Scottish Welfare Fund: statutory guidance June 2018

9. Review

First tier Review ^[58]

9.1 If an applicant disagrees with the outcome of their Welfare Fund application the Act requires local authorities to review the decision. The Regulations provide that applicants may seek, within 20 working days of being notified of a local authority decision, a review of the decision. Local authorities must, under the Regulations, arrange for a review of the decision to be undertaken by a decision maker who was not involved in making the original decision.

9.2 The Regulations allow a local authority to accept a review request made after 20 working days where it considers there are good reasons for doing so.

9.3 The local authority should include the process for review in the information on the Welfare Funds pages on their website, and should ensure decision letters contain information on the review process.

9.4 The decision on a first tier review replaces the original decision on the case, which will no longer be valid. The Regulations state that a review by the local authority may not result in assistance awarded being reduced or withdrawn.

9.5 The first tier review by the local authority offers an opportunity to “re-make” the original decision on a case, based on a thorough look at the evidence and any new information which becomes available. The first tier decision maker should review the case in full, taking into account any evidence provided as part of the review request.

9.6 The person carrying out the review will need to re-consider the merits of the case. They may need to gather additional information or evidence to do this. Where the first tier decision maker determines that the original decision should be changed but the applicant’s need has been met by other means, consideration of any detriment to the applicant should be given.

9.7 The applicant can ask for a first tier review if they want the decision that has been made on their case to be changed, for example, but not exclusively based on:

• not agreeing with the decision on eligibility, for example, due to repeat applications or the assessment of their income (stage 1 of decision making)
• not agreeing with the decision on qualifying circumstances, for example, the decision maker did not judge them to be in crisis but they disagree (stage 2 of decision making)
• of the opinion that the priority level allocated to their application was not appropriate/should have been higher (stage 3 of decision making)
• of the opinion that insufficient information was gathered during the application process to make a decision
• the application having been refused on the grounds that there is insufficient evidence, but the applicant considers that there was
• not agreeing that the support they have been provided with is appropriate to their needs, for example, they were awarded items and not money or they do not think that the money they were awarded was enough to buy what they need
• considering that there has been an error or failure in the decision making process, for example, a mistake in assessing the facts, or a failure to take into account a matter relevant to the decision

9.8 Review cannot be sought for policy decisions such as the level of priority set for awards in that period (stage 4 of decision making) – see financial management at Section 3.

9.9 Applications for review should:

• be made within 20 working days of the original decision, though the local authority may use its discretion to allow later applications, for example, when illness has prevented an application being made
• be made in writing and be signed by the applicant or emailed using a recognisable email address unless the local authority considers there are exceptional circumstances, for example, disability, health issue or problems with literacy
• contain the reason for requesting a review, a reference number or date of decision and any other additional information to support the case

9.10 Reviews of Crisis Grant applications should be carried out as soon as possible, recognising the circumstances of the applicant. The maximum processing time allowed for in the Regulations, for a first tier review of a Crisis Grant application, is no later than the end of the second working day after that on which the request was received. The Regulations provide that the maximum processing time for a first tier review of a Community Care Grant application should be no later than the end of the fifteenth working day after that on which the request was received.

9.11 Applicants should be notified in writing of the result of the review, giving reasons for the decision that was made ^[59] . In urgent cases, the result should be given as soon as possible, by phone, and followed up in writing according to the usual arrangements for notifying decisions.

9.12 The reviewing officer should feed back to the decision maker on the outcome of the review where appropriate and any key points relevant to future decision making. The review process should therefore help drive forward improvement and consistency in decision making.

How to treat additional information – as part of First Tier Review

9.13 The decision maker should ensure that they have all the necessary information before reaching a decision. Receiving new information can sometimes prompt other questions. Where new information becomes available to the local authority that may have led the decision maker to make a different decision if they had been aware of it, that information should be acted on as soon as possible. If new information is received as part of a request for a first tier review and the decision maker judges that an award should be made as a result of it, they should make the award straight away and let the applicant know, rather than waiting for any scheduled review meeting or process. The review process should be suspended but the papers held, in case the applicant still wants to pursue a review.

A Change of Circumstances Identified as Part of a First Tier Review

9.14 Similarly, if the circumstances of the applicant have changed since the date of the original application so that the decision maker would make a different decision in the new situation, the decision should be re-made as soon as possible. A change of circumstances is a change to the situation of the applicant which is relevant to the decision on the items they have applied for. This is information that could not have been taken in to account in the original decision as it had not yet taken place, so the case should be considered as a new case.

9.15 Examples include: a new health condition or deterioration in health which makes the applicant more vulnerable, or a family breakdown which means that they no longer have access to support. The case should be entered on the system as a new case, using existing information and any additional information that needs to be gathered as a result of the change of circumstances . Again, the review process should be suspended but the papers held, in case the applicant still wants to pursue a review. This is to avoid artificial inflation of the number of reviews as a result of changes of circumstances.

9.16 If a review decision has been correctly reached but a change of circumstances occurs after the review so that the applicant is facing a different situation, then the applicant should be advised to re-apply.