Care-home costs, top-ups and savings running low — Easy Read

Start with needs and the full price

Ask for a care needs assessment even if you expect to pay privately. Discuss whether a care home is the right option and what support it must provide. Obtain a written, itemised price showing the room, meals, personal care, nursing arrangements and extras. Ask how fees change, what happens during hospital stays, notice requirements and charges after death. Prices and contracts differ; do not rely only on a weekly headline figure.

Check whether NHS funding applies

Ask whether NHS Continuing Healthcare, called CHC, should be considered. It is for adults assessed as having a primary health need and is not means-tested. In a care home, an eligible CHC package includes assessed care and accommodation costs. A diagnosis alone does not decide eligibility. Use the CHC guides for requesting an assessment and challenging a decision. Do not assume every stay in a nursing home qualifies.

Understand nursing contributions and mental health aftercare

NHS-funded Nursing Care, called FNC, contributes to registered nursing care in a nursing home; it does not cover the whole bill. CHC eligibility should be considered first. Ask how FNC is treated in the contract rather than assuming the quoted fee will reduce by the same amount. Section 117 is a different, free mental health aftercare entitlement after specified Mental Health Act detention. Necessary specialist accommodation may qualify, but ordinary housing and unrelated costs are not automatically covered.

Ask for a financial assessment

If council funding may apply, ask for the needs assessment and financial assessment in good time. Provide accurate details of income, benefits, savings and property, and ask which items must be disregarded. Request the calculation, start date and amount protected for personal spending in a format you understand. The current capital limits and income rules should be checked for your situation. A low level of savings does not necessarily mean there is no income contribution.

The council’s budget must meet your needs

Where the council arranges a care-home placement, its personal budget must be sufficient for the assessed needs it must meet. At least one suitable, available placement must be affordable within that budget, allowing for your assessed contribution. If no suitable option is available at that amount, the council must increase the budget. Ask it to identify the actual option and explain how it meets your needs. It cannot require a top-up simply to repair an inadequate budget.

What a top-up means

A top-up is an extra payment for a genuinely chosen placement costing more than the sufficient personal budget. It usually comes from someone other than the resident. The resident can pay only in limited circumstances, such as an applicable 12-week property disregard, an appropriate deferred-payment agreement or qualifying section 117 accommodation. Ask for specialist advice on the particular rule. Do not confuse a top-up with the resident’s assessed contribution or an optional private purchase.

Check a top-up agreement before signing

The payer must be willing and able to keep paying. A written agreement with the council should explain the amount, payment method, reviews, increases and what happens if circumstances change or payments stop. Ask who is legally responsible and what the agreement covers. Family members are not automatically liable for fees because they are relatives. Get independent advice if pressured, if costs are unclear or if someone proposes signing for an adult without appropriate authority.

If the top-up becomes unaffordable

Tell the council and provider promptly. Ask for a reassessment, the options and a written plan. The council remains responsible for the arranged placement while it resolves funding or arranges suitable alternative care following assessment. It should not treat an unpaid top-up as permission to abandon the person’s needs. A different placement may be considered; there is no automatic promise of remaining in the same home at any price. Get urgent advice about a proposed move or notice.

A home is not counted in every case

Ask the council to explain the property rules before deciding to sell. A temporary care-home stay with an intention to return can have different treatment from a permanent move. The home may be disregarded where a partner or a qualifying relative continues living there. The rules consider matters such as age, incapacity and when occupation began; not every relative automatically qualifies. The council can consider a discretionary disregard in some other cases. Ask for the particular decision and reasons in writing.

Ask about the 12-week property disregard

Where the conditions apply, the council ignores the home’s value for an initial 12 weeks after a permanent care-home move. It can also apply when certain existing disregards end, for example following the death of a qualifying occupant. Income and other assessable assets can still affect charges, so this is not 12 weeks of automatically free care. Ask when the period begins and ends, what you must pay and what arrangement will follow.

Deferred payment means a debt paid later

An eligible deferred-payment agreement can postpone part of a care-home bill using security, usually against a property. It does not remove the debt. Eligibility depends on the care arrangement, assessable assets, property treatment and adequate security. Councils may also have discretion beyond the mandatory scheme. Ask what can be deferred, how much equity remains, interest, administration costs, ongoing contributions and repayment terms. Obtain independent advice before agreeing; it is not a guarantee that every fee or top-up can be deferred.

If you are paying privately and money is running low

Contact the council well before savings reach the point where you may qualify for help. Ask for assessments and a written decision about the date funding could begin. Do not assume it will repay past private bills or automatically cover the home’s existing private rate. Ask how your needs, preferred home and any proposed top-up will be considered. Keep the provider informed and request a safe plan if funding is disputed. Do not wait until the account is empty.

Check benefits and changes separately

Tell the relevant benefit office about a care-home stay and changes in who funds it. Some disability benefits can be affected; the rules differ by benefit and funding arrangement. Ask a welfare adviser to check the whole position, including any carer’s benefits. Do not give away money or transfer property simply to reduce assessed charges: deprivation-of-assets rules may apply. Inheritance, trusts and major financial decisions need individual advice.

Question a wrong bill or funding decision

Keep assessments, contracts, statements, top-up agreements and correspondence. Challenge factual errors or unexplained charges with the council or provider, and request a review. Use the relevant complaints process and, where appropriate, the Local Government and Social Care Ombudsman. NHS funding decisions have separate challenge routes. Ask what happens to payments and care while a dispute is considered. Do not ignore bills or assume a complaint stops a move; get urgent community care or contract advice if needed.

Paying for a care home

Start with the care you need

Check NHS funding

Ask the council about costs

The budget must meet your needs

What is a top-up?

Before anyone signs

Ask about your property

The 12-week property rule

Paying later

If savings are running low

Check your benefits

If a bill or move seems wrong

What you can do next

More useful links