The short version. A top-up is the difference between what a care home charges and what the council’s personal budget will pay. In England it is lawful, and common, but it is allowed only after the council has done something first: it must have made at least one suitable home available that is affordable inside the personal budget, and the statutory guidance says it should have offered more than one.
The council stays responsible for the total cost of the placement to the home. The top-up is an agreement about who reimburses the council, not a private bill from the home to the family.
Normally the top-up must be paid by someone other than the resident. There are three exceptions and no others.
When a family is asked for a top-up and cannot be shown which homes were available at the budget figure, that is an unevidenced top-up, and it is the point at which to stop and write to the council.
What a top-up is, and who owes the money
When a council arranges a care home place it sets a personal budget: the amount it has worked out that meeting the person’s assessed needs should cost. If the family prefers a home that charges more, someone can pay the difference. That difference is the top-up, or in the legislation, the additional payment.
Two details get lost almost every time. The first is that the council contracts with the home. Annex A of the Care and Support Statutory Guidance puts it plainly: where a person is placed in accommodation that costs more than the personal budget, “the local authority is responsible for the total cost of that placement” (paragraph 28). The home invoices the council for the full fee. The top-up flows from the payer to the council. A home that asks the family to pay it directly is running an arrangement the guidance does not describe.
The second is that the top-up is not a fixed sum for life. It is the gap between two numbers that both move. Homes raise fees annually. Councils reset personal budgets annually, and not always by as much.
The offer that has to come first
This is the part most worth knowing. The statutory guidance is not ambiguous about it: “The local authority therefore must ensure that at least one option is available that is affordable within a person’s personal budget and should ensure that there is more than one” (paragraph 12).
A top-up exists because a family chose to go above the budget. If nothing was available at the budget, there was no choice to make and nothing to go above. So the first question is never how much the top-up is. It is: which homes were available at the personal budget figure, and can I see that list?
If the honest answer is that the budget could not buy a place anywhere locally, then the budget is the thing that is wrong, and the route is a request to review it rather than a signature on a top-up agreement.
Who is allowed to pay
The Care and Support and After-care (Choice of Accommodation) Regulations 2014 set the rule: the additional cost is normally met by “a person other than the adult”, under a written agreement. A resident may pay their own top-up in three situations only, and the guidance lists them at paragraph 39.
| Situation | Why it is allowed |
|---|---|
| The resident is inside the 12-week property disregard | The value of their home is being ignored for those first 12 weeks, so they hold assessable income they will later be expected to use |
| The resident has a deferred payment agreement with the council | The cost is secured against the property and settled later |
| The accommodation is provided as section 117 mental health after-care | After-care itself is free, so any extra above what the authority would arrange is the resident’s own choice to fund |
Outside those three, a council that asks the resident to fund their own top-up out of their income or savings is asking for something the regulations do not provide for. This matters most at the end of the 12-week disregard, when a family that has been paying out of a parent’s own money has to move onto a different footing or a different home.
What the written agreement has to contain
Before it accepts a top-up the authority must give the payer enough information and advice to understand what they are agreeing to. The agreement itself has to set out the amount of the additional cost, how often it is payable, how it will be reviewed, and what happens if the payments stop or the payer’s circumstances change. The guidance adds that the authority “must make clear in writing the consequences should there be a break down in the arrangement”, including that the person may be moved to alternative accommodation (paragraph 33).
Read the review clause before the amount. A top-up that rises with the home’s fee increases is a different commitment from one fixed in cash terms, and over a placement lasting several years the two diverge widely.
When the payments stop
They do stop. The payer retires, or dies, or a second person needs care. The guidance is direct about what follows: where someone is unable to continue making top-up payments, “the local authority may seek to recover any outstanding debt and has the power to make alternative arrangements” (paragraph 38). Alternative arrangements means a move.
That is the reason to set a top-up against what the payer can sustain for the length of a placement rather than what they can manage in the month the decision is being made. It is also the reason to ask, in writing and before signing, what the council would do if the payments stopped: whether it would review the personal budget first, and what its policy is on moving a resident who has settled.
The unevidenced top-up
An unevidenced top-up is one requested without the council being able to show which suitable homes were available at the personal budget. It is not necessarily improper. It usually means nobody was asked, and a form arrived with a figure on it during the worst fortnight of a family’s year.
The remedy is a letter, not an argument. Asking for the evidence in writing puts the obligation back where paragraph 12 puts it, and it either produces a list of homes, which is useful, or it produces a review of the budget, which is more useful.
What to send the council, in writing
- Which suitable homes with vacancies were available at the personal budget at the time of the placement, and on what date that was checked.
- How the personal budget figure was calculated, and when it was last reviewed.
- Whether the council accepts that it holds the contract with the home and is responsible for the full fee.
- Who the council says is liable for the top-up, and under which of the three exceptions if it is the resident.
- How the top-up will be reviewed, on what date, and whether it is linked to the home’s fee increases.
- What happens if the top-up becomes unaffordable, and whether the budget would be reviewed before any move is considered.
- A copy of the council’s own top-up policy.
Outside England
The Care Act 2014 and the Choice of Accommodation Regulations apply in England. Wales, Scotland and Northern Ireland charge for residential care under their own frameworks, with different capital limits and different rules on additional payments, so none of the paragraph numbers above should be quoted to a Welsh, Scottish or Northern Irish authority. Start with the Welsh Government’s charging guidance, Care Information Scotland, or nidirect, each linked below.
Method. The rules described here are the Care and Support and After-care (Choice of Accommodation) Regulations 2014 (SI 2014/2670), read on legislation.gov.uk, and Annex A of the Care and Support Statutory Guidance issued under the Care Act 2014. The annex was read on 27 September 2026 in a local authority reproduction of it published in 2022; paragraph numbering in the current version on GOV.UK may differ, so quote the wording rather than the number when writing to a council. Quoted sentences are reproduced exactly.
What this page does not do. It gives no view on whether any particular top-up is reasonable, and it does not price care homes. It is not legal advice. For free regulated advice on a specific placement, Age UK, Citizens Advice and an independent financial adviser accredited for later-life advice are the routes to use.
Next revision. Reviewed when the Department of Health and Social Care revises the Care and Support Statutory Guidance, or when the annual charging circular changes the capital limits.
Cite this. Look Into, Care home top-up fees: when a council can ask, and when it cannot, 27 September 2026. https://lookinto.co.uk/care/care-home-top-up-fees/
Sources
- The Care and Support and After-care (Choice of Accommodation) Regulations 2014, SI 2014/2670, regulations 2, 3 and 5. legislation.gov.uk
- Department of Health and Social Care, Care and support statutory guidance issued under the Care Act 2014, Annex A, choice of accommodation and additional payments. gov.uk
- Walsall Council, reproduction of Annex A of the Care and Support Statutory Guidance, the copy read for paragraph numbering. go.walsall.gov.uk
- Department of Health and Social Care, Social care charging for care and support 2026 to 2027, local authority circular, for the capital limits. gov.uk
- Welsh Government, Charging for social care. gov.wales
- Care Information Scotland, Paying care home fees. careinfoscotland.scot
- nidirect, Paying your residential care or nursing home fees. nidirect.gov.uk