Scottish Welfare Fund review: final report

8. Assessment and review processes

Key points

• Providing a definitive view on the consistency of SWF decisions across Scotland is extremely difficult, since differences between areas do not, on their own, mean that guidance is being applied inconsistently.
• There is some evidence that, at a Scotland-wide level, decision-making practice appears to have improved since the inception of the scheme, with fewer applications recorded as rejected for being 'incomplete', and fewer Crisis Grant decisions being changed at Tier 2 review.
• However, there was some evidence of differences between areas in assessment and/or recording practices which seem unlikely to reflect different priority levels or local needs. This includes:
  • variations in the level of applications rejected as 'incomplete' (combined with evidence of variation in the approach to following up on missing information with applicants)
  • differences in the information local authorities require from applicants to support decision-making, and
  • perceived differences in local interpretations of specific terms in the guidance, including 'exceptional circumstances' or 'exceptional pressure'.
• There was also evidence of variation in exactly how local authorities communicate decisions, including whether decision letters are sent in every case and how clearly the reasons for decisions (especially rejections) are communicated to applicants. There was a desire among applicants and external stakeholders to better understand the basis of SWF decisions.
• Around 5% of Community Care Grant applications and 2% of Crisis Grant applications have resulted in requests for Tier 1 review. While the proportion of decisions resulting in Tier 1 review varies between local authorities, there is no consistent pattern to this and the reasons recorded for review make interpreting these differences difficult.
• However, for Crisis Grants, local authorities that were more likely to change their decisions at Tier 1 had fewer decisions changed at Tier 2. This may indicate that where the LA has a robust, self-critical approach to Tier 1 review this results in fewer decisions being overturned by the SPSO.
• There were some differences of opinion between local authorities and the Ombudsman over interpretation of the guidance, particularly with regard to the evidence that should be required of applicants and how much information gathering local authorities can reasonably be expected to undertake before arriving at a decision. However, local authorities clearly recognised the value of external scrutiny from the SPSO.
• Awareness of review rights was very variable among applicants interviewed for this research. Among those who were aware they could request a review but chose not to, scepticism about the value, fear of a second rejection, timing issues, and (for partial awards) concern that the whole award might be removed were all barriers to requesting review.

Local discretion is built into the SWF. As discussed in chapter 2, both local authorities and external stakeholders have commented on the tensions that can arise in delivering a consistent service while allowing for appropriate local discretion. The main mechanism to ensure consistency in delivery of the SWF is the statutory guidance^[63] which sets out the eligibility and qualifying criteria for assistance for the two schemes and limits to the number of awards. It also makes clear that local discretion should be based on the assessment of need, vulnerability, the consequences of not getting an award, and the likely impact, of the grant. Where applicants feel that a decision has not been fairly made, they are able to request a review of that decision – initially by someone else within the local authority (first tier review) and if they are not satisfied with this, by the Scottish Public Service Ombudsman (SPSO).

A key question for the review was how fair and consistent SWF decision-making is across Scotland. This chapter examines both the assessment process by which decisions are made and the review process when applicants are unhappy with those decisions. It explores whether current guidance is effectively supporting decisions, and where systems and guidance might need to be improved.

Assessment of applications

Assessing consistency in decision-making

It is important to acknowledge at the outset of this chapter that providing a definitive view on the consistency of SWF decisions across Scotland is extremely difficult. The quantitative management data can give us insights into potential differences in how the Fund is administered, via differences in reasons for rejecting applications, levels of reviews, and award size. Similarly, qualitative interviews with local authorities can help identify differences in approaches between areas, while interviews with applicants and external stakeholders can provide evidence on the perceived consistency of decision-making.

However, given that the SWF is a discretionary, not an eligibility-based Fund, differences between areas do not, on their own, mean that the guidance is being applied differently – rather, they may reflect legitimate differences in local practice aimed at better meeting local need, or differences in the priority levels applied by different areas at different points in time in order to manage budgets. These differences may be experienced or viewed as inconsistencies by applicants or other stakeholders – and may be viewed as unfair – but they do not necessarily imply that the guidance is being applied inconsistently by local authorities.

A definitive comparison of consistency of decision-making between local authorities would arguably require a relatively large scale desk-based review of actual documented decisions. This was beyond the scope of this review, but is something that may be worth considering beyond the review, as part of strengthening the ongoing monitoring and evaluation of the Fund.

