Resource AllocationSystems for Housing Related Support Mark Goldup HGO Consultancy Ltd
My background• Lifetime in housing-related support sector• Helped Oldham introduce SP into Individual Budgets pilot• Project managed large scale introduction of personalisation programme in Medway for housing- related support.• Was also part of Right to Control Kickstart support team
Aims of the Day• To explore the particular issues raised by developing resource allocation mechanisms for housing- related support• To outline the strategic context and choices that LAs have in how they develop a RAS for HRS• To demonstrate the HRS resource allocation tool published by ODI
Terminology A wide policy objective that aims to ensure that individual clients will have• Personalisation choice and control over how their needs are met A process whereby the client determines what their needs are and• Self-Directed Support how they should be met A sum that is anticipated will meet the• Individual Budgets individual’s needs. Not necessarily under direct control of individual. An amount of money made available to an individual client, under their control• Personal Budgets and linked to achieving specific outcomes. Term now used specifically to refer to social care payment• Direct Payments A mechanism for the payment of Individualised Budgets• Individual Service An alternative mechanism for the payment of an IB, where a third party Funds acts as the client’s agent to receive the PB and provide or purchase service’s on the clients behalf and under their direction
In Control illustration of the elements of an Individualised Budget
Why is Housing Related Support different to Adult Social Care• Not a statutory right• No infrastructure• Different role for providers• More specific objective• BUT wider range of interventions• Can be a passing need• Different forms of contracting• Not widely understood
Why do this ?It is believed that this approach• Is more effective in delivering outcomes• Is more efficient ie cheaper• Enables more people to receive the support they need IS THIS REALISTIC ?
Individualised Budgets – Why might they be cheaper• Cost of meeting desired outcomes rather than a fixed number of hours week in week out.• Many needs are time-limited but even short-term contracts can go on for 2 years• Involves moving from support provision to support co-ordination
Different Personalisation Models for HRS• Standard block contracts but with innovations• Core hours plus flexi hours• Core hours plus flexi hours plus cash• Core hours plus separate entitlement for DP• Individual Service Funds• Direct payments – payable in a number of ways
Who to offer Individualised Budgets to ? Everyone in need of HRS Everyone except those in immediate crisis Those in need ofEveryone with persistent vulnerabilities Accommodation Based Services ? Everyone also with social care needs Specific client groups No one with HRS needs
Integrated housing and support packages What are the core functions of supported housing beyond and above the delivery of individualised support• Monitoring of risk and continued vulnerability• Management of relationships• Facilitation of mutual support• Capacity to respond quickly• Enhancing security and sense of security
Medway approach• Supported Living Grant• Has to be spent on limited number of providers• 3 levels of Grant• Lowest level is renewable ad infinitum. Higher levels are paid for 12 months and can only be renewed for 5 years.• Is always paid in conjunction with at least one other grant element that is not tied
How integrated ?In Control’s view……. Each funding stream allocates into a local pot a set amount of money with a defined number of beneficiaries expected to achieve a Full fixed outcome. One eligibility criteria is established for access to the funding and one eligibility and allocation decision. Identity of funding would be maintained, the use of funding would continue to be restricted by the rules and regulations of each funding stream. An eligibility check for each funding stream, followed by a determination of how much money was available Composite for what purpose and with what restrictions. Such an approach would not be simple, resulting in a mesh of restrictions and requirements, current eligibility mean it would not be possible to deliver an upfront allocation prior to planning. The funding stream and allocation of resources from it operate in isolation of the other funding streams. Application, eligibility, Discrete allocation and monitoring takes place in accordance with discrete processes rules and regulations. BUT is it as simple as this…….
Principles behind design of RAS process• Needs to provides sufficient information to distinguish relative levels of need• Needs to be transparent and simple to complete• Needs to focus on outcomes• Needs to be time-efficient and cost efficient• Needs to encourages innovation and flexibility• Needs to be capable of adaptation and change• Needs to be fair and seen to be fair
ODI RAS Sample Domain high medium low none living No experience Some Is struggling indepen of experience of to liveSkills dently independent tenancy independe successf living. failure. ntly. ully
1. Skills My Advisors Points View ViewTo maintain the home environment undertaking day today tasks, including budgeting, cooking, cleaning etcA) I require active and ongoing support to develop and o o 3maintain independent living skills.[Daily support]B) I require regular support to develop and maintain o o 2independent living skills.[more than once a week]C) I require one off or occasional support to develop and o o 1maintain independent living skills.[no more than once a month]D) I have good independent living skills and do not need o o 0paid support gain or maintain daily living skills.[no support]
Problem with ODI RASAddresses dimension of how much BUT not how long for
Medway – Example of time limitsGrant Package Award Period Extendable up toAcquiring 12 months 5 yearsIndependenceLong Term Support 2 years UnlimitedSupported Living Level 1 – 2 Years Unlimited Level 2/3- 12 5 Years monthsResettlement 6 months 12 monthsCrisis Intervention 3 months 3 monthsHousing Options 3 months 3 monthsPractical Support 2 years Unlimited
Linking Assessment to MoneyMain considerations• Minimise disruption and manage pace of change• Manage risk to HRS budget inherent in move from fixed contract sums to individual entitlements• Facilitate long-term shifts from long-term high- value SP packages linked to long-term maintenance support to lower value ,short-term preventative work for more people• Contribute to savings targets – and relatively quickly.
Different approaches to pricing• Price per point – Weighted domains• Price per band – Based on Combined Score – Based on Highest Score• Price per package
Finding the values to use• Starting with a notional level of input required for different levels of need• Starting with average unit costs or total amount of money available
Final points• EVERYTHING HAS TO BE MODELLED• IT HAS TO BE KEPT UNDER REVIEW AND HAS TO HAVE FLEXIBILITY TO CHANGE• BUILD IN TRANSITIONAL PROTECTION AND SHIFT OVER TIME• ESTIMATES FOR REVIEWS & TURNOVER• BUILD IN OTHER TRANSACTIONAL COSTS