Implementation toolkit: top-ups

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IMPLEMENTATION
TOOLKIT
Top-ups
Produced by NAFAO on commission from:
Supporting implementation of the Care Act 2014
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Contents
Top Ups
Top-up Leaflet …………………………………………………………………….
3
Top-up financial questionnaire ………………………………………………….
9
Top-up agreement/contract ……………………………………………………… 14
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Information Leaflet Template on Choice of Accommodation
CHOICE OF ACCOMMODATION
THIRD PARTY TOP UP’S
WHAT DO I NEED TO KNOW?
Introduction
This leaflet tells you about your rights to choose the accommodation in which you will
receive care and support, whether it is in a care home, supported living or shared
lives, once the care planning process has identified that one of these types of
accommodation is the most appropriate way of meeting your needs. It also explains
what you will have to do if you wish to choose accommodation that costs more than
the amount that has been specified in your personal budget for the provision of
accommodation of that type.
For choice to apply the council could be proposing that you live in, a care home that
also provides nursing care, a shared lives setting or supported living and social work
staff will have advised you which will meet your care needs.
A personal budget is the cost to the council of meeting those of your needs which it
is required to or has decided to meet and has identified in your care and support
plan.
Your Right to Choose
The care planning process will have identified how your needs are to be met. Where
this involves a particular type of accommodation, you have the right to choose
between different providers and/or locations of that type of accommodation in
England and your social worker or care coordinator will be able to give you a list of
all of the relevant settings for you to choose from. You may wish to choose to live
near to where you are living now or move to a different area to be closer to your
family, or in a specialist home such as one run by a religious organisation. There are
special cross-border arrangements if you wish your local council to arrange for you
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to live in accommodation in Wales, Scotland or Northern Ireland. You should seek
advice from social work staff if you would like your local council to arrange this.
There are 6 conditions which need to be met for you to have your choice of setting.
Care and support needs
That your care and support plan specifies that your need a are going to be met by
arranging care in a care home, shared lives or a supported living accommodation.
Type of Accommodation
That the accommodation you choose is of the type specified in your care and
support plan.
Suitability of Accommodation
That the accommodation you choose is suitable to meet your eligible care needs.
Social work staff will advise you which types of accommodation are suitable to meet
the needs that are set out in your care and support plan.
Cost
Your council will have undertaken a care planning process and prepared a personal
budget for you that will cover the cost of meeting your eligible care and support
needs. The amount in your personal budget must be sufficient to meet your
assessed eligible needs and ensure that you have at least one choice of setting that
is affordable within that amount and the council should try to ensure there is more
than one affordable setting. However, you might wish to choose a setting that costs
more than the amount in your personal budget. If you do, a payment will need to be
made to pay the difference between the accommodations weekly charge and your
personal budget. These are called Top Up payments and these are explained later
in this leaflet.
If you choose a setting outside of your local area the local authority will still pay the
amount identified in your personal budget.
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Availability
The accommodation that you choose may not have space available. If you do not
want to choose different accommodation it may be necessary for you to go on a
waiting list until a place becomes available and go into alternative accommodation or
receive care at home while you are waiting. This is called an Interim Care
arrangement.
Your social worker will tell you how long you are likely to wait but this will only be an
estimate and not a guarantee.
If the temporary accommodation charges more than the amount in your personal
budget the council will pay the difference. If this happens and you decide to stay in
that accommodation permanently you will only be able to stay there if a top up is
made – top up payments are explained later in this leaflet.
Terms and Conditions
The provider of the accommodation you choose must agree to contract with the
council to provide you with accommodation subject to the council’s usual terms and
conditions.
If you are in Hospital
You have all of the rights set out in this leaflet if you are going to move from hospital
to accommodation of your choice, but there are some special rules for this.
Once the medical staff are sure that you can be discharged from hospital the law
requires that the council must arrange your move within a very short period. If the
accommodation that you choose does not have a place available, the hospital will
not be able to allow you to stay in hospital until a place becomes available and you
may need to have an Interim Care arrangement, as set out above.
Your Right to Choose More Expensive Accommodation and Top Up Payments
When making your choice, you may choose a setting that costs more than the
amount identified in your personal budget. There are many reasons why a setting
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may cost more such as commercial business reasons or because it considers it
provides accommodation of a superior standard, for example a bigger room or other
additional services.
The amount identified in your personal budget must be sufficient to meet your needs
and the council must ensure that at least one option is available that is affordable
within your personal budget and should ensure that there is more than one.
However, you can choose to live somewhere that costs more if you wish. If you do,
your family, a friend or someone else such as a charity, or in some circumstances
you, must be willing and able to make a top up payment to cover the difference
between the care homes fees and the amount in your personal budget for the likely
duration of your stay. Your council must never force you into having to pay a top up
fee because no suitable accommodation is available within the amount in your
personal budget. In these circumstances, the personal budget must be adjusted to
meet the costs of the accommodation needed to meet your assessed eligible needs.
It is very important that you are aware of the following:-
 The amount set in your personal budget will be reviewed regularly and may
increase to ensure the amount is still sufficient to meet your eligible needs.
However, the council cannot guarantee that the accommodation will
increase its costs at the same rate and this may affect the level of the top
up payment.
 The top up will always be the difference between the care home’s fees and
your personal budget.
 Whoever is paying the top-up (you or the third party) will need to sign a
written agreement that they are willing and able to meet the difference in
cost and will continue to do so throughout your stay. Prior to signing the
agreement, the person paying the top-up will have to satisfy the Council
that they can afford the weekly top up amount. (They will need to complete
a financial circumstances form providing details of their assets and
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liabilities, as well as their income and expenditure) [delete as
appropriate]. If the person paying the top-up cannot satisfy the Council
that they will be able to afford the top up for the likely duration of your stay,
the Council will not agree to arrange care and support in the preferred
accommodation.
 The person paying the top-up should be aware that the top-up amount may
vary as providers review their fee levels.
 If the person paying the top-up is unable to continue to pay the difference
you may have to move to another room within the accommodation or to
another accommodation that charges fees that are within the amount set in
your personal budget.
 Any move to other accommodation will only happen after a community care
and risk assessment of your needs to make sure that the other
accommodation is right for you.
I am a considering paying a top up fee, what does this mean for me?
The council providing care and support will want to know that you are willing and
able to make the additional payment for the likely duration of the contract. They will
therefore want to assure themselves that you can afford this and will ask you to fill
out a financial questionnaire and to sign a written agreement confirming you are
willing and able to make the payments.
What will be in the written agreement?
The written agreement must include the following:

