A top-up fee ... is the difference between what the local authority are prepared to pay - assuming that the resident is fully funded - and what the home charges
Yes, this is the definition that I was working to. The issue really comes into play when say, using Jennifer's example, someone who has been self-funding at a cost of £600 per week drops to the minimum asset level and the LA (local authority) then is responsible for funding his/her care. Now it may be that the LA has arbitrarily
eek: is this possible???) set the maximum amount that they are willing to fund at £400 per week - that leaves a shortfall of £200 per week.
It seems that it is not an unusual practice (this is just based on reading other accounts on the Internet - not first hand experience) for LA to ask relatives to make up the difference in the form of a "top-up", as it is not legal to accept payment from the patient once their assets fall below the minimum.
What is not entirely clear is what would happen if the top-up was not funded. I have read that the LA may propose to move the patient to another facility whose fees are within their range if it can be shown that the care at the new facility would be adequte for the person's needs. I have also read that such moves have been challenged as it would be too upsetting to the person with dementia and put their health at risk.
If a person with dementia is not self-funding, this type of "negotiation" may take place during the process of agreeing on a suitable home. For example, the LA may have block-booked places in a home that makes visiting for family members very difficult, but a local home may charge more than the LA normally pays.
That it why the line in the government guidance
"If your local council cannot suggest a place that meets your needs in your local area then they should be prepared to pay more than their usual amount." is so important when dealing with LA representatives.
Take care,
Sandy