Eleanor Roosevelt, 1958

'Where, after all, do universal human rights begin? In small places, close to home -- so close and so small that they cannot be seen on any map of the world. Yet they are the world of the individual person... Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.' Eleanor Roosevelt, 1958

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Saturday, 15 June 2013

Putting the cart before the horse: Resource Allocation Systems and community care

The Journal of Social Welfare and Family Law has published a paper on Resource Allocation Systems (RASs) by Luke Clements and myself.  A pre-publication version can be downloaded from here (doc).  The paper is based on a series of requests made under the Freedom of Information Act about how local authorities developed their RASs, and how they worked.  We consider issues of transparency, which I have discussed before on this blog, but also look at issues like how RASs were developed, how they take into account informal support, whether RAS questionnaires might miss some eligible needs, whether RASs will lead to a more equitable distribution of resources for different groups, and the accuracy of RASs.  Here are the seven conclusions we drew from this research:
1. Obtaining information about the inner workings of RASs can be challenging, with some local authorities even refusing to disclose details following requests under the FOIA;
2. Once obtained, information about the inner workings of RASs can be extremely complex, reflecting their increasing degree of sophistication, but making it hard to extract any clear criteria for resource allocation in order to understand underpinning assumptions;
3. Many local authorities are no longer using points-based RASs and report problems with accuracy and complexity – some have resorted to ‘ready reckoners’ instead;
4. RASs differ in how they take into account informal sources of support, with a small number of local authorities appearing not to take this into account at all or doing so in ways which could penalise individuals living with informal carers;
5. There is uncertainty, from an equalities perspective, as to whether RASs should allocate resources differently according to an individuals’ user group, with some local authorities believing that use of a universal RAS is mandated by ‘equalities legislation’ and others taking into account local variations in the unit costs of care for different groups;
6. Even those local authorities using universal RASs may apply it differently for different user groups, with some groups receiving personal budgets of much lower value than that indicated by the RAS;

7. Overall RASs do not accurately predict the value of personal budgets as applied in contemporary local authority social care delivery.

2 comments:

  1. Kirsty Keywood13 July 2013 at 07:50

    I was terribly impressed with the paper, Lucy, and depressed at your findings. I found the effects of RAS on personal budget allocations especially shocking. The panacea of personalisation is becoming a by-word for care on the cheap :(

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    1. Thanks Kirsty! Yes, it's very depressing isn't it. I am a big fan of DP's when they work well - but it increasingly looks as if they are simply a cut by the back door. Another issue that I'm interested in is to what extent there are reasonable accommodations in self-directed support for people who want to use a DP to employ a PA (or who would benefit from it), but who don't have a carer who can manage it on their behalf. I've heard that people using new pre-payment cards are being prohibited from using management companies... so there's no way they can have a PA unless they employ them directly.

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