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"Thanks so much for all your help, advice, patience and effort from day one to today - I can’t imagine how this would have turned out without your skill and stamina."

- A son acting for his mother in a care fees dispute

"Your impact has definitely been felt by all involved, it’s efficient, intelligent and dynamic. I can feel that the opposing party are raising their standards, as soon as they hear from you."

- Sister of disabled man challenging care package

< Back to care journey

Perhaps the biggest cause of an adult entering a care home is the development of dementia to a point that they are no longer safe in their own home. In these circumstances it is often daughters and sons who choose the residential care.

The social services supported adult has a free choice as to which care home they want to live in. They can live wherever they wish to in the UK subject to the care home being capable of meeting their needs and willing to enter into a suitable contract with the home at a price the council is willing to pay.

If the home is more expensive than the council is willing to pay, the adult has a free choice provided a third party pays the difference in price. See top ups.

The resident themselves can pay the difference in price if they have a deferred payment agreement.

Top ups

Where daughters and sons choose care, this brings them directly to the issue of whether they are prepared to subsidise their parent's care fees.

When writing the care plan, the local authority must set a personal budget sufficient to provide the care. Local authorities all have set rates that they expect to pay care home providers to meet particular classes of need. Due to public spending cuts, these prices are often lower than care home providers believe is necessary to provide an adequate service.

Many care homes will not offer care at the local authority price. They will tell the relative that the placement can only be secured if a third party pays an additional fee.

In practice, many local authorities simply provide relatives with a list of care homes and advise them to look round. What they should do is identify at least 1 care home where there is a current place at the time of need at the price the council are willing to pay.

Relatives who consult Wrigleys almost never tell us that they were given this information and they often feel that they have no choice but to pay the top up requested by the home believing that there is simply a cap on council fees payable to meet need.

In fact, if the council are unable to identify such a current placement at their price they must agree to pay the cost necessary to meet the adult's needs.

Top ups are a common source of complaint with relatives often feeling that they have been given no choice but to contribute.


FAQs on Deferred Payments

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General Enquiry



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NHS Continuing Care Enquiry



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Venue: Radisson Blu, Leeds

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