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Editorial guide

Local-authority & NHS funding11 min readPublished on 27/07/2026

The care home fees are no longer affordable: what actually happens and what to do first

The money is running out and the fees are still due. The instinct is to say nothing and hope — and that is exactly what turns a solvable problem into a notice to leave. There is a defined route, it starts with a financial assessment, and the threshold that triggers council help is one many families cross without noticing. Here is the order to do things in, and the one payment you may never have owed.

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The month the numbers stop working

Sometimes it creeps up: savings draining faster than the plan assumed. Sometimes it arrives at once — the home raises its fees, or a spouse dies and a pension stops.

The most common reaction is also the most damaging: say nothing, hope something turns up, keep paying from whatever is left. That is precisely how a situation with a defined route through it becomes arrears — and unpaid fees are one of the few grounds on which a home can serve notice.

The route: ask for a financial assessment

If your relative is paying for their own care and the money is running down, the step that matters is a financial assessment from the local authority — alongside a needs assessment if there is not a current one.

Two things families get wrong here:

  • They assume the council is only for people who have nothing. It is not. Capital is assessed against thresholds, and when savings fall below the upper limit the council may start contributing. Many self-funders cross that line without realising, and keep paying in full for months afterwards because nobody told them.
  • They wait until the money has actually gone. Ask when you can see it coming — typically several months out. Assessments take time, and help is not usually backdated to cover the period before you asked.

Keeping the house out of it, for now

If the value of a property is what tips the assessment, ask about a deferred payment agreement. It lets the council cover fees now, secured against the property, so the house does not have to be sold in a hurry at whatever price the market offers that month. It is a loan rather than a gift — interest and fees apply — but it removes the forced-sale timing, which is often where families lose the most money.

Also worth checking, because it is missed constantly: if your relative's needs are substantially health needs rather than social care needs, ask for an NHS Continuing Healthcare checklist. Where it leads to full funding, it changes the picture entirely.

The payment you may never have owed

If a relative has been paying a third-party top-up to fund a more expensive home, this is the moment to look at it again.

A top-up must be genuinely voluntary and affordable, and agreed in writing. It is not something that can be required to secure a placement meeting the assessed needs — the council must be able to offer at least one suitable option at its own rate. And if the person paying it can no longer afford to continue, that is a change of circumstances the council needs to know about, and the arrangement has to be reviewed rather than simply enforced.

Families pay top-ups they never owed, for years. Ask to see the written agreement and how the figure was arrived at.

Other things to check before you conclude it cannot work

  • Attendance Allowance and other benefit entitlements, which are widely under-claimed.
  • The invoice, line by line. Extras that no one uses any more often keep billing quietly.
  • Whether the fee increase itself was applied correctly — check the contract's notice period and review terms.

If arrears have already built up

  • Go to the home before it comes to you. Homes have every interest in a solution: someone leaving gives them an empty room and an unpaid balance.
  • Put any payment arrangement in writing, and record that an assessment is under way.
  • Involve the social worker — this is exactly their job.
  • Answer every letter in writing. Silence is the only thing guaranteed to make it worse.
  • Get free advice from Age UK or Citizens Advice before signing anything that commits a relative personally.

If it genuinely cannot work

Sometimes the numbers do not come out even after all of this — often in a home priced well above the local rate. Moving to a more affordable home is a legitimate decision, and it is far better made calmly than under a notice period.

Looking elsewhere is not the same as deciding to move. It is having a benchmark. Some families find a comparable home twenty miles away at a very different weekly rate; others find theirs is already the best available, which is just as useful to know.

The practical point

This does not get solved by economising and it does not get solved by waiting. It gets solved by asking for the assessment early, claiming what is already due, questioning a top-up that may never have been owed, and knowing what the market around you actually costs.

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Capital thresholds, financial assessment rules, deferred payment agreements and top-up arrangements differ across England, Scotland, Wales and Northern Ireland and are revised over time. Check the position where your relative lives and read the contract before agreeing to any payment arrangement. This article is general information, not legal or financial advice: contact Age UK or Citizens Advice for free guidance, and take independent advice before entering a deferred payment agreement or committing to a top-up. Curalune does not allocate places and cannot guarantee availability.

Paying less is mostly a paperwork problem

What a family actually pays is decided less by the home's headline fee than by three applications: the council's financial assessment (capital above the threshold means paying in full — below it, means-tested support starts), NHS Continuing Healthcare, which covers the entire fee when the need is primarily a health need and is worth requesting a checklist for even if you expect a no, and Attendance Allowance, which is not means-tested and is missed by a great many families. If the home is the only asset, ask the council about a deferred payment agreement before selling anything.

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