In 2013 the charity Independent Age published an excellent report into third party care home top-up fees. It’s worth promoting the report again here, as it contains vital information for all families faced with paying care home top-up fees. (See below for a link to more recent findings, too.)
The report revealed that many care home top-up fees should not be charged at all. It also shows that in many casers local authorities should be meeting the full costs of care.
Care home top-up fees – some key points from the Independent Age report:
- Top-up fees are required only when the person needing care or their family have specifically requested more expensive accommodation. They should not be charged just because a care home costs more than the local authority/council is willing to pay.
- Care home top-up fees should only be paid by relatives who are able and willing to pay them.
- Local authorities are responsible for top-up arrangements. However, many such arrangements are made between a care home and a relative – with the local authority out of the picture.
- Often local authorities fail to direct people towards independent advice; they also fail to explain a person’s right before top-up contracts are signed.
- Many local authorities are in breach of the Choice of Accommodation Directions (LAC(2004)20. These Directions prevent local authorities/councils from asking for top-up fees as a blanket policy.
- If a relative cannot pay third party top-up fees, the local authority is responsible in full for the full cost of care.
These are just some of the many important points that come out of the report. It also names specific councils/local authorities and highlights the degree to which they are ignoring their responsibility towards relatives – and breaking national guidance on third party top-up fees.
So remember these 5 points about top-up fees – regardless of where the care is being provided:
- They should only be charged if a person is receiving a genuine upgrade in the services they’re receiving.
- The family must give informed consent before any top-up fees are charged.
- Top-up fees are voluntary.
- They are the exception – not the general rule.
- They should not be requested from families to plug the gap in local authority funding.
One final point – many families are told to pay top up fees before their relative has been assessed for full NHS Continuing Healthcare funding. This is completely the wrong way round. Read more about care fees and NHS Continuing Healthcare.
Remember that if you do receive NHS Continuing Healthcare funding, this cannot be topped up – and no one should ask you to. Top up payments are for social care (local authority care) only. It is unlawful for NHS Continuing Healthcare funding to be topped up. The NHS Choices website reinforces this point:
“Is it possible to pay top-up fees for NHS continuing healthcare? No, it is not possible to top up NHS continuing healthcare packages, like you can with local authority care packages. The only way that NHS continuing healthcare packages can be topped up privately is if you pay for additional private services on top of the services you get from the NHS. These private services should be provided by different staff and preferably in a different setting.”
What’s your experience with top-up fees?