Sam Newman Director - Personalisation Programme OLM Group Yorkshire and Humberside Region

This Morning

 General Introduction  More detailed introduction to framework  Round table discussion  Questions  More detailed introduction to practical tools  Round table discussion  Questions

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)

1.

Seven key issues Duty to offer an assessment

In 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’s eligibility 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

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Indicative allocation – approximate.

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Only agreed after plan.

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Councils should agree the amount of money after understanding needs and risks.

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Final figure requires a judgment by the council. Therefore less important that the RAS is a very accurate predictor.

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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.

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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 Map

Key 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 – 2 nd 130 councils attended.

October London: • 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