A 'Third Party Top up' is an agreement between a care provider, North Yorkshire Council and a third party in circumstances where the cost of a requested care home is higher than the identified cost of meeting a person's care needs. This third party undertakes to pay an additional contribution covering this difference in cost for the duration of the person’s stay in the home, this is paid either directly to the provider or via North Yorkshire Council.
The rules about charging in residential care are set out in the Care Act 2014. Every April our Health and Adult Services, produce a leaflet ‘What you should expect to pay for care’ which provides up to date information about the charges a person may pay for care.
Residential or nursing care
Some care homes are registered as Residential Homes, others as Nursing Homes and some provide both forms of care and are sometimes referred to as 'Dual Registered Homes.' All homes provide 24 hour care and support with daily living tasks, but nursing homes always have an onsite registered nurse and can provide support with health-related needs.
People in receipt of care and their families
Agreeing a ‘top-up’ fee
If you or your family have chosen a care home that is more expensive, your Adult Social Care Team Worker will discuss your options with you, including the potential of covering the additional costs. This is called a ‘top-up’ or ‘third party contribution’ and is the difference between what the council will pay for your care (the personal budget amount) and the cost of the more expensive care home you or your family have chosen.
The person paying the ‘top-up’ must be both willing and able to meet the additional cost for the likely duration of your stay in the care home, recognising that this may be for some time into the future. The council has a duty to ensure that the person paying the ‘top-up’ enters into a written agreement, agreeing to meet that cost.
The council will provide the person paying the ‘top-up’ with sufficient information and advice to ensure that they understand the terms and conditions, including actively considering the provision of professional, independent financial information and advice.
Price increases
Occasionally a review of the payments being made will need to be completed. This may be because of a change in circumstances or an increase / or decrease in the fees being paid to the care home. When this happens, the council will set out in writing how any increase in costs may be shared. If the person paying the ‘top-up’ is unable to meet any increases in payments, then they must contact the council as soon as possible to discuss the available options.
Neither you or the person who is paying the ‘top-up’ should pay any additional monies to the care home without first discussing this with the council and receiving confirmation of the increase in writing.
Changes in circumstances of the person making the ‘top-up’ payment
The person making the ‘top-up’ payment could experience an unexpected change in their financial circumstances that will impact on their ability to continue to pay the ‘top-up’ fee. Where a person making the top-up payment is unable to continue making ‘top up’ payments, the council will seek to recover any outstanding debt and has the power to make alternative arrangements to meet the needs of the person in receipt of the service, subject to a social care assessment.
Residential or nursing care
‘Top-up' payments are not affected by the type of care home a person is resident in as you will only be offered care homes suitable for the person’s needs. Any 'top-up' cost will be based on the difference in cost between the two homes where a more expensive home is selected.
Information for care home providers
Requesting a ‘top-up’ fee
If a person has chosen a care home that costs more than their personal budget amount and the chosen provider’s rate, a ‘top-up’ payment could be required from a third party to pay the difference in the costs between the preferred option and the personal budget amount.
Who is responsible for organising the ‘top-up’?
A ‘top-up’ must be agreed with the council and the third party beforehand.
The council needs to ensure that a third party understands the commitment of entering a top-up arrangement and this would be discussed by the council’s Adult Social Care team with the third party. An agreement would be entered into and signed by the council, third party, and yourself as the provider.
What if the third party stops paying the ‘top-up’ or can no longer afford to do so?
If the third party informs you that they are no longer able to pay the ‘top-up’ charge, this must be reported to the council via the Provider Return for the relevant payment period as soon as the first payment is not collected.
You must not request payment from anyone else other than the person who has entered into the Third Party Agreement.
Can I increase the 'top-up’?
An increase in the third party 'top up' amount cannot be requested by a provider without the prior agreement of the council who will discuss this with the third party to ensure they are willing and able to increase their third party contribution payment. Only once all parties agree and a contract amendment has been issued noting the date of the change can the top up increase.
