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Care funding · UK guide

Care Home Top-Up Fees: What They Are and Who Can Pay

A top-up fee is the gap between what the council will pay and what the care home charges. It must usually be paid by a third party — not the resident — and must be set out in a written, signed agreement before the placement starts.

Legal basis: SI 2014/2670 · Care Act 2014 ss.34–36 · statutory guidance Ch.8

§1

What is a top-up fee?

When the council funds someone's care, it agrees to pay up to a set weekly rate for a place in a suitable home. If the home you want charges more than that rate, the difference is a top-up fee. The council's rate covers the care; you (or a third party) cover the premium for the preferred home.

Worked example — weekly costs

Council's agreed weekly ratehypothetical
£800
Preferred care home's weekly feehypothetical
£1,100
Top-up fee (difference)
£300 / week

At £300/week, a top-up costs £15,600 per year. Over three years that is £46,800 — a significant commitment that must be stress-tested before signing.

Average self-funder costs in England (June 2026): £1,299/week residential; £1,535/week nursing. The council will rarely pay those rates in full — the gap between the council rate and the home rate is what creates the top-up.

§2

The council cannot force a top-up

Before any top-up conversation, ask the council for a list of homes it can fund without a top-up. Under the Choice of Accommodation Regulations 2014, the council must offer at least one suitable home within its standard rate. If it cannot, it must fund whichever suitable home is available — even if that costs more than its usual rate.

A top-up is only legal when the placement is a genuine choice — the funded alternative exists and has been offered. If a council presents only homes that require a top-up, that is unlawful. Challenge it in writing.

The council must carry out a sustainability assessment before accepting a top-up agreement — checking that the third party can afford the payments for the foreseeable duration of the placement. Councils that skip this step are failing their statutory duty.

§3

Who can pay a top-up — and who cannot

The top-up must almost always come from a third party — a family member, friend, or charity — not the resident themselves. The resident is supposed to be fully funded by the council. Asking them to contribute directly from their own savings is unlawful under the Care Act framework.

Can pay

Adult child of the resident
Sibling or other relative
Close friend
A registered charity
A discretionary trust (with legal advice)

Cannot pay

The resident from their own savings
Someone who cannot sustain it long-term
The resident via an informal back-channel

If the third party dies or can no longer pay, they must notify the council immediately. The council cannot simply evict the resident — it must reassess and, if needed, fund a suitable alternative place within its standard rate.

§4

What care homes actually charge

Self-funder rates vary widely by region and home quality, but national averages give a starting benchmark. Council rates are typically set well below the self-funder market rate — which is where the top-up gap originates.

Average residential care (England, Jun 2026)
£1,299/week
Average nursing care (England, Jun 2026)
£1,535/week
NHS Funded Nursing Care (FNC), 2025/26paid by NHS, not council
£267.68/week
Capital threshold (upper) — council fundingsavings threshold
£23,250

NHS Funded Nursing Care (FNC) at £267.68/week is paid directly by the NHS to the nursing home for the registered nursing element. It is not a top-up and does not reduce the council's obligation. If your parent qualifies, the FNC payment reduces the home's privately-billable nursing rate — but the council top-up calculation remains separate.

§5

The top-up agreement — what must be in writing

A top-up arrangement must be documented in a formal written agreement before the placement starts. The Care Act statutory guidance (Chapter 8) is explicit: a verbal understanding has no legal standing and leaves the third party exposed if costs change or the resident is asked to leave.

STEP 1

Named parties

The agreement must identify the third party by name — not just reference 'a family member.'

STEP 2

Weekly amount and review date

The top-up sum, the council's rate, and a fixed date for annual review must all be stated.

STEP 3

Sustainability check

The council must confirm it reviewed whether the third party can sustain payments for the expected duration.

STEP 4

Signed by all parties

The council, the care home, and the third party must all sign before any top-up payments begin.

STEP 5

Annual review

Both the top-up amount and the third party's financial position must be reviewed at least annually.

§6

If you cannot afford a top-up

If no family member can cover the top-up, the council must still find a suitable funded place within its standard rate. It cannot place someone in a home that is only available with a top-up and then leave them there when the top-up fails. Families who cannot afford top-up payments should push back — the council's duty to provide a suitable free place remains.

Some local authorities will also discuss a Deferred Payment Agreement (DPA) if the resident owns a property. A DPA is not the same as a top-up — it lets the council fund the full cost of care now, with repayment deferred until the property is sold. See the FAQ below for the distinction.

Never sign a top-up agreement you cannot sustain. If a third party signs and then cannot pay, the council may seek to move the resident to a cheaper home — causing real distress. Sustainability must be tested honestly before the placement starts.

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FAQ

Common questions about top-up fees

A top-up fee covers the gap between what the council agrees to pay and what the care home actually charges. If the council's rate for a place is £800/week but your preferred home charges £1,100/week, the £300/week difference is the top-up. It is not a penalty or a surcharge — it is the real difference in cost between a standard-funded place and the place you have chosen.

Generally no — but there is one narrow exception. The Care Act rules that the resident cannot normally pay their own top-up because they are supposed to be fully funded. The exception: if the resident has a third-party trustee holding funds separately (for example, a discretionary trust), a payment can be arranged — but only with careful legal advice.

Asking the resident to pay directly from their own pocket is unlawful.

Yes — the council must always offer at least one suitable home it can fund without a top-up. Under the Choice of Accommodation Regulations 2014, the council cannot push you towards homes that all require top-ups. If they cannot offer a suitable no-top-up home, the council must pay the full cost of the home you need. Always ask: "What homes can you fund without a top-up?" before agreeing to pay one.

The council must carry out a sustainability check before the agreement is signed — and must annually review it. If a top-up becomes unaffordable, the council cannot simply evict the resident. It must reassess the person's needs and, if necessary, fund a suitable alternative place at its rate. Councils are supposed to avoid placing families in agreements they clearly cannot sustain.

Yes — the Care Act statutory guidance (Chapter 8) requires a written, signed agreement before any top-up starts. The agreement must name the third party, state the amount, confirm the council reviewed affordability, and set out the annual review date. An informal verbal arrangement has no legal standing and puts the third party at risk.

No — a Deferred Payment Agreement (DPA) is completely separate. A DPA (Care Act ss.34–36) lets the council fund your care upfront and recover the cost from your estate when your home is eventually sold. It is used when someone owns property but has savings below £23,250.

A top-up is about choosing a pricier home; a DPA is about deferring payment of the standard council rate. You can have both — but they are different obligations with different rules.

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