OK. This will not be definitive but I will try and explain.
Firstly, most of us have an impression of how Social Care is paid for. I will try and explain 'top-up' for home care but it does apply to care in a Care Home too.
So, there you are trying to sort out the provision of care for a parent. This post was not about what you have to pay because the government says that it will be £xxx if you have more than £14,250 in savings and an income over £189. This will be worked out and you will have to contribute whatever that figure is.
There is, however a maximum the council will pay per hour and multiples are worked out by the hour even if you are having fractions of an hour at some times. Still with me?
So for every hours of care (at home) they will explain they will pay £x. The first thing is that they will go to their preferred providers who they can put in at this figure - they have agreed this with them. However, this figure is not what any other care provider in the area is charging. This is because they cannot run their business on this amount. Because it is too low for businesses to survive they may come back and say their one surviving care provider (they did have three but two went out of business) doesn't have anyone at the moment - would you like to use direct payments and find your own carers.
Sounds like a good idea. You ring round and find no one charges this amount. Not only do they charge more for an hour, they also, not unreasonably, charge even more than half that for a half hour (often used for meal provision). In addition they may charge more per hour (and per half hour) at the weekend and they also charge a travel fee for each visit over a certain mileage. So, the SS are offering to 'put care in' and will pay a certain amount. If you go down the road of direct provision you will have to pay the "top-up" to meet the fees I have just described.
What do you do? You could wait for the preferred provider to have someone free - knowing that a) they may be working on a tighter schedule to make the hour's pay work for them and b) the last two went out of business - what if these do too.
So you may decide you will "top-up". All this is before you pay anything the government has decided you need to contribute. You will probably think it is a good idea at first - after all you need the care urgently and the figure plus the amount you need to contribute is one you can afford, even though the person needing care is on a low income.
The government has worked it so that you pay the maximum you have to on a low amount of care but this does not increase so you know you can cover that. However, every time more care is needed so is 'top-up'. You may have to move to a cheaper carer, forgo some care, or what ...?
This is top-up and for anyone dealing with it, it can be a worry and I thought the article might help.