What are top-up fees?
The Trust has to provide you with services that meet your needs, no matter how much it costs, but you or your family have the choice to pay a bit more for your residential accommodation if you would like to stay somewhere more expensive – these are called top-up fees. The Trust can’t put you somewhere and expect you to pay extra costs if you do not need it.
You or your family have the choice to pay a bit more for your residential accommodation if you would like to stay somewhere more expensive.
Top up fees would be the difference between your personal budget and the cost of the care home you want to go to. This might mean that your personal budget is £200 a week but you want to go to a care home that costs £300 a week – you could choose to pay £100 a week in top-up fees to make up the difference.
If you are doing this, you have to sign a contract with the local Trust to make sure you can afford the cost of top-up fees. This contract will also decide how often you pay your top-up payments and whom they’re paid to. If you do not make your top-up payments, you may have to move to a different place that is within your personal budget.
The Trust will review the agreement from time to time to make sure they know of any increases in charges and how they will divide this.
Generally, the Trust should be looking at your income only in attempts to recover any residential care costs, however, under the HPSS'72 it can try and recover them from a spouse, civil partner or children. If the relative is on limited income, the Trust will not pursue the payments, but if the Relative can afford payments, the Trust can pursue them through court. In practice, the Trust does not usually pursue the Liable Relatives.
Residential services under Guardianship Order
What is Guardianship?
Guardianship is a form of care, regulated by the Part II of Mental Health Order (NI) 1986. The purpose of the Guardianship is to provide a less restrictive care alternative to a hospital detention.
Under Guardianship Order, you may be referred to different forms of community help while staying in your home, or you may be referred to residential accommodation. If you are under Guardianship Order and you are referred to residential care, this is free of charge, but you can only benefit from this if it has been decided that Guardianship is the most appropriate form of care for you – application for Guardianship can only be made by an Approved Social Worker or your nearest relative.
The Trust acts as a Guardian, which in practical terms means that they appoint an officer to act as one. Your nearest relative can also be appointed a Guardian, with their consent.
Under Guardianship the patient can be required to:
- Reside in a place named by the Guardian and
- Attend treatment, training and other services in community as prescribed by the Guardian.
While you cannot oppose the Guardianship order being made as the patient, you can apply to have it reviewed by the Mental Health Review Tribunal, and your nearest relative can oppose an application for Guardianship to be made.
It is also important to remember that the Guardianship does not assume any powers to compel admission to a place named by the Guardian. As the patient, you cannot be forced to take part in the prescribed community activities or treatment and if you consistently resist the exercise of Guardian powers, the Guardianship may not be appropriate form of care for you.
Sometimes both patient and carer consider applying for Guardianship to avoid charges for Residential Care but it is important to remember that Guardianship has some implications, which the patient and/or carer should be aware of – one of them is that you cannot get Direct Payments while in free residential care under the Guardianship.