Thursday, 14 October 2010


Helping a relative or loved one to move into a care home is always a traumatic and emotional experience. So an unwelcome addition to this stress is when the local council social services inform you that you will have to sign a third party top-up agreement to keep your relative in the care home that you have chosen.

Our advice line has been getting more and more calls from families who have been routinely requested to pay more money for their relative’s care home fees in addition to the contribution made by social services. This is a worrying trend that is one of the main topics of concern to reach our advice line. In fact, it is not unusual for us to receive calls from distressed family members who are being given wrong information about third party top-ups or who feel bullied and threatened into signing a top up agreement with the council or the care home.

Recently, I was contacted by the wife of an elderly gentleman who had been in a care home for a number of years because of dementia and other serious health problems. He had been assessed as needing residential care because his wife, who had looked after for him for years, was not longer able to manage his care at home. Now that his savings had reduced to the capital threshold of £23,250, the local council had become involved in contributing towards his care home fees. The wife, whose own income was supplemented by Pension Guarantee Credit, was told by a social worker that if she did not agree to pay a substantial monthly top up to the care home fees, her husband could be returned home.

I was able to advise her that this was incorrect because firstly, her husband had been assessed as needing 24 hour care and the council had a duty to provide this, and secondly, guidance suggested that councils should not make third party agreements with relatives who were unable to financially sustain the arrangement. Our enquirer contacted me again to tell me that the advice and guidelines I had given her enabled her to challenge the council’s stance on this matter and it had now agreed to pay the care home fees in full.

Third party top-up agreements should only be requested by councils in certain circumstances, not as a matter of course. Only where a care home that is more expensive than the usual council rate has been chosen by an older person on the basis of preference rather than on the basis of their assessed care needs and where a cheaper, but still appropriate care home vacancy is available, can councils ask families to pay more. There are clear government guidelines on this issue for councils to follow and it is important to seek expert advice from organisations like Counsel and Care before signing a third party top-up agreement.

However, I do remain concerned how many people remain unaware of this and continue to pay out often from their own retirement savings to ensure that their loved one remains living where they want to be. The forthcoming cuts to council budgets has the potential only to make this situation worse, unless we do more to highlight people’s rights and entitlements in this area.

Posted by Pat Lacroix, Counsel and Care Second Tier Advice Worker

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