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Care-home top-up fees in England
When can a care-home top-up fee be requested?
Where a local authority is arranging a care-home placement, a top-up can arise if the person chooses accommodation that costs more than the amount in the personal budget and the statutory conditions are met. The local authority should still make at least one suitable option available within the budget. A top-up should be a genuine optional choice — not a way to make a family cover a shortfall caused by the authority failing to commission suitable care.
Reviewed 17 September 2026 by Paris Theodorou, Solicitor & Principal. England guidance only.
The basic rule
A top-up is an additional payment for preferred accommodation
The Care Act charging framework distinguishes the person's assessed contribution from an additional payment for a more expensive preferred placement. Where the statutory conditions are satisfied, a third party — and in limited circumstances the resident — may agree to meet the difference. The arrangement should be transparent, affordable and recorded properly.
What the local authority should do
There must be a genuine affordable choice
Offer a suitable option within budget
The statutory guidance says a local authority must ensure at least one accommodation option is available and affordable within the person's personal budget, and should ensure more than one where possible.
Do not make a top-up compulsory
An additional payment is meant to reflect a genuine preference for a more expensive option. It should not arise simply because there is no suitable accommodation available at the authority's usual rate.
Check willingness and affordability
The person paying the top-up should understand the amount, likely duration and consequences if they can no longer pay. The authority should consider whether the arrangement is sustainable.
Keep the funding structure clear
Where the authority arranges the placement it is generally responsible for contracting with the provider and paying the full amount, including the top-up, although the guidance allows a different payment arrangement where all parties agree and the rules permit it.
Questions to ask before agreeing
What should a family check?
What is the person's personal budget and how was it calculated?
Which suitable care-home option is available without a top-up?
What specific additional preference is the top-up paying for?
Who is legally responsible for paying it and to whom?
Can the amount increase, and how will increases be reviewed?
What happens if the third party can no longer afford the payment?
Is the person actually in a different funding regime such as NHS Continuing Healthcare or Section 117 aftercare?
Do not confuse funding systems
A local-authority top-up is not the same thing as NHS CHC
NHS Continuing Healthcare is a separate, non-means-tested NHS funding regime. Where a person is eligible for CHC, the NHS is responsible for arranging and funding the assessed package needed to meet eligible health and associated social-care needs. A family should not assume that ordinary local-authority top-up rules answer a dispute about what the NHS should fund.
If a top-up feels wrong
Ask the authority to explain the legal and financial basis in writing
Request the needs assessment, care and support plan, personal budget, list of suitable placements offered, top-up agreement and any correspondence explaining why the chosen home costs more. The issue may be a valid preference payment, a commissioning problem, or a wider dispute about which public body should fund the care.
If care fees have already been paid and the concern is that NHS funding should have applied, use our separate guide to identify the correct retrospective route.
Can care-home fees be reclaimed from the NHS? →Unsure which funding regime applies?
Start with the assessment and funding documents
If a top-up, CHC decision or other care-funding issue is unclear, send us the documents you have and a short explanation of who is paying what.