Yorkshire and Humberside Region

Sam NewmanDirector - Personalisation ProgrammeOLM Group

General IntroductionMore detailed introduction to framework

Round table discussionQuestions

More detailed introduction to practical toolsRound table discussionQuestions

This Morning

Common RAS Framework

•Sponsored and commissioned by ADASS

•9 month programme – Jan 09 – Sep 09•Three phases

•Design•Test•Publish

•We have just completed final products•National launch – October 2nd

Common RAS Framework  Process

•Partnership:•Sam•David Todd – symmetric sd•Tony Bennett – citizen leader

•Advice from in Control•Co-production – 18 councils, 8 citizen leaders•Consensus

Common RAS Framework: Products

•Principles and Policy Advice - including best practice solutions to key issues, and legal advice

•Set of Practical Tools:•Questionnaire•Scoring framework•Financial Framework•System map

Common RAS Framework  

•Ambition of the programme is to offer value to all councils

•Councils early in their process can take the products ‘out of the box’ and use them

•More experienced councils can bring coherence to solution to key issues like:

•Informal social capital and family support•Legal issues•People with high support needs

Common RAS Framework  •Not mandatory!!•Please extract as much value as possible out of this work

•Some councils are using tools out of the box – best place to start

•Some are using tools to improve their existing RAS

•Some are using the framework document to benchmark practice

•Can we all do with a bit more consistency and coherence?

Principles and Policy Advice •Principles and values:

•Social model of disability, citizenship•Solutions to key issues:

•Assessment•FACS•Future proofing•High support needs•Informal support•Family carers•Equalities

•Legal Issues

Principles and Policy Advice 

The framework is based on an important set of principles

•the social model of disability,•the idea of citizenship•a focus on outcomes.

Principles and Policy Advice 

It shows how to develop a RAS applying the principles of:

•Co-production•Equitability•Transparency•Sustainability•The use of appropriate language

Principles and Policy Advice 

It shows how to develop a RAS that is:

•Simple•Rational•Works out how much money someone is likely to need for their support•Not precise but sufficiently accurate•Gives an indicative allocation / upfront allocation(Final allocation needs to be agreed between person and council)

Seven key issues 

1.Duty to offer an assessmentIn a personalised system an assessment is

•A Needs based resource allocation methodology – with help to complete if needed•A support planning process – with appropriate levels of help to complete•A proportionate sign off by the responsible council

In these circumstances a duplicate conventional community care assessment is not required. The same holds for reviews and re-assessments.

Seven key issues 

2. FACS

•Eligibility under FACS must be established as a result of an assessment – (not screening?).

• The decision on eligibility should be separate from the process to decide the indicative allocation.

•Before agreeing the support plan, the council should check that the plan will ensure all eligible needs are going to being met.

Seven key issues 

3. Equalities

• RAS is potentially a useful tool in helping identify and reduce unfairness

• It must be operated in a way that challenges rather than maintains the existing patterns of spending.

• Single RAS recommended – universal identification of need

• Can make transitional financial adjustment to indicative allocations to reflect current market costs

• Must be linked to a strategy for reducing these cost differences over time.

Seven key issues 4. People with high support needs•The RAS should be applied comprehensively.

•Everyone who goes on to need an on-going support package should have been given an indicative allocation

•People with high support needs should not be excluded

•Councils should avoid applying a “cost ceiling” to the RAS.

•Some people will have very specific needs – interpreter, specialist advice. Discretion required when fixing final budget.

Seven key issues 

5. Future-proofing

•The RAS is part of council policy•Most appropriate methods for inflation are ok•Councils can change policy•Any changes to a person’s allocation will require new assessment (RAS, Plan and agreement)•It is unlikely that a council could justify a reduction in resources following an individual review, unless the person’s needs had reduced, or eligibility criteria had changed.

Seven key issues 6. Informal support

•Must take full account of the role of carers in providing ongoing support.•RAS must identify persons overall support needs, and what proportion of these needs are being met through informal support•It must identify the impact on informal carers of continuing to provide this support.•The indicative allocation is adjusted for level of informal support.•Informal support must be ‘willing and able’.•The adjustment should take account of both the level of informal support being provided AND the impact on the informal carer.

Seven key issues 7. Needs of Family

Carers•Assessment process to include (or leads on to) a full carer’s assessment (unless refused)•May result in a direct payment to the carer, provision of services, or access to advice and information.•This can be non means-tested and available in situations where a person does not meet the council’seligibility criteria.•The aim of this support is to make sustainable the contribution of an informal carer to the support needs of a disabled person.•No policy requirement to extend personal budgets to include support for carers.

Resource Allocation and the Law: Indicative Allocation

•Indicative allocation – approximate.•Only agreed after plan.•Councils should agree the amount of money after understanding needs and risks.•Final figure requires a judgment by the council. Therefore less important that the RAS is a very accurate predictor.•Relatively crude RAS’s can work so long as checks in place

Resource Allocation and the Law: Duty to Assess Need

•What constitutes an assessment is not prescribed by statute or case law.•Fair Access to Care Services: assessment must be proportionate. Must include a decision by the council about eligibility.•An assessment incorporates both the decision about eligibility and the appropriate support – the whole process.•In SDS – people are given more control over identifying needs and support.•Together with council decision this = completed community care assessment.•It is not necessary to carry out another form of community care assessment

Resource Allocation and the Law: FACS

•Transparency•No cost ceilings•Must meet eligible need – but can choose cost effective option

Resource Allocation and the Law

•Informal Support•Discharge of Community Care Responsibilities•Decision making processes•Challenge•Review – ok to change mind•Equalities•Mental capacity

Resource Allocation Framework

•Is it clear•Is it helpful•What is the most helpful component•What could it have included that it doesn't•What’s good – what could be better

3 comments/questions from each table please

Practical Tool One : Questionnaire •Simple, easy to use, based on citizenship,

respectful language•9 domains:

•Meeting personal care needs•Keeping myself safe•Eating and drinking•Making decisions and organising my life

•Being part of my community•My role as a parent or carer•Running and maintaining my home•Having work and learning opportunities

•Managing my actions

Questionnaire 

•Domain 10 = informal support•Domain 11 = needs of family carers

•Doesn’t attempt a scientifically correct answer – would be weak legally

•Ensures culture change•Ensures shift in power and decision-making

•Allows for real change – support planning•Tested with more than 400 people in 18 councils

Practical Tool 2: Scoring Framework

•Constructed through consensus•Tested using ‘1,000 minds technology’•A good starting point•This is a key part of an overall ‘policy’ position of each council

Practical Tool 3: Financial Framework 

•9 Steps•Works anywhere•Concept of contingency built in•Supports key principles of RAS

Practical Tool 4: System Map

•Places RAS in context•It must be part of an overall system change

•Incorporates FACS•Before support planning•RAS = personal budget calculator/assessment?

•Crucial in relation to legal duty to offer assessment

Practical Tool 4. :System MapKey Steps

•Contact•Reablement•Upfront Allocation – RAS•Support Planning•Agreement•Organising support•Review

Common Resource Allocation: Practical Tools

•Are they good enough to use out of the box if you don’t have a RAS?•Can they help in benchmarking/improving your RAS if you have one•What is helpful•What could be better•3 comments/questions from each table please

What happened since

•National Briefing Event – 2nd October London: 130 councils attended.

•Strong support for regional and national collaborative learning

•12 councils participated in recent planning event for national learning set.

•Common RAS formally launched at national NCAS conference in Harrogate end Oct 2009