Factsheet: Care home top-up payments

Summary

January 2025 (FS38)

This factsheet explains how to make top-up payments for someone moving into a care home.

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If you need care in a care home or nursing home

When we complete your support plan, we will allocate an amount of money to meet your care and support needs. This is called a ‘personal budget’. Where possible we will offer you the choice of at least one care home that is within that budget.

If you turn this down and choose a care home that costs more than your personal budget, somebody will need to pay a ‘top-up payment’ for the difference. The difference between the care home fee and your personal budget is (usually) paid by a third party.

You will still need to pay your client contribution towards your care and support. For more information about client contributions, see our leaflet:

What you will need to pay towards the cost of your care and support.

Who can pay a top-up payment?

Top-up payments are paid for the duration of your stay in the care home. They are usually paid by a family member, friend, or charitable organisation. This is called a ‘third party top-up’. The money used must not belong to you (the person living in the care home).

If you are moving into a care home, you can only pay your own top-up fee (a ‘first party top-up’) in certain circumstances:

during a 12-week property disregard period
under the Deferred Payment Agreement (DPA) scheme
if you are receiving free aftercare under S117 of the Mental Health Act

In all cases, a financial viability check will be done to ensure the top-up payment is affordable.

For more information, read our factsheet ‘Financial assessments for residential care’.

Checking and paying a top-up payment

When arranging a top-up payment for the first time, we will check if the person paying it (the payee) can afford it. We will send them an application form, an agreement form and request evidence of their income, savings and outgoings.

Once all information is received and we agree that the top-up is affordable, we will confirm the outcome and the agreement. This commits the payee to paying the top-up for the duration of your time in the care home.

The top-up must be paid regularly and on time. If payment is not received, the person living in the care home may need to move out.

The amount for the top-up will normally be paid to the Council. We will include this amount in our payment to the provider. The client contribution will continue to be paid directly to the provider.

The top-up agreement

The agreement will include:

the top-up payment amount
the personal budget amount
how often payments must be made
who to pay
how the arrangement will be reviewed
what happens if somebody cannot keep up with payments
the effect of any increases in fees made by the care home
the effect of any changes in somebody's financial circumstances

Changes to fees

Our local authority rates usually change on the first Monday of the tax year in April. The contract for the care home placement will be between the Council and the care home. This means that any changes to fees will need to be agreed by the Council following a set process.

Your personal budget will be reviewed regularly. It may increase if the amount is not enough to meet your assessed eligible needs. We cannot guarantee the care home will increase its costs at the same rate.

The top-up amount may change when the provider reviews their fees. We will contact you each year about any changes to fees.

What happens if the person cannot pay the top-up?

If somebody paying the top-up can no longer afford to pay it, the person living in the care home may have to move. This could be to another room in the care home, or to other accommodation within their personal budget limit. They will have an assessment or review of their needs, to ensure that the new accommodation is suitable.