Care Home "Top Up" Fees


Registered User
Oct 25, 2006
My Mum has been in a Care Home since July and has vascular dementia. She has recently had a financial assessment and is fully-funded as she has monetary assets of under £2,000. However, the Care Home has asked my Dad to pay a "top-up" fee of nearly £20 per week. This is over and above the payment made by the social services and the social worker says that we should negotiate to get it reduced as it is entirely between the Care Home and us (even though she is fully-funded).

We recently visited a solicitor as my Dad was keen to make his will and she told us not to pay the "top-up" fee as it wasn't compulsory. So, where do we stand? The top-up fee is a considerable amount for my Dad to pay and he won't accept any help from us (too proud!) After numerous discussions and 'phone calls to the Care Home Manager I am constantly fobbed off with "the owner will have to decide and he is away/busy/on holiday in Mauritius" !! I have today written to ask for the top-up fee to be reconsidered. Does anyone have any experience of negotiating these top-up fees downwards? Any advice or tips to give?

I do appreciate that many people have to pay huge amounts for Care Homes and so our problem may seem inconsequential. We are very grateful that Mum's care is fully-funded, but for my Dad, this "top-up" fee is a huge sum out of his weekly income and I am worried about his ability to cope financially.


Registered User
Jul 5, 2008
NW England
Hi Susan
Have you been in contact with Social Services. If SS are paying the care fees then they have the contract with the home, not your dad.

I definately wouldn't pay anything to the home at this point in time.


Registered User
Jan 31, 2004
near London
I would write to the care home and ask what is the reason and basis for the proposed charge.

Simply to ask for an additional sum is not acceptable.

Always good to get things in writing - if necessary, to use against them.


Registered User
Sep 13, 2008
We paid a siliar amount 'top up ' when mum was in repite ,the SS were aware of it ans it were them that informed me there were top ups charged by some homes


Registered User
Oct 25, 2006
Thank you for your replies. It was the Social Worker who told us that the Care Home might ask for a top-up fee. She said we should negotiate with the Care Home to reduce it. It is on top of the full funding and the social worker described it as a private arrangement between the Care Home and my Dad.

I asked the care home manager what it was for and she told me it was the ensuite bathroom to my Mum's room. But Mum is doubly incontinent and can't use the bathroom (I wish she could - it's lovely!) I pointed this out to the Manager and she said the bathroom was still used because they had to sit Mum on the toilet to dress her - but there is an upright chair in the room, so I don't know why they don't use that? I realise that the ensuite is there and can't be taken out, but it seems galling that my Dad has to struggle fianancially to pay for something Mum can't use.

The solicitor we saw about the will worried me as she said the care home might start threatening that Mum would have to leave if the top-up fee waasn't paid, but she advised us not to pay it. The trouble is, neither Dad nor myself are the sort of people who can cope with ignoring bills and unpleasantness if they are not paid! In every other respect the Care Home is fantastic and the manager says she will do all she can to persuade the owner to reduce the fee - it's just that nothing is happening and we now have an invoice for the second month's fees.

I have written to her formally asking for the owners contact details. I don't know what else to do. I would pay it myself, but the solicitor said on no account must anyone other than my Dad undertake to make payments as the Social Services could use this to reduce the amount they will pay. I would give the money to my Dad for him to pay over, but he is too proud to take it and insists it is his responsibility.

I wonder if anyone else has had problems with these top-up fees and successfully negotiated them downwards?

Thanks for your ocmments so far - all help and advice is most welcome.



Registered User
Jan 4, 2006
Hiya Susan,
I googled 'care home top up fees' this morning and found some useful articles...they seemed to say
...if mum is fully funded the contract is between the local authority and the care home
...local authority could try to move mum to a 'cheaper' home in the area if there is one that they have a contract with

I dont know whether or not the alzheimers helpline might have someone who could give you information on where you stand, or Help the Aged.

As you have not requested a room with an en there one the en suite appears to be the justification for the excess charge?

Hope you can sort something soon....I know what you mean about coping with and dad can do without the added stress.

Love Helen


Account Closed
Jul 16, 2008
Top-up fees

Top-up fees cannot be paid by the person receiving the care home service.

Top-up fees can only be paid by a family member, or a friend, or someone else other than the person receiving that thing called ‘care in a care home’, but paid in the ‘best interests’ of that person receiving care in a care home, by someone.

A link that may be of interest to you:

Top-up fees only apply if someone is placed to live in a care home that is “more expensive” than that amount of money which the local authority/social services is/are willing to pay. Assuming that your relative is funded by social services/local authority.

That should always be known and made known to you, before your relative moves into the care home.

So, if a relative moves his/her relative to a care home which is “more expensive” than whatever the local social services/local authority is willing to pay, then there will be top-up fees needing to be paid, but only by the person asking for that particular ‘more expensive’ care home.

And only if the social services have made that known to you beforehand, not after the event of moving your relative to that particular care home.
Last edited:


Registered User
Oct 25, 2006
Thank you for all your responses. Mum was moved into this care home as respite care when my Dad was admitted to hospital for an emergency operation (brought on by stress), so we had no choice in the room, or in the home itself. It turns out to have been a great choice for her, as it suits her needs so well, but we never had a "choice" in the home or the room, which has the unused ensuite. The good news, however, is that I spoke with the manager today and she has managed to get the entire fee waived. It's such a relief! She was quite outspoken on her views of top-up fees and how she would like for nobody to have to pay them, but it is not in her hands to decide. However, she has managed to exert some influence, resulting in the waiver.

So, if anyone else is faced with this sort of payment - it is worth arguing against it as you may be lucky like us and get it waived.
It was a good day today - we took my little cocker spaniel to see Mum and sat with her in the garden. The weather was lovely and Mum was so pleased to see my Tilly. It's funny, sometimes she forgets who we are, but she never forgets Tilly and always enjoys stroking her and telling her she's a good girl. Mum had had a bath (not her favourite occupation!) but she was quite calm after it and enjoyed the sunshine in the garden.


Margaret W

Registered User
Apr 28, 2007
North Derbyshire
Sue I am so glad you got it sorted, but generally if you choose a home or a room whis is priced higher than the local authority figure then you have to pay the difference. Pity my mum paying £525 a week. I could cry.