For the personalisation agenda it is an uncomfortable truth – many social workers remain far from convinced by resource allocation systems as a means of calculating personal budgets for their clients.
Local resource allocation systems did not allocate money effectively in line with clients’ needs, said 62% of social care professionals polled for Community Care’s annual personalisation survey, up from 47% in 2011. Social workers complained at being left in the dark over the inner workings of their RAS and then being tasked with explaining the funding implications to often distressed service users.
[See full coverage of our 2012 personalisation survey, sponsored by Unison and The College of Social Work]
“We are now subject to a tick box assessment resulting in a computer generated budget, the basis of which is not explained to us,” said one respondent.
But not all local authorities are freezing social care staff out of the RAS development process. When Hartlepool Council began its shift to personalisation in 2006 it actively made sure that social work had a place at the head of the table.
Tips for an effective resource allocation system
Involve social workers when designing a RAS and listen to their concerns;
Acknowledge differences in specialities in social care, potentially with different allocation tables for different client groups;
Treat the RAS as a starting point for support planning, not the end point; it needs to be followed up with good support planning.
Source: Hartlepool Council
Ensuring frontline social worker has a voice
It appointed Sarah Ward, a practising social worker and former learning disabilities nurse, as one of three “social care transformation leads” tasked with driving forward personalisation. Six years on Ward feels her frontline experience has played a part in ensuring that the “majority” of social workers are backing the shift to personalisation and giving the RAS a chance.
“Initially the social workers were a little bit like ‘why do we want to change something, what we do is great’. Then they started to shift a little bit – they started to get good outcomes,” Ward says. “I think it worked better because I’m on the frontline. If you have a senior manager saying ‘this is what we’re going to do’, the social workers think ‘what the hell do they know, they don’t even work in social care?’”
Working alongside Ward as Hartlepool’s “transformation leads” are Jeanette Willis, the council’s head of finance for adult and community services, and Neil Harrison, head of service for disabilities. Between them the three developed a RAS based on models developed by personalisation charity In Control. The two-part system comprises a self-assessment questionnaire for service users and a set of allocation tables to calculate an indicative personal budget based on the questionnaire answers.
Making the RAS the start, not the end point
Prior to launching the RAS, Hartlepool asked its social workers to put themselves in their clients’ shoes and test it out. For over 300 cases, social workers filled out the self-assessment questionnaire and were given the chance to challenge the allocations.
“We made sure we had workers on cases that knew the clients. So when we ran the RAS and calculated the points we were able to ask, ‘is that reasonable?’, says head of finance Willis.
Viewing RAS allocations as a starting point, not an end point remains a key part of Hartlepool’s ethos. Reviewing allocations is part of the process and if initial allocations are deemed insufficient, further care planning work is done with individuals to ensure their needs are met, says Willis.
But Ward stresses that the RAS offers a more equitable starting point for both service users and social workers when it comes to planning care than traditional assessments.
“I’ve seen cases where two people have had very similar needs, but they’ve also had social workers with very different views about how money should be allocated so have come out with vastly different allocations. In one case one person got £2,000 a year spent on them and another had £20,000 a year,” she says.
“The RAS creates more equity. If Jeannette and I answer the questionnaire in the same way, we will come out with the same starting point.”
The value of transparency
Hartlepool has also worked hard to be “transparent in what we’re trying to achieve” with the system, says Willis. A key part has been making the RAS as accessible as possible. The questionnaire uses “simple language” rather than jargon to make it as easy as possible for service users and staff to understand.
And while many councils have been accused of using their RAS to cut costs post-recession, Hartlepool points out that its four RAS allocation tables – covering older people, physical disabilities, mental health and learning disabilities – are the same as when they were introduced in December 2006. They are also applied to all cases apart from people in crisis.
“It isn’t about the money. What our system does is sets the bar,” says Willis. “It shows what we expect people to work within. It has enabled workers to challenge and it’s enabled people to challenge. Often people challenge themselves because they didn’t realise what was being spent on them.”
Ward agrees that the RAS shouldn’t be a cost-cutting tool. “I’d say in about 20% of cases, we are always going to have to allocate resource outside of the RAS,” she says. “We never, ever say ‘that’s it! That’s your allocation.’ I see so many authorities abusing the system so badly, using it as a way of racheting down allocations for people.”
Another facet that sets Hartlepool’s RAS apart from systems used in other councils is the way it accounts for support from family members and carers. While some councils reduce people’s recorded needs if they indicate they have family or carer support, Hartlepool includes the needs but adjusts the overall allocation at the end of the process. It means that if something happens to a carer the needs are still in the system.
“It’s about getting an accurate assessment of the person’s needs, regardless of who is meeting them,” Ward says.” I’ve read assessments that would say “no needs”. But the man has a spinal injury – of course he’s got needs. There’s a difference between “no needs” and “no needs for us to provide for.”
The Hartlepool team is constantly trying to improve and develop thei system.
Ward is in the middle of phasing in a RAS for children’s services, again with social worker involvement. Willis is currently developing a system for mapping spending on care and “capture exactly what personal budgets are” to “make sure we have the right data” to base future tweaks to the RAS on.
Both Willis and Ward acknowledge that their personalisation drive remains a work in progress. But buoyed by their success so far and with the backing of Hartlepool’s leadership, they are confident the council’s personalisation agenda will go from strength to strength in the future.