Our 'Ask an expert' looks at what happens if you're asked for a 'top-up' to pay for a person's care.


Q: ‘Our aunt’s local authority says there are two care homes suitable for her, but they’ve asked us to “top up” the fees because she only has her pension and no savings.'

About third-party top-ups 

Local authorities set their own limits on how much they will pay for different kinds of care in their area. By law, they should still offer a choice of suitable accommodation within this budget.

Perhaps there are no care home places available within the local authority’s budget that meet your aunt’s needs. If so, they would then be responsible for paying extra for a more expensive home – they should not ask you or any other ‘third party’ for a top-up.

The local authority should give your aunt genuine options, with at least one available place within their budget that meets her needs. Ideally, they should offer more than one option.

When to top up?

If the local authority offers a suitable care home place that's within their budget and you reject it in favour of a more expensive care home, then they may ask you for a top-up. The place they first offer you must be one that would actually meet your aunt’s needs.

The local authority should provide information about paying for care and be clear about their responsibilities. You should not be given the impression that you need to top up your aunt’s fees if it’s the local authority’s duty to pay for her place. If you disagree with the local authority’s decision, you could ask them for information about their complaints process.

What should happen?

Before anyone commits to a top-up agreement, the local authority should provide the right information and advice about what it could mean for the future.

If you agree to pay a top-up fee, the local authority should make sure that the details are set out in a written agreement between you and them. If the top up is being paid directly to the care provider, this written agreement should include them too.

The local authority must ensure that you are willing and able to meet the extra costs. The agreement should include information about what will happen if the fees increase or if any are not paid.

This agreement is likely to say that your aunt could be moved if her needs can be met somewhere else that’s within their budget, and if you cannot pay the top-up anymore.

Next steps

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Dementia together magazine: Oct/Nov 17

Dementia together magazine is for everyone in the dementia movement and anyone affected by the condition.
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Dementia together magazine is for everyone in the dementia movement and anyone affected by the condition.
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