Care home top-up fees: the rules
Top-ups are the third-party payment used to bridge the gap between a council's contract rate and a more expensive home. The rules are clear, often ignored, and worth knowing.
The short answer. Top-ups are lawful only when there is a genuine choice. The council must offer at least one suitable home at its contract rate. A top-up cannot be required to access a suitable home, only to access a more expensive one the family prefers. The top-up payer must be a third party (family member or charity), not the resident, except in very narrow first-party top-up cases.
When top-ups are legal
- The council has offered at least one suitable home at its contract rate.
- The family prefers a different home that costs more.
- A third party (not the resident's own savings) pays the difference.
- The top-up agreement is signed and reviewed regularly (usually annually).
When top-ups are not legal
- No suitable contract-rate home offered. The council must find one or pay the higher rate itself.
- Top-up demanded to access any home at all in a particular area.
- Top-up paid from the resident's own savings (except first-party cases - see below).
- Top-up amount not transparent or set above the actual price difference.
Care and Support Statutory Guidance ↗
First-party top-ups
Allowed in three narrow situations: 12-week property disregard period, deferred payment agreement, and if the resident is funded under Section 117 mental health aftercare. Outside these, the resident cannot top-up themselves.Care and Support Regulations 2014 ↗
What if the top-up payer can no longer pay
The council steps in to find another suitable home at its contract rate, or to renegotiate the existing fee. The resident must not be moved without their needs being assessed and their preferences considered. Age UK keeps the most readable summary. Age UK top-up fees ↗
Frequently asked
How big are top-ups typically?
Anywhere from £50 to £400 per week, depending on the area and the home. Always ask for a written breakdown of contract rate vs full rate.
Can the home raise the top-up later?
Only if both the council and the third party agree, and the rise is justified by genuine cost increases. Review annually.
What if no contract-rate home has any vacancy?
The council must pay more, not the family. Document the offers made and the dates. This is one of the most under-enforced rules in the system.
Last reviewed 2026-06-21. Clinical reviewer pending appointment (target Sep 2026); meanwhile reviewed by the editorial team.