Councils flouting rules on care home ‘top-up fees’


Nearly half of councils who answered a Freedom of Information request are ignoring new rules intended to protect families from paying unfair care home fees for their relatives. 

This means families of the poorest pensioners could be subsidising the cost of essential care unnecessarily, according to new research from Independent Age, the older people’s charity.

The rules around care home ‘top-up fees’ were tightened last year but a Freedom of Information request sent to every council in England by Independent Age found that for the period April to June 2015, 43% did not comply with at least one of the requirements to:

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  • have a written agreement in place for all top-up fee arrangements in their area
  • carry out annual reviews of top-up agreements as a matter of course
  • ensure all top-ups in their area were arranged with the involvement of the local authority

Top-up fees are an option for care home residents whose fees are partly or fully paid by their local council. They are intended to be voluntary payments by relatives for ‘extras’ such as a larger room or a nicer view.  It’s estimated that almost 50,000 older people in England have a ‘top-up’ paid towards their care costs by a relative, ranging from tens to hundreds of pounds every week.

“Too many care homes are charging pensioners’ families for care that should be free, and too many councils have been turning a blind eye to the practice,” said Janet Morrison, chief executive of Independent Age. “The Care Act was intended to stamp out this abuse but it is clear from our research that it is still going on.”

The Care Act, which came into force in April 2015, tightened the rules by saying that top-up fees should always involve the informed consent of all parties, involve a written agreement and that arrangements should be reviewed regularly. Today’s research reveals that despite the introduction of the Act, poor practice is continuing among a significant minority of councils.

The new findings come as social care budgets are under pressure as never before. The Association of Directors of Adult Social Services estimate that councils have faced reductions of £4.6 billion to adult social care budgets since 2009-10 – almost a third of net real terms spend. And while local councils on average pay £512 a week towards a care home place, analysts’ estimate that the real cost is between £554 and £625 a week.

Janet Morrison, Chief Executive of Independent Age, said: “We understand that councils are under huge financial pressure. But in a drive to find savings to social care budgets, they must not pass the burden of this ‘secret subsidy’ on to the families of poorer pensioners.

“It is only poorer pensioners who qualify for a local authority funded care home place, and yet it is their families that are being asked to make up the shortfall in care budgets. We hear all the time from families who are willing to do anything they can to ensure their elderly relatives get decent care, even if they’re struggling financially themselves. That’s why it’s so important that there are rules to make sure they do not feel pressured into paying fees unnecessarily.

“Top-up fees must always be optional, affordable and transparent. The rules introduced by the government should ensure that is the case. So it is very worrying that so many councils are still failing to follow these basic principles.”

The findings do suggest that there has been some progress since the introduction of the Care Act. A total of 48% (58 out of 122) of local authorities have written agreements in place for all top-up fees entered into since April 2015. Whereas in 2013, only 28% even had information about all top-up fees in their area, according to previous research by Independent Age.

A fifth of councils (20%) did not respond to the Freedom of Information request.

Tags : Care HomescouncilsIndependent AgeThe Care Acttop-up fees
Andrew Seymour

The author Andrew Seymour


  1. In my opinion Janet Morrison CEO is out of touch with the costs related to Elderly care homes. Our group has not had an increase from Birmingham City Council for 8 years now .Top -up fees have to be charged in order to safe-guard the roofs over our residents heads. The cost of care is the cost of care .Local Authorities should fulfill their statutory duty to recognize and pay sustainable fee levels to stop Care homes going out of business. We have an increasing aged population and a decreasing amount of care homes we are on Collision course for a care home crisis.


    Mike Gimson
    Moundsley healthcare group

  2. I certainly agree with Mike Grinson, I manage a small family owned residential home for adults with learning disability, it is not just the local city council that are out of touch with the costs of running a care home but also the central government, everyone deserves a 5* service but how can that be maintained when the funding is such for a 2* service. It is very worrying as we all know our own household bills have risen to epic proportions, so the costs of just household utilities alone in the care home is absolutely firghtening, thats with out the staffing costs, recruitment & continuous training, all of this should be taken into account, but sadly it isn’t. I do worry that small family run business’s will be lost as they can’t begin to compete with the Big Boys! the big care providers can run at a loss as some of the care homes that they own, help to sustain the others. It will be a great loss to the care field if small family run buisness’s have to close. I thought that when David Cameron became Prime minister that he would have some level of understanding as he had first hand experience of having a child with disabilities, but again, how can he have a true understanding when he himself is a millionaire and has no monetry contraints, I wish that he and his team came and spent a month with a care home manager just to see first hand how we have to manage our meagre amounts! We as care providers & care managers do a fantastic job with the resources that we do have, my staff team are absolutely fantastic & often we all “Give” our time for free, because WE CARE, and that is just what the local council & the Government rely on KINDNESS!
    I could go on about how I feel because I am passionate about the care field & I have lost great caring staff to big supermarkets chains because the money is better for “Shelf” stacking or being on a till than it is for caring for others.

    Helen L West Care manager.

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