scottish welfare fund for second-tier review panels
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Scottish Welfare Fund For Second-tier Review Panels. Aims Of The Course. To know the process for review To understand the role of the review panel To understand the approach to decision making To explore some issues likely to arise - PowerPoint PPT PresentationTRANSCRIPT
Scottish Welfare FundFor Second-tier Review Panels
Aims Of The Course
• To know the process for review• To understand the role of the review panel• To understand the approach to decision
making • To explore some issues likely to arise • To gain an overview of Scottish Welfare Fund
grant conditions
Review Process Overview
DecisionApplicant
unhappy with decision
Applicant unhappy with
customer service
Scottish Public Sector
Ombudsman
Local authority complaints procedure
First-tier review
Second-tier review
Judicial review
First-tier Review
A different decision maker makes a new
decision looking at all the evidence afresh
NEW DECISION
This replaces the original decision
Applicant may ask for review of first-tier review because of•Mistake in applying guidance (eg, eligibility, qualifying criteria, priority, grant amount, evidence gathered)•Decision unreasonable•Application treated unfairly•Not given chance to put case properly
Purpose of Second-tier Review
1. Ensure correct, reasonable and fair decisions are being made and guidance followed
2. Check guidance is being applied consistently
3. Provide feedback on unintended consequences of Guidance & local policies
4. Promote confidence in the Fund, demonstrate impartial scrutiny & add credibility to the Fund as a whole
SWF Guide para 11.9
Is Decision Correct, Reasonable and Fair?
Step 1 Can you deal with it? (remit)Step 2 Is there an error in the decision or is it unreasonable or unfair?
NO YES
Tell applicant (in writing)Give reasonsFeedback to decision makerRecord decision
Step 3 Refer back to decision maker or remake
General ApproachFor each stage of decision making ask yourself these questions1. Was guidance and local policy followed correctly?2. Was relevant information considered and irrelevant
information disregarded (eg, no bias)?3. Was evidence weighed correctly?4. Was there enough evidence to decide the facts5. Did applicant have a reasonable chance to put their case?6. Did decision maker exercise discretion, and make informed
decision based on merits (eg, and not on rule of thumb)?
IS DECISION REASONABLE?
Is Decision Reasonable?
Could a reasonable person– who knows the guidance
and– who knows the facts
have reached this decision
• Another reasonable person could disagree
• But should not offend logic or good sense
Facts and Evidence
• Relevant facts are needed for each stage of decision making
• Need to look at evidence to establish the facts
• Some evidence has greater weight
• Balance of probability• Some issues
– Lack of evidence– Inconsistencies– Mental ill health– Corroboration– Previous applications
Stages of Decision Making
Stage 1 Are they eligibleRepeat applications/ exclusions/ qualifying benefit
Stage 2 Do they qualifyDo personal/ family circumstances meet the criteria in guidance
Stage 3 Are they a priorityHigh, medium or low given nature, extent, severity and urgency of need, vulnerability
Stage 4 Is there money in the budget
Crisis GrantStage 1 Eligibility• ID/home address• Repeat applications
– 3 per 12 months– 28 day rule
• Other resources eg savings or STBA• Exclusions
– Excluded items/ needs eg phone
– Benefit sanctions• Qualifying benefit
Stage 2 Qualifying conditions
• Immediate living expenses because of emergency
• Items or living expenses because of disaster
Crisis Grant Stage 1 EligibilityRepeat Applications
Guidance Possible issuesMaximum 3 awards in rolling 12 month periodEXCEPTION Discretion to allow more awards in exceptional circumstances where applicant can show no fault on their part
Has DM asked about exceptional circumstances 3 awards to each member of couple rather than 3 awards to couple
Not if previous award (or refusal) in last 28 days for same items or services EXCEPTION Relevant change of circumstances
28 days runs from date each application receivedSame item requested?If so, is there a relevant change of circumstances?
Crisis Grant Stage 1 EligibilityExclusions
Guidance Possible issuesBenefit claim pendingEXCEPTION if need severe enough
No evidence that benefit claim made DM wrongly referred for DWP short-term advance
Other resources Other resource not actually availableExcluded needs eg, TV, phone, debts, no recourse to public funds
European national wrongly excluded
Benefit sanctionsEXCEPTIONS food for children, disaster
Evidence that need so severe that exception should be made? Has DWP refused hardship payments?
Crisis Grant Stage 1 EligibilityQualifying Benefits
Guidance Possible issuesIncome supportIncome-based JSAIncome-related ESASavings or guarantee pension credit Universal creditPayment on account of one of these (= short-term advance)
No benefit or other means of support eg, while waiting for 1st wage, while challenging fit for work decision or pending other appeal, because DWP say not eligible (eg, 16/17s)Applicant gets contributory ESA or contribution-based JSA only
EXCEPTION No other means of support and grant will help avoid serious risk or damage to health or safety
Examples in SWFG para 6.2 (eg, domestic abuse) – has DM indicated that only listed exceptions apply?
