When talking to social workers and community care assessors/workers, nowadays, the RAS is often part of their everyday language. RAS stands for ‘resource allocation system’ whereby an assessment document produces a monetary amount, depending on the answers about ‘needs’ which the assessor puts in. Most RAS tools are based on the local cost of service provision for different service user groups. This varies across the country, and therefore each RAS calculator is going to be different based on the costs of services in that area.
Some companies who design RASs believe their model to be extremely accurate at predicting an adequate sum of money, IF the correct costings for services are entered and IF the workers input the correct answers, having interpreted the questions within the assessment correctly. Quite a lot of ‘Ifs’, one might think, in this current culture.
The RAS is a hangover from the implementation of SDS (self-directed-support). This was brought in amongst lots of excitement, ‘blue sky thinking’, and talk of personalised services and person-centred support plans. My first blog post talks more about this era but for now we have what we have; many councils use a RAS on a day to day basis. The acronym has become a standardised piece of jargon that workers have to explain to often perplexed individuals who don’t have the knowledge or understanding of the original concept.
Many councils tell their workers that ANYTHING (even £1) contended for over and above a RAS-modelled sum needs to go to a panel for approval. Funding panels are another issue generating a lot of emotion in workers and managers alike, and are a topic for another posting. However, often workers want to try to keep a package within a RAS to negate the need to go to panel, what with all the additional paperwork and emotional energy generally required to evidence one’s case for additional funding.
The RAS is a delicate instrument and can so easily become completely unworkable. For example, if a finance manager within a council realises they need to make 20% savings from the social care budget, it would seem a simple solution to write a 20% deflater into a RAS calculator. The effect is to constrain practitioners to attempt to design or co-produce a plan within a budget that is logically far less likely to meet an assessed need. Inevitably this results in perplexed workers fiddling and adjusting the assessment to try and make the money fit the needs they know that the person in front of them has.
Companies who sell RAS products are often despairing at such tweaking behind the scenes, because it makes their product look bad; and service users are in the middle of a whirlwind of discussions and strife, whilst the workers cannot fathom why they cannot make a budget fit the need.
There are obvious risks with an approach that sees the RAS as more than merely one factor in the process. Under the Care Act, a service or a budget offered to meet an assessed eligible unmet need, MUST be sufficient to meet that need. It doesn’t matter whether a RAS tool tells you there is £50 a week available, if you, the professional, know and have assessed that person as needing a package that you know to cost £100. If it costs £100, then this is the service which the council MUST provide, in order to remain lawful. This principle remains the same as it was pre-Care Act; if a worker decides, maybe because of the desire not to go to panel, that they will only put in a package that meets some of the needs, even with the agreement of a service user who knows no different,or decides to describe some of the need as a want, they will be wittingly or unwittingly exposing themselves and the council to the risk of judicial review. These basic legal principles are so often lost within cultures where it is processes that lead and where workers use automated systems and databases as their guide, rather than an awareness of the law.
The Care Act Guidance gives some warning about an unthinking reliance on a RAS:
“There are many variations of systems used to arrive at personal budget amounts, ranging from complex algorithmic-based resource allocation systems (RAS), to more ‘ready reckoner’ approaches. Complex RAS models of allocation may not work for all client groups, especially where people have multiple complex needs, or where needs are comparatively costly to meet, such as deaf- blind people. It is important that these factors are taken into account, and that a ‘one size fits all’ approach to resource allocation is not taken. If a RAS model is being used, local authorities should consider alternative approaches where the process may be more suitable to particular client groups to ensure that the personal budget is an appropriate amount to meet needs.(11.23)”
There are then three requirements for funding within the Care Act Guidance:
- Transparency – you must be able to explain to people how your RAS works. Eeks! This doesn’t mean the PhD level maths about the algorithm that’s driving the end result, but the basic factual and rational link between the needs, the points, the pounds, and the market rate for the proposed response for meeting the need!
- Timeliness – the guidance talks about how important it is to give people their indicative budget UP FRONT so the person knows how much there might be to meet their needs (and their reasonable preferences). Eeks! This is awkward isn’t it? Lots of councils don’t tell people what their indicative budget is for a number of reasons: setting people’s expectations too high when they see a large monetary amount written down and then having to re-educate them into realising that the indicative budget isn’t the final budget, for one! For this reason, some councils have stopped the indicative budget figures being printed onto the assessment document. This creates a mystery around the indicative budget because people don’t know how much is in their ‘purse’ to begin with and therefore can’t possibly begin to shop for themselves! Another reason why some councils don’t provide the indicative budget amount is a general belief amongst workers that the RAS is NEVER accurate and therefore they don’t want to worry someone by telling them their indicative budget comes out at £50 for a package that will, and always has – cost £300. (Maybe that indication is because someone somewhere has had the brainwave of writing in an automated deflater?!)
- The final requirement for funding is Sufficiency – the amount of budget that the council makes available for someone HAS to be enough to meet their needs. As explained earlier, this is a longstanding legal principle that is simply reinforced under the Care Act. So don’t plan solely with the RAS amount – you need to be confident that the final package is sufficient to meet the person’s needs.
Confused? Yes, it’s baffling. The RAS has unwittingly morphed into an entity with more power than it should ever really have had.
However, it needn’t be this way. The RAS can be a useful tool if councils trust their model enough to make service users aware of the indicative budget, which in turn will allow them to genuinely be involved in spending this in a way that promotes control by the individual over their life and their care (the 4th of the Section 1 areas of Wellbeing). It will also require workers to appreciate that the RAS is there, but it’s really just a red herring – a tool there to help them, as well as management. The risk is that using one can divert attention away from the requirement to provide a care package which is sufficient to meet the assessed eligible unmet needs of service users. One way of understanding how to view the RAS is to remember, when care-planning, that the staff are professionals exercising skilled judgement and that without their authentic opinions and reasoning as to why £x is enough, to meet a particular need, councils would have no evidence basis for backing up the view that the statutory function has been lawfully discharged in the first place, if challenged via the legal process. They can and should use a decent RAS as a guide, but not a determinant of the cost of a package of care.
With understanding of the question of sufficiency, balanced with respect for reasonable preferences for people, balanced with a notion of achieving Best Value which is not solely financially driven, we can, as staff, navigate our way through the requirements of the Care Act, whilst freeing ourselves up from being driven purely by process. When we assess people and work with them to meet needs, we can regain control of our practice if we can see the opportunities that the Care Act gives us. They are there for the taking; we just need to be brave enough to pick them up, work towards understanding them, and be mindful of the red herrings that can divert our attention along the way.