However, taking these limitations into account, there is evidence from the SWF management information and the SPSO's data on second tier reviews that at a Scotland-wide level, decision-making practice appears to have improved since the inception of the scheme:

• The amount of missing or incomplete information about applications has reduced – the monitoring data shows a reduction in applications rejected for being 'incomplete' and a reduced use of the 'other' code as a reason for rejection over time, indicating an improvement in assessment practice and recording.
• Fewer Crisis Grant decisions being changed by the SPSO at tier 2 review – the proportion of Crisis Grant reviews that were upheld (i.e. the original decision was found to be incorrect) has fallen from 35% in 2017/18 to 18% in 2021/22.^[64] Tier 2 review decisions are one indicator of how well initial decisions are made, so this indicates that, overall, Crisis Grant decisions appear to have become more consistent with the guidance over time. The SPSO attributes this, in part, to the higher numbers of repeat applications, which are reflected in requests for review. As repeat applications beyond the statutory maximum (three per year) have to be assessed as 'exceptional circumstances', the SPSO often assess that the eligibility criteria is not met (in line with local authorities' assessments).

At the same time, although as discussed it is important to be cautious in inferring that differences between local authorities necessarily implies inconsistency, there is some evidence of differences between areas in assessment and/or recording practice which seem unlikely to be explained by differing priority levels or local need:

• The level of applications rejected as 'incomplete' varied considerably between areas. Although some level of variation might be expected, this may suggest that some areas are doing more to follow-up with applicants where they have not provided enough information initially. There was evidence from the qualitative interviews with local authorities that there was variation in this regard, with some local authorities describing putting considerable effort into contacting applicants to talk through their application and 'fill in the gaps'.
• The evidence review and qualitative data collected from local authorities identify some differences in the information required to support decision-making. In particular, while some local authorities stated that they needed to check participant bank statements for audit purposes, others indicated that they view this as a barrier to applying and actively avoid requesting these. As discussed in chapter 3, applicant experiences support the idea that requiring bank statements can be a barrier to applying.

More exceptionally, one area mentioned using their online application system to 'screen out' ineligible applications. However, other areas were clear that they would not do this as it could exclude people who had just filled in their form poorly: "it can make people fall through the cracks." While exceptional, this example may indicate some ongoing issues around the application of 'gatekeeping' in the application process (as flagged previously by CPAG and others, who have raised concerns about 'eligibility checkers', in addition to issues with online forms requiring information that not everyone will have – such as National Insurance numbers – that can prevent people from being able to apply).^[65]

• Perceived differences in local interpretations of specific terms in the SWF guidance. Interviews with local authority decision-makers as well as external stakeholders indicated some uncertainty over the application of particular terms in the guidance and a perception that differences in understanding were leading to some inconsistency in their application to decisions across areas. In particular, the question of what should be included under 'exceptional circumstances' or 'exceptional pressure' criteria was highlighted.

The SPSO commented that this was particularly challenging during the pandemic. On the one hand, it was suggested that some of the early pandemic messaging from the Scottish Government was interpreted differently by different councils, with some viewing the pandemic itself as constituting 'exceptional circumstances' and others linking it more specifically to individual financial circumstances. On the other, the SPSO felt that some councils had not always consistently factored in the impact of the pandemic into determining whether people were facing 'exceptional pressure'. They gave examples of a support worker being unable to attend during the pandemic, or a household being unable to use the laundrette because of pandemic restrictions, meaning that households that might not ordinarily qualify or items that might not meet the necessary priority level ought to be granted. This had led to an increase in the SPSO disagreeing on cases where they felt they did meet the exceptional circumstances criteria.

Although these pandemic-specific issues in interpreting what counts as 'exceptional' no longer apply, there remained a perception that this and other terms in the guidance could be 'tightened up' to improve consistency in decision-making.

Consistency of communication of decisions

In addition to the question of whether decisions themselves are being made consistently, the review also explored how decisions are communicated. The regulations require that all SWF applicants receive a decision in writing, unless the applicant requests otherwise. Local authority managers all stated that applicants were written to by email or letter to communicate SWF decisions (with the exception of one that said they only communicate via the applicant's preferred mode). In general, they reported including similar elements in the written decision, in line with the statutory guidance, sometimes drawing on previous feedback from the SPSO. However, there was some evidence of variation in the level of detail provided in the initial decision-letter – for example, one area stated they had streamlined their initial letter, and only include more information on the guidance and exactly why they are not eligible if the decision goes to first tier appeal. Another stated that they only advise successful applicants of the review process over the phone.

There was also some variation in whether or not local authorities also phone applicants as well as communicating decisions in writing. A number of areas said they always phoned with the outcome, both to ensure that applicants get their decision as quickly as possible and so that they can provide additional information on other support. However, this was not universally the case.