The amount of the top up payment

The amount of the person’s personal budget

How often payments must be paid

To whom the payments must be paid – this should normally be the council as
they must have oversight of all top up arrangements as they are ultimately
responsible for the full cost of care should the top up arrangement break down.
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
How an arrangement is to be reviewed

The consequences should you be unable to continue to make a payment. This
could include moving the person receiving care.

The effect of any increases in charges made by the provider

The effect of any changes in the financial circumstances of the person paying the
top-up.
Other Information
If you or your family have any other questions about your rights to choose
accommodation, please talk to your social worker.
Information on payments for the accommodation is given in a separate leaflet
“XXXXX” (general leaflet on charging) which your social worker can provide for you.
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Application to make a top up payment for accommodation charges
Please Return to:
Local authority address
Instructions For Completion
1.
2.
3.
4.
Please complete this questionnaire in full
Please write legibly (print if necessary)
Please declare ALL income and expenditure
Please ensure all values are verified by an Officer OR by providing supporting
documents
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Personal Details
Title: Mr / Mrs / Ms / Miss
First Name(s) _____________________ Surname________________
Date of Birth: ____/____/________
National Insurance No: _______________________________
Full Home Address & Postcode: ______________________________________________________
________________________________________________________________________________
Marital Status (please circle)
Married / Single / Widowed / Divorced
Dependants (Children of 17 and under)
Age
___
Date of Birth
_________________________
Address
_________________________________________
___
_________________________
_________________________________________
___
_________________________
_________________________________________
Employment
Are you employed?
Yes/No
What is your occupation?
___________________________________________
Name of your Employer?
___________________________________________
Address of Employer?
___________________________________________
___________________________________________
Income (Gross) from Employment?1
£________per ________Hourly/Weekly/Monthly (please circle)
If presently unemployed, please state the date you became unemployed.
__ __ / __ __ /__ __
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Your Income
How Often?
Company & Reference/ Account
Number
Amount?
(Please Circle)
State Retirement
Pension*
Documents
seen by
Officer
Week/ Fortnight/
Four Weeks
£
Week/ Fortnight/
Four Weeks
£
Week/ Fortnight/
Four Weeks
£
Week/ Fortnight/
Four Weeks
£
Week/ Fortnight/
Four Weeks
£
*With all benefit payments, please enclose either the ‘Letter of Award’,(which will be returned) a copy
of the front page of the Benefit Book, or a copy of a bank statement indicating the benefits received.
Evidence of all expenses must be provided to & verified by the Officer conducting the
interview
Your Spending
How Often?
(Please
Circle)
Amount?
Rent & Ground Rent1 (less
Housing Benefit)
Week/Month
£
Council Tax 2
(less CT Benefit)
Week/Month
£
Mortgage repayment
Week/Month
£
Insurances
Week/Month
£
Food
Week/Month
£
Maintenance payments
Week/Month
£
Other
Week/Month
£
Company & Reference/
Account Number
Documents
seen by
Officer
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Your Debts
Company & Reference/ account number
Amount?
Rent or Mortgage
£
Council Tax
£
Utility Bills
£
Bank Loans
£
Credit Cards/
Store Cards
Other (Specify)
…………………….
Documents
seen by
Officer
£
£
Please provide proof of monies owing.
Final Demands/ Court Orders
Order details/instalments
______________________________________________________
______________________________________________________
Your Capital
& Savings
Savings
Accounts
Stocks/
Shares
Other
(Specify)
Company & Reference/ account number
Amount?
Documents
seen by
Officer
£
Number held:
£
£
Do you own property? YES / NO If Yes, please provide details of all the properties you own
Estimated Documents
Your
Mortgage
Address & Post Code
Market
seen by
Property
Balance
Value
Officer
UK
£
£
UK
£
£
Overseas
£
£
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DECLARATION

As far as I know the information that I have given on this form is true and complete.

