Resource allocation at the micro level in adult social care: determinants, methods and guidance

Introduction

The challenge of matching resources to needs in social care is a longstanding one. Most recently as part of recent changes in adult social care services in England, the allocation of resources to individual users needs to become a more transparent process enabling individuals to shape their own support plan and the services that they subsequently receive. Personal budgets are viewed as a key mechanism to achieve this. The associated support plan may be constructed by the service user, possibly with assistance from a family member, or a professional may manage the care package on the user’s behalf. A national evaluation of individual budgets highlighted the complexities of developing reliable and acceptable mechanisms to allocate personal budgets between people in different circumstances. This provides the context for the research, which aimed to promote a greater understanding of resource allocation in adult social care services. First, approaches to resource allocation for individual service users used within adult social care services throughout England were identified and classified. This was supplemented by more detailed work in a subset of local authorities to compare approaches to resource allocation both between and within the four principal adult social care user groups (older people’s, mental health, learning disability and learning disability services) using data on assessment and subsequent service receipt for individuals. This was linked with relevant descriptive data about local authorities such as expenditure and that related to characteristics of the area. Second, these data were used to develop models to explain resource allocation for each of these principal adult service user groups. This process wasinformed by a phased consultation with managers with budgetary responsibility in local authority adult social care services and the views of users, carers and other interested parties.