The SPSO have noted that decision letters should be sent for all applications, both for administrative fairness and because even successful applicants may not completely agree with their decision. The SPSO also indicated that there were some ongoing issues around whether decision letters consistently included enough information to help applicants understand the decision – for example, explaining why someone's circumstances are not classed as exceptional based on the guidance.

The views of applicants interviewed for this review also indicate room for improvement in how decisions are communicated, particularly (but not only) when the application is rejected. Although recall could be an issue (applicants did not always remember exactly how decisions were communicated), there were examples of applicants who were adamant that they had not received any written confirmation of the reasons for their application being rejected. In other cases, they said they had not received a decision in writing at all (just a phone call saying their application had been rejected). Even where applicants had received a letter or email, they were not always able to understand the reasons given – for example, being told they did not meet the criteria, but without an explanation they could understand of how or why they did not meet them.

When applicants felt they had not received an adequate reason for rejection, this could add considerably to their feelings of frustration and anger about being turned down for a grant. It could also lead to a perception that there was no robust basis for decisions:

"It's down to their imagination and what they think, but they are trying to cut you down and give you as little as possible."

(Applicant 1, who reported receiving a rejection text with no further explanation)

Where applicants were partially successful, but had received less than they requested, there was a clear desire to understand more about the basis for the calculation:

"I said that wouldn't do. I had £29 on meter. It was an emergency. £20 is not enough to cover the bill. They just said that was all they could manage. The girl on the phone said she'd have given me more, but it's not up to her."

(Applicant 11)

External stakeholders interviewed for the review noted that they were not always privy to the detailed reasons for decisions, which made it hard to judge consistency of decisions with any certainty. However, while some felt decision making was reasonably consistent, others described situations where they had two clients applying in what they viewed as identical circumstances but with different outcomes. There was a desire among stakeholders to better understand the basis of SWF decisions, so that they could better support and advise their clients:

"At the moment I would say we're reluctant or hesitant to promote any local authority fund or benefits or anything like that, because like I said we don't know how the decision-making is being done … if we had some form of reassurance in the form of understanding how the decisions are made then we could better promote that by being very clear and managing those client expectations."

(External local stakeholder 19, Charity)

Review

Tier 1 reviews

Review requests have been more common for Community Care Grants compared with Crisis Grant applications. Across the life of the Scottish Welfare Fund, 5% of Community Care Grant applications resulted in a Tier 1 review compared with 2% of Crisis grant applications. Overall, just under half of both Community Care Grant (46%) and Crisis Grant (45%) Tier 1 reviews between 2013/14 and 2020/21 resulted in the decision being changed.

The proportion of applications resulting in Tier 1 reviews and the proportion of Tier 1 reviews resulting in changed decisions have both varied significantly between local authorities for both grant types. The reasons for this are not completely clear. There was some evidence that Tier 1 reviews are more common in higher-pressure areas, with higher than expected levels of applications and higher overspends, which might be expected to lead to a higher proportion of decisions being queried. However, this was not always the case – there were some relatively lower pressure areas with relatively higher proportions of reviews. Comparison of the reasons for Tier 1 reviews is limited by the fact that a number of local authorities have coded all their Tier 1 Community Care Grant reviews as 'other reason'.

Qualitative data from local authorities indicated differences between areas in who conducts Tier 1 reviews – whether this is another decision-maker at the same level within the same team, a more senior staff member within the same team, or (more rarely) someone from a completely separate team to the SWF assessor. There is no obvious pattern, however, in terms of which any of these approaches being associated with a higher or lower level of decisions being changed at first or second tier review.

Tier 2 reviews

SPSO statistics indicate that requests for Tier 2 reviews have grown over time - In the latest year pre-Covid (2019/20) the SPSO received 1,038 Tier 2 review applications – a 29% increase on the 805 in the previous year.^[66] This related to 339 Community Care Grants and 699 Crisis Grants. In 2021-22, Crisis Grant review requests increased (740), but Community Care Grant review requests (213) were down compared with 2019/20. The increase in Crisis Grant review requests was particularly apparent in Quarter 4 of 2021/22, and the SPSO comment that this appears to be linked to the cost of living crisis.^[67] However, although requests for review have increased over time, it remains the case that Tier 2 reviews are only requested for a tiny fraction of all applications.

Community Care Grant reviews have more commonly resulted in a recommendation to change the original decision – around half of Community Care Grant reviews have been upheld in recent years, since 2017/18. As discussed above, Crisis Grant uphold rates have been declining in recent years.

