‘Top up stealth tax’ forced on older people entitled to free care

Age UK has revealed that the families of a quarter of care home residents whose care is supposed to be funded by their local authority are being forced into paying top up fees.

• This is affecting almost 50,000 families
• Fees vary but can amount to thousands of pounds per year
• These fees are meant to be voluntary but now families are being forced to pay them and the system is being abused.

What are top up fees?

When a person is moving into a care home they take the means-test to decide whether they are able to pay all the fees for their own care or whether the council should contribute. To qualify for state-funded support, they must show that they have modest assets - which currently can only be up to the value of £23,250.

In its latest 'Behind the headlines' report, Age UK has revealed that even those who have met these strict conditions to pass the means test are now being made to pay ‘top up fees'. These fees are paid by a third party such as another family member on behalf of the care home resident to supplement the council's payment of their care.

This can amount to a considerable amount of money. Age UK says the size of top ups varies from £25 a week to over £100 a week.

Stealth tax

Top up fees are being described as a ‘stealth tax' because they are supposed to be voluntary. 

For example: people can opt to pay for a home closer to their family or for extra facilities. However, if there is no local care home place that the council has enough money to pay for, the resident is now being forced to contribute to their ‘free' care if they want to live in their chosen area. Top up fees are also being demanded when:

• The cost of a care home which the council originally had enough money to fund has gone up
• A ‘self-funder' has run out of money so they become eligible for free care, but need to pay a top up

Age UK says this is taking advantage of a law which was supposed to give older people more comfort and freedom.  It is also holding up hospital discharge, as social services are unable to provide a free place so offering a top up place which families are unable to pay.

Case study: Linda's mother

Linda's mother went into a care home in 2015 and is funded by the council, who helped her to find a care home that did not require a top up.

Just four weeks after her mother had moved in, Linda was told that her mother could only remain if a top up of £120 a month was paid. This has since increased to £160. Linda has been told that her mother will have to look for a different home if she is unable to pay the top up.

Age UK calls for change

As Linda's story shows, 'top up' is abusing the rights of care home residents. It is now calling for these steps to be taken:

1. Councils need to make people aware of independent information so they can make informed decisions.
2. Costs need to be made clear. Councils should provide a statement setting out what they have paid for, including care and support, accommodation and ‘hotel costs'.
3. Care home contracts should give residents much greater protection against eviction and should clearly set out the circumstances in which care homes can give them notice.