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If the local authority makes the arrangements for the person you look after to move into a care home, they should make all reasonable efforts to offer them a choice of placements. These placements could be in one of the local authority’s own homes, or in a private or voluntary home. Some local authorities will have a list of preferred providers which they will usually recommend.

If you or the person you look after do not like the home suggested, or you both have a particular home in mind, you can ask the local authority to arrange a place of your choice. This is called preferred accommodation, and the home can be anywhere in England or Wales or, by special arrangement, in Scotland.

The local authority has a duty to explain this right of choice to you and the person you're looking after. This free choice is subject to certain conditions, which include the following:

  • the preferred accommodation must be available,
  • the preferred accommodation must be likely to meet the person’s needs, and
  • the cost of the care home should be no more than the local authority would usually pay for a home that would meet the assessed needs.

Where preferred accommodation is more expensive

If the person you're looking after chooses a care home which is more expensive than the local authority would usually pay, a third party (such as a relative or friend) can agree to top up the difference in cost, or the person you're looking after can enter into a deferred payment scheme (see the Deferred payment section, above).

Guidance to local authorities about choice

Local authorities have been given guidance to take into account when making decisions about how much they will pay towards a particular care home.

They must look at individual circumstances when they compare the cost of the preferred accommodation to what they would usually pay. They should not, as a matter of routine, ask third parties to make top-up payments if the accommodation is over a certain limit. They have discretion to pay above the normal amount if they think it appropriate.

They must be careful to compare costs only with care homes which would fully meet the resident’s needs.

The way local authorities commission services is important. If they fail to pay reasonable amounts to care homes in their area, those needing residential care may be under pressure to pay top-up fees.

To meet assessed needs it may be necessary to find a care home outside the local authority area. Even if this is more expensive the local authority will need to meet the cost if there is no viable alternative.

Challenging requests for top-up payments

You or the person you're looking after can make a complaint about an assessment.

For example, it may be that the local authority has failed to take into account all of their needs, including psychological, religious and cultural. It may be possible to argue that only certain care homes can meet those needs, even if they are more expensive.

If the local authority is arguing that there are care homes that are suitable at a lower price than the preferred accommodation, you can ask them to give you specific examples and check whether or not there are any vacancies.