Care home top-up payments
Page contents
- Summary
- If you need care in a care home or nursing home
- Who can pay a top-up payment?
- Checking and paying a top-up payment
- The top-up agreement
- Changes to fees
- What happens if the person cannot pay the top-up?
- More information
Summary
This factsheet explains how to make top-up payments for someone moving into a care home.
April 2023 (FS38)
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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 affordable within that budget.
If you do not want this option and choose a care home that costs more than your personal budget, a ‘top-up payment’ would be required. This is when the difference between the care home fee and your personal budget amount is usually paid by a third party for the duration of your stay in the care home.
The person moving into the care home will need to continue to pay their client contribution towards their 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’ on our website eastsussex.gov.uk/factsheets.
Who can pay a top-up payment?
Top-up fees are usually paid by a family member, a friend, or a charitable organisation. This is called a ‘third party top-up’. When a third party agrees to pay the top-up, the money used must not belong to 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 a limited number of 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 needed 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 who is 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 full duration of the placement.
The top-up must be paid regularly and on time. If payment is not received, the person may need to move out of the care home.
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 the payee cannot keep up with payments
- the effect of any increases in fees made by the care home
- the effect of any changes in the payee’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. However, we cannot guarantee the care home will increase its costs at the same rate. This may affect the level of the top-up payment.
The top-up amount may change when the provider reviews their fees. If fees increase, the top-up amount may also increase. We will contact you each year about any changes to fees.
What happens if the person cannot pay the top-up?
If the person paying the top-up can no longer afford to pay the top-up, the client may have to move. This could be to another room in the care home, or to other accommodation that charges fees that are within their personal budget limit. The client will have a social care assessment or review of their needs, to ensure that the new accommodation is suitable.
More information
For further information about top-up payments, please contact the Finance and Benefits Assessment Team by email to fab@eastsussex.gov.uk or phone 01323 464 699.
To get more copies of this factsheet, or any of the other leaflets or factsheets mentioned, please visit our website eastsussex.gov.uk/factsheets. Or, contact Health and Social Care Connect, our customer contact centre on 0345 60 80 191, using Minicom via type talk on 18001 0345 60 80 191 or email HSCC@eastsussex.gov.uk.