National Ombudsmen
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Southampton Council criticised over care home ‘top-up’ fees

Southampton City Council wrongly charged an elderly woman’s family ‘top-up’ fees for her residential care, finds Local Government Ombudsman, Dr Jane Martin.

In her report, issued today, she says that, in line with Government guidance: “because no accommodation was available at the Council’s ‘usual rate’, the Council should have paid to accommodate the woman elsewhere and should not have sought additional fees beyond the assessed contribution.”

The Ombudsman therefore welcomes the Council’s acceptance of her findings, and its agreement to pay the full cost of the woman’s care, less her assessed contribution, and refund ‘top-up’ fees wrongly charged.

The family of an elderly woman were told they needed to find a nursing home placement to enable her to leave hospital, where she was admitted after suffering a stroke. The woman’s daughter said they could not find a care home place at the Council’s usual rate that met her mother’s assessed needs. This meant the family had to choose a home where the rates were higher than the Council’s ‘usual rate’, and the Council charged them ‘top-up’ fees.

However, Government guidance states that, where a home is not available at the Council’s usual rate, it should make suitable alternative arrangements and seek no contribution from the individual other than their assessed contribution. So the family should not be have had to pay the additional top-up cost of £187.56 per week.

The Ombudsman found maladministration causing injustice, and the Council accepted her findings and agreed to her recommendations that it should:

  • meet the full cost of the woman’s care in the care home from 31 July 2011 (less the assessed contribution she needed to pay)
  • refund the top-up fees the family had paid from 31 July 2011 and pay them interest on those payments at the Council’s standard interest rate
  • pay the family £500 to recognise the time, trouble and distress caused to them
  • review the Council’s guidance for staff regarding the availability of services at the Council’s ‘usual rate’, and
  • in the short term, negotiate access to placements at the Council’s ‘usual rate’ with key care home providers. In the medium term, to hold discussions with care home providers to develop an agreement on fee levels.


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