Can a care home ask my family for a top-up fee?

A third-party top-up bridges the gap between what the council will pay and a more expensive home the family prefers. It is lawful in defined circumstances and unlawful in many of the situations where it is actually demanded.

The precondition everyone forgets

Before a top-up can be relevant, the council must have identified at least one suitable home available at its standard rate. If no such placement has been offered, there is nothing to top up: the council must meet the assessed need at its own cost. Ask, in writing, which homes the council says it can fund — that single question resolves a large share of disputes.

The rules on who pays and how

• Top-ups must be paid by a third party — a relative or friend. Residents generally cannot fund their own top-up from income or from assets above the lower capital threshold, because that would undermine the financial assessment.
• The agreement must be in writing, setting out the amount, how and when it will be reviewed, and what happens if it can no longer be sustained.
• In a council-funded placement, the agreement should be between the council and the payer, not directly between the care home and the family. A home invoicing relatives directly may be acting unlawfully — raise it with the council and then the Local Government and Social Care Ombudsman.

Before you sign, and if it becomes unaffordable

Negotiate the review mechanism, not just the figure. Fee increases must be handled as the written agreement provides, and an unexpected large rise that the agreement did not anticipate can be challenged. Ask what happens if the payer dies or loses their income, and get the answer written in.

If you can no longer afford it, tell the council and the home promptly. The council must then find an alternative suitable funded placement — it cannot simply evict the resident, must give reasonable notice, and the resident has a say in any alternative proposed.

One grey area: using the resident’s Attendance Allowance towards a top-up. In principle the money is theirs, but an arrangement that effectively has the resident funding their own top-up cuts across the purpose of the means test. Take advice from Age UK before agreeing to it.