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5 How much will local authorities pay for care homes?

After the financial assessment has been completed, your relative should be provided with written information from the local authority detailing how the charges are worked out and what is payable.

Local authorities should pay a realistic amount that will provide your relative with the care they need, as outlined on their care plan. However, it does stand to reason that they will be looking to do this in the most cost-effective way.

Councils have a standard rate (also called the usual cost) that they are usually prepared to pay for care. They will have different rates to cater for people needing different levels of care – for example, in a care home with personal care only or in a care home with nursing. 

If your relative has dementia, the council will usually pay more to a care home to cover his or her needs. 

If your relative:

  • qualifies for help with financing a place in a care home, the local authority will pay the fee directly to the chosen care home
  • doesn't qualify for help with financing a place in a care home, he or she will be looking to self-fund a care home
  • is unhappy with the assessment, he or she can challenge the local authority's decision.

If the local authority is funding a place in a care home

Your relative should choose from care homes that have places available and which can meet their assessed needs – at the rate the local authority is prepared to pay. If there are no care home places available to meet your relative’s assessed needs at the council’s standard rate, the local authority should pay the extra for them to go to a care home that meets all of their assessed needs. 

For example, if your relative needs to be in a care home in a particular area to be near to family and/or friends, but the only homes available in that area are more expensive, then the local authority where your relative has been assessed should pay the additional cost. It is essential, though, that these needs are recorded up front in your relative’s needs assessment so you can prove that the care homes the council is offering you do not meet them.

In Northern Ireland, the Health and Social Care Board (HSCB) set a tariff level, which is used as a guide by the HSC as to what is fair and affordable for your relative’s type of care and is known as the standard regional rate. Your relative should choose from care homes that have places available and can meet their assessed needs. If there are no care home places available to meet your relative’s assessed needs at the regional rate, the HSC should pay the extra for them to go to a care home that meets all of their assessed needs.

Third-party top-ups

If your relative’s care home fees are funded by the council but he or she would prefer to live in a care home that costs more than the council is prepared to pay – for example, they want to live in a certain area out of preference, or they have chosen a high-end 'luxury' care home – they can do this if someone will agree to pay the difference. 

This is called a ‘third-party top-up’. The top-up can be made by a friend, a relative or a charitable organisation. The third party will need to demonstrate they are able to pay the difference between the local authority’s standard rate and the care home’s actual fees.

More information

Page last reviewed: February 2017
Next review due: July 2018