Fair access to care services (FACS): prioritising eligibility for care and support
Assessment - Resource allocation: where do the priorities lie?
The aim of the Resource Allocation System (RAS) should be to provide a transparent system for the allocation of resources, linking money to outcomes while taking account of the different levels of support people need to achieve their goals. It allows people to know how much money they have available to spend so that they can make choices and direct the way their support is provided.(‘Personalisation and support planning’, DH, 2010, para 129)
The ‘Personalisation and support planning’ section of the 2010 DH Guidance identifies the need for local authorities, and other organisations involved in FACS processes, to have a transparent system for allocating resources within agreed priorities. To achieve this, staff should be able to:
- work within and apply the council’s resource allocation system (RAS)
- explain to people and their carers how the council’s RAS works, and how it applies in their individual situation
- ensure that people and their families have been informed about, and understand, the options for holding a personal budget, direct payments or a managed personal budget; know the specific support available within each of these options; and have had the opportunity to choose which suits their needs best
- agree with individuals their preferred method of holding the personal budget and any support they need to set it up and manage it effectively and securely
- work within the council’s financial systems to:
- provide individuals with an early indication of the level of funds for which they are likely to qualify, and agree the final amount of money that is available on the basis of their assessment, and the needs and outcomes for which it is provided
- set out the arrangements for monitoring the use of the budget
- provide information about the sources of support and advice if an individual or carer has difficulties in managing a personal budget
- support the family, or act directly, to make arrangements for Deputyship through the Court of Protection where a person is assessed as lacking mental capacity to manage their own finances, and does not have a Lasting Power of Attorney for their finances.
Self-funding and charging
Deidre’s story – assessment helping a self-funder to choose and plan care
Deidre, aged 84, has Parkinson’s disease. She moved to adapted housing near her daughter, who often works away from home in the week. An assessment identifies Deidre’s need for visits twice a day. Because she has a good pension and owns her own home, she is not eligible for publicly funded care. When Deidre’s daughter and the home carer recognise that she needs more support, a review of her care plan leads to increased support which Deidre pays for.
Laing and Buisson  estimate that 43 per cent of older or physically disabled residents in independent care homes fund the entire cost of their care – this goes up to 49 per cent of residents in nursing homes. When individuals or carers are seeking or are referred for an assessment, they should be made aware that:
- their individual financial circumstances will determine whether or not they have to pay towards the cost of the support provided
- their ability to pay will have no bearing on the decision to carry out an assessment of their needs, or on its outcome
- they can still expect information and advice about local options for care and support, whether or not these will be funded through the local authority
- the basis and level of detail of the assessment process will be the same whether or not they have the funds to pay for their own support.
Staff carrying out financial assessments should handle the task sensitively, recognising that individuals and carers may find it embarrassing or demeaning to be examined on all aspects of their capital, income and outgoings. Individuals and carers should be given a clear statement of the basis for any charges, how they can challenge or appeal the results, and sources of reliable and independent financial advice.