The latest in our series of informative Care Act webinars, this session explored the challenges of the new eligibility criteria, examined the pros and cons of different approaches to resource allocation and looked at the question of transparency.

1. 1
Assessment and resource allocation
This webinar is not due to start until
12pm on Tuesday 23rd June 2015
Please make sure you have tested your sound
before this webinar starts
If you need support with this please email:
events@ripfa.org.uk or call 01803 847264

2. 2
Assessment and resource allocation
Presenter: Colin Slasberg,
Independent Consultant
Date June 23 2015

3. Aim
To explore the relationship between resource
allocation and assessment, its impact on both equity
and the vision of personalisation and the potential
impact the Care Act
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4. Agenda
What is the national strategy re assessment and resource allocation?
Is it built from the right lessons?
If not, what are the right lessons?
Can up-front allocations resolve the problems?
Does it matter?
What can councils do if they are concerned?
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5. The national strategy
› The driver for change to the eligibility process was concern about the
‘post code lottery’. Dilnot noted people with similar needs had very
different levels of support around the country
› The ability of councils to set their own Fair Access to Care Services
threshold was held responsible for the post code lottery
› Since April, there has been one threshold that all councils will work to
– the National Eligibility Threshold (NET)
› Needs within the NET will be ‘eligible’ and a duty to meet; ‘non-
eligible’ needs may be met if the council so chooses
› The Government does not, however, expect significant change
› The policy objective is ‘that the threshold describes a level that
can maintain current practice’
› The financial impact has been assessed as a mere 0.1% of
spending
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6. Have the right lessons been learned?
› There is an immediate paradox in that the Government itself has
acknowledged that the ‘vast majority’ of councils already have the
same threshold. This does not square with blaming the post code
lottery on different thresholds
› The doubts deepen when other evidence is examined:
› The Audit Commission 2008
› PSSRU 2012
› Government Impact Assessment
› The evidence clearly shows that eligibility criteria in themselves make
no difference, with Government itself coming to the conclusion in its
Impact Assessment that
− ‘in practice there is little relationship between a local authority’s
stated local threshold and how that authority is meeting needs’6

7. Questions/ comments
1. With a ‘yes’ or ‘no’ response, has your council
planned for a change in the number of needs assessed
as eligible as a result of the NET?
Click ‘yes’ or ‘no’ on your screen now.
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8. Questions/ comments
2. More generally how much difference do you expect
the NET to make compared to FACS?
Choose an option on your screen now.
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9. 9
How the current system works

10. ELIGIBLE
NEEDS
NEEDS
‘LOST TO
THE
SYSTEM’
Henwood and
Hudson
THE RANGE OF NEEDS MET
EXPANDS OR CONTRACTS TO FIT
THE BUDGET
This requires highly pliable criteria,
ostensibly designed to allow for
individuality but used by senior
managers, usually in panels. This is
the ‘street level bureaucracy’.
The policy objective of creating
equity through consistency based
on need and risk is thus subverted.
Declaring a need eligible is
effectively signing a blank cheque.
This creates a major financial risk .
This is resolved by making ‘eligible’
needs a maximum offer. This
requires a circular process whereby
a need is deemed a need only if
there is resource to meet it.
THE DUTY TO SPEND WITHIN A
BUDGET MEANS THAT IF THE
DUTY TO MEET NEED
CONTINUES TO COMPRISE A
MAXIMUM OFFER, PLIABLE
CRITERIA ARE REQUIRED TO
ENABLE COUNCILS TO ENSURE
SPEND IS MATCHED TO BUDGET
CASE BY CASE
These conditions pertain under
NET. PSSRU found that the NET
criteria resulted in some increase
in consistency amongst care
managers, but this fell short of
being consistent. Further, the
care managers had yet to be
subjected to how their councils
will require them to interpret the
NET.
How the system works
THERE WILL NOT THEREFORE
BE A NATIONAL STANDARD
AND THE POST CODE
LOTTERY WILL PERSIST
BUDGET

11. Deficit-led practice
Service-led practice
Standardisation
of needs
ELIGIBLE
NEEDS
NEEDS
‘LOST TO
THE
SYSTEM’
Henwood and
Hudson
The source of de-
personalisation and poor
value for money
CSCI FINDINGS, 2008
Spending is controlled with
an appearance of equity
and appearance that all
the important needs are
met
Preventive and
wellbeing needs are
not acknowledged
Some needs met
that should not be
Does it matter?
BUDGET

12. Will personal budgets through up
front allocations solve the problem?
› In theory, the answer is yes
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ASSESSMENT
Needs categories and
indicative allocation
(RAS)
SUPPORT
PLANNING
Specific needs and
service requirements
ACTUAL
ALLOCATION
Indicative allocation
merely ‘adjusted’
following SP

13. Will personal budgets through up
front allocations solve the problem?
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• However the theory does not work:
• It is unlawful for councils to offer any less than required to meet
‘eligible’ needs
• It is contrary to the duty of best value to offer more
• This means that the actual allocation cannot be an adjustment of the
up-front allocation, but must work independently from it. Research
shows that the actual allocation differs from the indicative allocation
by a factor of 2.5, both up and down
• Only very small numbers of people have had authentic
personalisation, but this has been based on the 1996 Direct Payments
provisions and is not related to this model

14. Questions/ comments
3. Do you believe your authority should
review:
› The Resource Allocation System you
use
› Whether or not to continue with up-
front allocations
Choose either one or both of the
options on your screen now.
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15. What can councils do?
› The primary legislation – the Care Act and Regulations – does
not make perpetuation of the current system inevitable. It is the
planned interpretation of the legislation through the Guidance
that creates the problem. Whilst not an action to be taken
lightly, a council may buck Government guidance if it believes to
follow it would be detrimental to the community it serves.
› Of particular note:
› The Act introduces personal budgets, but not in the form
practised. They are no more than the financial value of the
services to meet agreed needs – this can only be known
following support planning
› The Act creates two groups of needs – those that are a duty
to meet and those that are a power to meet. This opens the
door to delivering what has been known as the key for two
decades but never delivered – the separation of assessment
from resource allocation 15

16. Separation of assessment and
resource allocation
ELIGIBLE
NEEDS NEEDS A
DUTY TO
MEET
NEEDS
THAT CAN
BE
AFFORDED
NEEDS
THAT
CANNOT
BE
AFFORDED
Needsrequiringpublicfundingto
enableareasonablelevelofwell-
being
NEEDS
LOST TO
THE
SYSTEM
Current system Alternative system
ROBUST CRITERIA
Delivered by a
corporate standard for
‘significant impact on
well-being’, thus
creating an authentic
minimum guarantee
BUDGET BUDGET
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17. Implications of the alternative
system
› It will make person-centred practice possible.
However, it will take practitioners some time to
absorb the implications and learn new skills and
attitudes
› The open acknowledgement of any funding gap
would change the political dynamics, both locally
and nationally. Information can be used to inform
longer term strategic and financial planning
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18. Questions/comments
4. Do you believe this analysis of the
current national situation - whereby
there is inequity and depersonalisation -
is sound?
Choose yes or no on your screen now.
5. If so, do you believe your authority is
an exception?
Choose yes or no on your screen now.
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19. Relevant resources
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20. Create an online account
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our learning resources
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account at:
› www.ripfa.org.uk/me
mbership/create-an-
online-account
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21. Contact
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help@ripfa.org.uk
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