Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
3. Department of Health and Social Care. Care and support statutory guidance. Available at: https://www.gov.uk/government/publications/care-act-statutory-guidance
4. The Care and Support (Charging and Assessment of Resources) Regulations 2014, SI 2014/2672.
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
This article is made available for general information, education and professional reference. It may be downloaded, printed and shared for non-commercial purposes, provided that it is reproduced in full, is not altered in any way, and is properly cited as the work of Nellie Supports Ltd. This material must not be edited, adapted, sold, republished, incorporated into commercial products, or used for commercial training, assessment, report-writing or advisory services without prior written permission from Nellie Supports Ltd.
This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide explains what to do when care home fees increase. It covers what the contract governs, the notice required, how to question an increase, the difference between fee increases and increases arising from changed needs, the position where the local authority is funding, and why a rising fee is a good moment to test NHS Continuing Healthcare eligibility.
Care home fee increases and what to do
Care home fees rise, sometimes sharply, and a significant increase is often the point at which a family first looks seriously at whether the NHS should be funding the placement at all.
Start with the contract
The contract between the resident and the home governs fee increases, including how much notice must be given, how often increases can be applied and whether any cap applies. Read it before responding. Many disputes about increases resolve on the contract terms rather than on anything about the care itself.
Notice and consultation
Homes should give reasonable written notice of an increase, in line with the contract, with an explanation of the reason. An increase applied without notice or outside the contract terms can be questioned. Ask for the basis of the increase in writing, including what has changed in the home's costs.
Increases arising from changed needs
This is a different situation. Where the fee rises because the person now requires more care, for example additional staffing or one to one support, that is a change in the package rather than an inflationary increase. It also indicates increased need, which is directly relevant to NHS Continuing Healthcare and worth acting on.
Where the local authority funds
Where the placement is funded by the local authority, the authority negotiates the rate with the home, and the resident should not be asked to make up a difference except through a properly agreed additional cost payment. If a home approaches the family directly for more money in that situation, involve the local authority.
Use it as a trigger
A significant increase is a good moment to request a Checklist. If needs have grown enough to justify a higher fee, they may have grown enough to change the eligibility picture. If the person is eligible, the Integrated Care Board meets the full cost of the placement and the increase becomes the Board's problem rather than the family's.
If you cannot afford it
Tell the home promptly and in writing rather than allowing arrears to build. Ask the local authority for a needs assessment and financial assessment if you have not had one. Request a Checklist at the same time. A move should be a last resort, and the person's needs and wellbeing must be considered in any decision about one.
Key takeaway
Read the contract first and ask for the basis of the increase in writing. Where the rise reflects increased care needs, treat that as a signal to request a CHC Checklist, since eligibility would transfer the whole cost to the NHS.
Add a Title
Add paragraph text. Click “Edit Text” to update the font, size and more. To change and reuse text themes, go to Site Styles.
Add a Title
Add paragraph text. Click “Edit Text” to update the font, size and more. To change and reuse text themes, go to Site Styles.
Frequently asked questions
How much notice should we get?
Whatever the contract requires, which should be reasonable and in writing with an explanation. An increase applied without notice or outside the contract terms can be questioned.
Can we refuse to pay an increase?
Withholding payment risks the placement rather than resolving the dispute. Raise it in writing, ask for the basis, and refer to the contract terms. Get advice if the amount is significant.
The fee went up because needs increased. What does that mean?
It indicates increased care needs, which is directly relevant to NHS Continuing Healthcare. Request a Checklist, because eligibility would mean the Board meets the full cost.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.