitable care home is available within the person’s personal budget. If no suitable home is available at that amount, the council may need to review the budget.

Can the resident pay their own top-up fee?

Usually not, but there are limited exceptions, such as during a 12-week property disregard, through some deferred payment arrangements, or from certain disregarded income or capital. Ask the local authority for written clarification if this is suggested.

How long do care home top-up fees last?

A top-up fee can last for as long as the resident stays in the higher-cost care home and the local authority does not cover the full fee. This could be months or years, so long-term affordability is very important.

Can top-up fees increase?

Yes. A top-up can increase if the care home raises its fees, if the resident’s needs change, or if the local authority contribution does not rise by the same amount. The agreement should explain how increases are handled and how much notice is given.

What happens if I can no longer afford the top-up?

Tell the local authority as soon as possible. The council may review the placement, ask whether another person can pay, negotiate with the care home, increase the budget if necessary, or consider a move to another suitable home. Do not wait until arrears build up.

Can my relative be moved if the top-up stops?

Possibly, but the local authority should consider the person’s assessed needs, wellbeing, mental capacity, dementia, family contact and whether another suitable home is available. A move should not be treated casually, especially if the person is settled or vulnerable.

Is a top-up fee the same as self-funding?

No. Self-funding means the person pays the full cost of their own care. A top-up usually applies when the local authority is already contributing, but the chosen care home costs more than the council’s personal budget.

Is a top-up fee the same as extra charges?

No. A top-up fee usually covers the gap between the local authority budget and the care home’s core fee. Extra charges may be optional payments for services such as hairdressing, chiropody, newspapers, toiletries, private phone lines or outings.

Should I sign a top-up agreement?

Only if you understand it and can afford it long term. Check the weekly amount, whether it can increase, what happens if you cannot pay, whether you are acting as guarantor and whether a suitable care home is available without a top-up.

Can a care home ask me for a top-up directly?

Be cautious. If the local authority is arranging the placement, the top-up should be properly agreed and recorded. Ask whether the local authority knows about the payment and whether it is included in the written agreement.

Can I challenge a top-up fee?

Yes. You can ask the local authority to explain why the top-up is needed, identify a suitable home within budget, review the care needs assessment, review the personal budget and respond in writing. If unresolved, you can use the complaints process and seek advice.

Should I get legal or financial advice before agreeing to a top-up?

Advice is sensible if the top-up is large, the agreement is unclear, you feel pressured, you are asked to sign as guarantor, the person has dementia, or you are unsure whether the council’s budget is enough to meet assessed needs.