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.