Crisis Grant Stage 2 Qualifying Conditions
Immediate short-term living expenses needed because of an emergency
• ‘Emergency’ = circumstance of pressing need which needs immediate action
• Eg, losing money or having money stolen, having had to leave home suddenly
Items or living expenses needed because of a disaster
• ‘Disaster’ = event of great or sudden misfortune, usually causing damage to, destruction or loss of, possessions or property
• Eg, serious flood or fire
Community Care Grant
Stage 1 Eligibility• ID/home address• Repeat applications
– 28 day rule• Exclusions
– Excluded living arrangements– Excluded items/ needs– Capital limit– Benefit sanctions
• Qualifying benefit
Stage 2 Qualifying conditions• Moving out of care• Staying in community• Setting up home after
unsettled way of life• Families under
exceptional pressure
• Caring for prisoner on release on temporary licence
CCG Stage 1 EligibilityRepeat Applications
Guidance Possible issuesNot if previous award (or refusal) in last 28 days for same items or services EXCEPTION Relevant change of circumstances
28 days runs from date each application receivedSame item requested?If so, is there a relevant change of circumstances?
CCG Stage 1 EligibilityExclusions
Guidance Possible issuesExcluded living arrangements
Confusion about short-term care arrangements
Savings Has any disregarded income been counted (eg, PIP, AA)? NB, no test of other resources so eg, should not be told to claim budgeting loan instead
Excluded needs eg, TV, phone, debts, no recourse to public funds
Confusion about whether maternity expenses are excluded (should not be except (usually) for first child)
Benefit sanctions Blanket exclusion – CCG grant can be allowed if doesn’t undermine sanction
CCG Stage 1 EligibilityQualifying Benefits
Guidance Possible issuesIncome supportIncome-based JSAIncome-related ESASavings or guarantee pension credit Universal creditPayment on account of one of these (= short-term benefit advance)
(probably most relevant to crisis grants)Exercising judgement – how to determine whether likely to get benefit when leaving care? Requiring too much proof of this
EXCEPTION Likely to get benefit when leave careOR no other means of support
CCG Stage 2 Qualifying Conditions
Guidance Possible issuesSomeone move out of residential care into the community
Category confusion – eg, if type of accommodation doesn’t qualify, applicant should be considered under other headings
Someone stay in the community rather than have to go into care
Applying too high a test of risk of going into care (eg, doesn’t have to be certain /more likely than not – just an ‘identifiable’ risk
Someone set up home after an unsettled way of life
Can’t get CCG for another temporary address
Families under exceptional pressures
Use of discretion over what is a ‘family’, eg if shared care
Someone caring for a prisoner or young offender on release on temporary licence
Speed of decision – because need is for living expenses for a few days
Stage 3 Assessing Priority
High Medium Low
Need ImmediateSevere
Less immediateLess severe
Not time critical
Vulnerability High Moderate Some resilience
Consequences of no grant to health/ wellbeing
Significantly adverse
Moderately adverse
No identifiable effect
Effect of grant ImmediateSubstantial
Noticeable Minor
Assessing PriorityPossible Issues
• Whether DM has exercised discretion reasonably
• Whether DM has wrongly used a rule of thumb or list – emphasis should not be on the general importance of an item (which would apply to anyone) but on the impact an award for the item may have on the applicant’s particular circumstances that led to qualifying for a grant
What Level of Grant
• Amount discretionary but should meet the need
• For crisis grant, max based on % of income support
• Can award goods or vouchers instead of cash
Possible issues• Applicant prefers cash not
voucher/ goods• Amount not enough to
meet the need• Objection to referral to
foodbank• Food vouchers by default
(rather than because right option for applicant)
• Standard item not appropriate for applicant’s needs
Communicating Original and First-tier Decision
• Time limits– Crisis grants as soon as
possible 2 days maximum– CCGs 15 working days
• Method– By phone for crisis grant if
possible (Always follow up in writing)
• Advice on other support– Eg, debt advice, benefit
check
Possible Issues• No written decision• No clear
explanation of reasons for decision
• Inadequate information about right to review
Panel Decisions
Panel CANNOT reduce or remove an award
Correct, fair and reasonable?
Yes
Uphold
No
Refer to DM Remake
Changes of Circumstances
• If likely to affect outcome of review then review suspended
• DM makes new decision(no first-tier review recorded)
• Applicant can request review• Then request second-tier review • If there is an unrelated change of
circumstances, applicant must re-apply
Processes – Time Limits
Second-tier review• Time limit to apply
– 20 working days from first-tier review decision • Time to decide
– 5 working days CG– 30 working days CCG
Composition of Panel
• Minimum of two people (one for crisis grants)• And someone to keep record of proceedings• Can include
– other local authority staff – elected members– members of local third sector organisations– members of other Local Authorities
Procedure• Paper-based – applicant and DM do not attend• Can be held electronically (eg teleconferencing) • Panel can contact applicant and DM if necessary• Chair elected by panel, manages meeting, checks
record of proceedings and has casting vote
Supporting The Applicant
Applicants should be• notified of the date and time of the review• given the opportunity to submit additional evidence• given sight of all evidence and information which will
be before the panel• offered the chance to provide a phone number so
that the panel can contact them (panel can use other means if applicant can’t use phone)
• given as much information as possible throughout about their review
Monitoring And Policy
Feedback to Scottish Government will include:• Reports on numbers of reviews – numbers and
reasons reviews are sought• Discussions with decision makers and review
officers – giving feedback• Sampling of paperwork for reviews.• Development of the Decision Makers Guide
and relevant case studies.