Top Up Fees

The Local Authority do not have to agree to third party top up fees and could do so if they believe the third party cannot reasonably afford to pay the top up fees.

If you want further information or advice please call me for a no obligation chat on 01536 276300 or use our online enquiry form.

Top Up Fees

If your relative enters care there are a different number of ways to fund the care. These are;

  • Local Authority funding based on a means test
  • Self funding based on means test
  • Fully funded NHS Continuing Healthcare

The Local Authority and NHS are two different authorities. The Local Authority cannot fund health need care so it is the duty of the NHS.  There are two situations where top up fees may come into play;

  • The Local Authority may be funding the care but they provide a personal budget, therefore only giving each person a set amount per week but the care fees in the current setting amount to more than this budget.
  •  You may have been found eligible for NHS Continuing Healthcare and in order to remain in the current care setting, discussed paying a top up three via a third party such as a family member as the NHS only pay a set amount per person.
Third Party Top Up – Local Authority

The regulations governing third party top up state that a Local Authority may place a person in a more expensive accommodation if a third party agrees to make up the difference between the usual cost level and the actual fee. The Local Authority do not have to agree to third party top up fees and could do so if they believe the third party cannot reasonably afford to pay the top up fees.

Choice Of Topping Up

The lawfulness of a topping up arrangement is simple. The question is whether the resident has been placed in a more expensive home out of choice and whether a cheaper home could have met his or her needs fully.

If there has been a genuine choice and a cheaper home was available then the top up fee would be lawful. However, if no cheaper home was available that would meet the assessed needs then entering the more expensive home would not be through choice. In this case, the Local Authority should cover the more expensive cost and a top up fee should not be paid.

Even where there is no choice involved, the Local Authority can just leave it up to the care home to try and obtain the top up fee from a third party. This is unlawful if the expensive home was not by choice, as the Local Authority remains responsible for the entire fee.

Local Authority Paying Lower Costs

If a Local Authority sets its usual cost level, it must be able to demonstrate that it is sufficient for meeting the assessed need of residents and ensuring that the care setting provides the resident with the level of care services that they could reasonable expect to receive if the possibility of resident and third party contributions did not exist.

If there are no resident places available at the level the Local Authority are willing to make, the Local Authority must make alternative, suitable arrangements and seek no additional contribution.

NHS Top Up Fees

Legally, if a person is found to have a health need then paying top up fees is illegal as the NHS have to fund the entire cost of care.

Top up fees may be required in a situation where your relative has settled in a care home and has been found eligible for NHS Continuing Healthcare but the NHS are refusing to cover the higher cost of that care home and suggesting that your relative moves to a cheaper care home.

To resolve the dispute, a best interest decision should be made. If it is in your relatives best interests (such as a decline in health if they move) to remain in the care home, then the NHS should pay the higher cost.

NHS Top Up Fees

Legally, if a person is found to have a health need then paying top up fees is illegal as the NHS have to fund the entire cost of care.

Top up fees may be required in a situation where your relative has settled in a care home and has been found eligible for NHS Continuing Healthcare but the NHS are refusing to cover the higher cost of that care home and suggesting that your relative moves to a cheaper care home.

To resolve the dispute, a best interest decision should be made. If it is in your relatives best interests (such as a decline in health if they move) to remain in the care home, then the NHS should pay the higher cost.

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