If my financial circumstances change I must notify the Council immediately, e.g.: If I become
unemployed or change jobs.

I am willing to make payment of the top up to [local authority name] for the length of stay in
the accommodation. It is likely that there will be an increase in the top up each financial year
but these will need to be reviewed and are not automatically to be taken on by one party..
This will be discussed with the local authority following a review of the personal budget.

I understand that if I default on the top-up payment the local authority may take action against
me. This may result in the accommodation being terminated and alternative accommodation
arranged.

The top-up payment must not be derived from the person’s savings or capital unless it is a
property that is subject to the 12-week disregard or the costs of care are being met through a
DPA.

A top-up payment must be paid in addition to the assessed contribution.
Print name…………………………………………………
Signed…………………………………………………. Dated______/______/______
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Draft third party contribution written agreement
[Local Authority Name & Address to be entered here]
THIRD PARTY CONTRIBUTIONS AGREEMENT LETTER
THIS AGREEMENT is made on the Date between Local Authority Name and Address of
the first part
And of
(Name of Provider)
(herein after referred to as “the Contractor”) of the second part
And
(Name of person making the top up contribution)
of
contribution)
(Address of the person making the top up
WHEREAS
1.
(Name of Resident)
of name and address of local authority
(herein after called “The Resident”) wishes to reside at a care home, supported living,
shared lives called
(herein after called “The Home”) which is a Home
operated by the Contractor.
The Contractor is willing to provide the Resident with care under and in accordance
with the terms and conditions of the Contract (as herein after defined)
2.
The Resident/a Third Party has agreed to pay the Council the top up contribution (as
herein after defined)
3.
In the light of the agreement of [the Resident/a Third Party] herein contained the
Council is willing to nominate the Resident for occupation of the Home and Provision
by the Contractor of Residential Care under and in accordance with the terms of the
Council's Residential and Nursing Care contract.
NOW IT IS HEREBY AGREED BY AND BETWEEN THE PARTIES HERETO as follows:
4.
Definitions
In this agreement the expression already defined shall have the meanings assigned
thereto and the following expression shall unless the subject or context otherwise
require have the following meanings.
“The Contract” The Council's Residential and Nursing Care Contract signed by the
Service Provider.
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“Third-Party” A persons or persons who have entered into an agreement to pay the
top up contribution.
“Resident”
The person living in the accommodation [and who has entered into an
agreement to pay the top up contribution.
“Top Up Contribution”. The difference between the Service Provider’s rate and the
person’s personal budget
“Service provider rate”. The amount the provider charges.
“Personal budget”.
in the care plan.
The cost to the local authority of meeting the needs identified
Agreement
The person making the top up contribution agrees to pay the Sum of
being the difference between the Service Provider's rate (which at the date hereof is
per week) and the person’s personal budget. (which at the date hereof is
per week). This should be paid on a monthly basis unless alternative arrangements
are agreed in writing.
The Council is responsible for notifying the person making the top up contribution of
any changes to the charges outlined in this agreement.
Terms otherwise used in this Agreement shall have the same meaning as in the
Contract.
5.
The person making the top up hereby agrees to pay the Top Up Contribution to the
Council in line with the Local authority’s payment schedule.
6.
For the avoidance of doubt it is hereby declared and agreed between the parties
hereto as follows:
a.
Arrangements will be reviewed in line with arrangements for reviewing the cared
for person’s financial assessment and personal budget. These are reviewed
following a change in circumstances or on an annual basis.
b.
The person making the top up shall notify the Local Authority immediately of any
changes in their circumstances which could affect their ability to make Top Up
Contributions. This may trigger a review of arrangements.
c.
If there is an increase in the difference between the Service Provider's weekly
rate and the Declared Price a review will take place to discuss how the increase
will be shared. . I,e both parties will pay the same percentage increase in their
contributions.
d.
The person making the top up shall forthwith make arrangements to pay the Top
Up Contribution by direct debit or such other arrangements as the Council may
reasonably require.
e.
.
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f.
In the event of the failure by the person making the top up to pay the Top Up
Contributions in full at any time the council will have the right in 4-weeks’ notice
to withdraw the Resident from occupation of the accommodation and place them
in alternative accommodation that is affordable within the amount identified in the
cared for person’s personal budget.
g.
Without prejudice to its right under clause 3 (b) herein the Council agrees
with the Contractor that it will use all reasonable endeavours to keep the
Contractor advised of any substantial delay in or change in the pattern of
payment of the top up payment by the person making the top up.
AS WITNESS the hand of the person making the top up payment and the hand of the duly
advised representatives of the Council and the Service Provider the day and year first before
written.
Signed:
(Signature of Budget Holder)
On behalf of Local Authority
Signed:
(Signature of Contractor)
On behalf of: …………………………………………
(name of Home)
Signed: ………………………………………………..
(Signature of person making the top up
payment)
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