More families of elderly people in costly care homes in Cheshire East will be asked to pay 'top-up' fees as the cash-strapped council struggles to balance its books.

And the authority's executive director of adults, health and integration admitted last night (Monday) she 'couldn't rule out' the prospect of having to move some residents who are in care homes above the council's budget.

Helen Charlesworth-May was speaking as the adults and health committee was discussing an £11.8m overspend in adult social care for the last financial year – 2023/24 – and how they were going to balance the books this coming year when the pressure will be even greater.

Mrs Charlesworth-May told the meeting it was 'absolutely necessary, in the circumstances the local authority finds itself in, we are going to have to ask for more third party top-ups'.

"We will have to be much, much stricter about our standard price, and we will have to be much more direct in requiring families to make a third party top-up if their accommodation of choice is more expensive than that," she said.

"Those are all tricky things to do, not things we have done historically, but they are absolutely things we're going to have to do now and forever."

Cllr Janet Clowes (Wybunbury, Con) asked: "So we're not just talking there about people coming into the system and perhaps having to make do with a home that is not exactly what they want because of cost?

"But I'm assuming we're also talking about those top-up arrangements that then fail and may involve moving people from where they are to somewhere that satisfies our cost element?"

Mrs Charlesworth-May replied: "Certainly, top-ups for new people entering the system.

"Moving people is much more difficult because of the risks associated with that, but we can't rule it out."

Jill Broomhall, director of adult social care, said the cost of care packages to the council had risen significantly.

"The cost of packages of care for people transitioning from children services who have some really high needs are astronomical," said Mrs Broomhall.

"For example, we have 44 people under the age of 65 in residential care at a cost of £6.6m per year.

"We have 109 people in supported living at a cost of £8.2m per year."

"The costs of providing care are huge.

"We are seeing more individuals requiring one-to-one support and two-to-one support for sometimes 24 hours a day because of their frailty, their physical needs, their emotional needs and behavioural needs – packages of care of £4,000 per week."

Nantwich councillor Anna Burton (Lab) asked if Cheshire East – which has a higher elderly population than average – could get support from central government, but was told it was not available.

Cllr Burton said: "I just cannot believe that, in a civilized society, we're in this situation where we have to have these discussions."

Mrs Broomhall said: "I cannot believe that, in a civilized society, this is where we find ourselves.

"And that is the plight of every social worker in Cheshire East at the moment – that we cannot believe that, every day, we are making decisions between where people would like to spend the remainder of their lives and where we will pay for them to spend the remainder of their lives."