Comparison of Tier 2 review outcomes by local authority was limited by the low overall numbers of reviews. However, for Crisis Grants, local authorities that were more likely to change their own decisions at the Tier 1 review appeared to have fewer decisions changed at Tier 2 review. This may indicate that where the LA has a robust, self-critical approach to Tier 1 review this results in fewer decisions being overturned by the SPSO.

The value of having external scrutiny of decision-making via second tier SPSO reviews was clearly recognised by local authorities:

"With really tricky cases, we've always been really interested to know what the SPSO's thoughts are behind that. We are really keen on improving our decision making and knowing we are on the right track. We seem to be."

(Local authority manager 14)

Managers discussed reviewing SPSO feedback with the individual decision-maker and wider team, as well as using it to inform wider training and make improvements to communication with applicants.

However, there was also a perception that the SPSO sometimes appeared to interpret the guidance differently to local authorities (in ways that local authority managers disagreed with). In particular, it was suggested that the SPSO was sometimes more 'lenient' in the evidence it required, that it had more resource or ability to gather evidence than would be feasible for local authorities (particularly within the statutory timelines), and that the SPSO did not always take appropriate account of local authorities' limited budgets and priority levels. Examples were given of the SPSO accepting the applicants word on their bank balance when the local authority would have insisted on seeing a statement, being able to access information from GPs when they did not respond to requests from the local authority, and wanting the local authority to furnish a house more fully than they had determined was feasible given the priority level the area was operating at.

The SPSO acknowledged that local authorities faced significant resourcing challenges, but noted that it was a requirement of the guidance to fill gaps in the evidence, and felt that this entails making sufficient enquiries when dealing with vulnerable applicants, who will not always present themselves in the best way. Where the Council could not reasonably have been expected to access the information that led to a decision being changed, the SPSO stated that they would record the reason as 'new information'. However, they acknowledged that assessing whether a Council could reasonably be expected to have accessed information could sometimes be 'borderline', which might be the source of some of the points of disagreement between the SPSO and local authorities. At the same time, the SPSO indicated that the most common reason for disagreeing with a local authority's decision for both types of grant in 2021/22 was not that new infomration had arisen, but that they judged there had been 'incorrect intepretation of the available information'.

There were also apparent differences of opinion between the SPSO and some local authorities around what level of information is required to support applications – for example, the SPSO states that a full month's bank statements are not required to evidence that an applicant does not have any funds available and that a screen shot of a statement covering a few days would be sufficient, while some local authorities indicated that bank statements were required by their internal audit requirements.

Applicant views of the review process

Of the 46 applicants interviewed for this report, only 4 said they had requested a review of an SWF decision. The three who had requested Tier 1 reviews only each reported very different experiences – one had their decision changed and received the full amount they originally applied for; one had the decision upheld, but was unhappy with the reasoning as they felt the reviewer had not clarified why they disagreed that their circumstances were exceptional (which was the basis for the application having been turned down); and a third said they had requested a review by email, but had heard nothing back at all, which had left them "really angry". The fourth applicant had also requested Tier 2 reviews more than once. They reported generally being very happy with this process, even though their requests were not always upheld:

"If they have done everything they were meant to do, there's not very much they can do except agree with the decision, but they will definitely do all they can to help you."

(Applicant 2, repeat applicant for both grants)

Among other applicants, awareness of the right to request a review was very variable. Interviewees could not always recall being told this was an option – as discussed above, some acknowledged that their recollection was imperfect, or that they had thrown the letter out once they realised their application had been rejected. However, some were adamant they had not been told about the right to review, including applicants who felt they might have requested one had they known about it.

Where applicants had been aware of the right to review but had not requested one, in spite of their application being unhappy with the outcome, this reflected a combination of:

• Scepticism about the value – a feeling there was "no point", as it was unlikely to change the decision. Sometimes this was linked with a lack of clarity about the eligibility criteria and whether or not they had met them (as discussed in chapter 2).
• Fear of a second rejection – applicants described feeling "a bit defeated" by the first decision, and felt that they did not want to risk being "knocked back twice"
• Timing issues – with Crisis Grants in particular, there was a perception that the process took too long, and that they would have received their next benefit payment anyway by the time a decision was reached
• Among those who had received partial awards, there was a concern that requesting review might result in the whole award being removed:

"I thought about it but I couldn't be bothered with the stress when I had that much else going on and I needed that money, I had nothing."

(Applicant 4, who had been awarded under a tenth of the amount requested)