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29th July 2013

Confusion over top up fees widespread, survey reveals

‘Postcode lottery’ for top-up fees in social care?

A survey published last week by the charity Independent Age has exposed that there is much confusion among councils over top-up fees to supplement means-tested council funding. Findings of the survey include:

  • 129 authorities (86% of all English councils responsible for social care) responded to a Freedom of Information request
  • Only 36 said they knew about all top-up payments in their area and so were able to be sure that families were "able and willing" to pay them
  • One in four councils said they directed families to independent advice before agreeing top-up fees
  • One in five carried out annual checks to ensure they were still able to afford to pay

This shows that there is widespread ignorance of the legal duties of councils as mandated by legislation.

The survey shows that there is some thing of a ‘postcode lottery’ when it comes to top-up fees for social care; in England, the only places where families of older people in residential care don't have to pay a top-up fee are the Isles of Scilly, Tameside in Greater Manchester and Tower Hamlets.

Up to 56,000 families paying

In other areas of England, the practice of care home top-up payments is widely used to get families to pay. In what Independent Age calls a "secret subsidy”, the estimate is that around 56,000 are paying extra towards the care of an elderly relative. Some interpret this large scale requirement for top-up fees to be paid by families as indicative that councils are not paying enough for care places.

Legislation sets out that such payments are voluntary and do not influence the quality of care. They are designed to cover ‘value-add ons’ such as bigger rooms or nicer views. As they stand, the care bill reforms currently in committee stage in the House of Lords seem unlikely to change the situation because they do not enable the older person or their family to challenge the reasonableness of that cost by independent review.

No reason for inconsistent social care with QCS

Even though it appears that at council level there is a muddled understanding of top-up fees, there’s no reason for the quality of social care to be as inconsistent.

QCS compliance management enables health and social care providers to demonstrate their attention to detail when it comes to CQC compliance.

QCS enables care homes, domiciliary care provides, Dentists and GPs to achieve the highest standards of care. With QCS eliminates the potential for misunderstanding and inconsistent standards.

Click here to find out more - take a FREE trial of the QCS compliance management system.

Click here to see the article ‘Families paying 'secret subsidy' to meet care home costs, warns charity‘ at

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

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