Processing of Claims
|
Fig. 4.1: Results of BFI’s assessment for Processing of Claims |
|
|
Source: BFI analysis
For an explanation about how to read this radar chart see Executive summary.
4.1 HB and CTB are vital payments made to help people on low incomes. As these groups of people are at risk their claims should be dealt with quickly and accurately.
Backlog of work
4.2 At the time of our first inspection London Borough of Bromley had a backlog of work that was rapidly increasing. We were told this was partly due to the setting-up of a Pre-assessment team and the introduction of checks for renewal claims under section 1(1A) and 1(1B) of the Social Security Administration Act 1992. London Borough of Bromley also told us that it could not be confident about the validity of its management information regarding outstanding work.
4.3 During our first inspection London Borough of Bromley had 8,421 items of post outstanding. We made recommendations aimed at improving the management and control of the backlog. We recommended that London Borough of Bromley:
· introduced clear and precise measures to prioritise types of correspondence received
· introduced controls that effectively identified the age profile of outstanding post
· introduced systems that provided management assurance that:
– controls were effective
– the workflow was being managed
– priorities were being met.
4.4 During our second inspection, we were told London Borough of Bromley had cleared its processing backlog by May 2003. However work outstanding had fluctuated between May and the on-site phase of our inspection reaching its lowest at 1,842 items of work outstanding by October 2003. This equated to less than 2 weeks post and was the XXXX XXXX XXXX XXXX XXXX XXXX XXX
4.5 Since our first inspection London Borough of Bromley had implemented a workflow management system, including document imaging. This allowed London Borough of Bromley to identify and profile the age of all outstanding work. It also provided management assurance that the workflow was being actively managed through a series of management reports.
New claims – speed of processing
4.6 Regulation 76(3) of the Housing Benefit (General) Regulations 1987 states that every claim must be decided within 14 days of the relevant information having been received or as soon as is reasonably practicable thereafter. There is a similar provision in respect of CTB at regulation 66(3) of the Council Tax Benefit (General) Regulations 1992.
4.7 In addition to the statutory requirements the Best Value regime also requires local authorities to measure and report the average end-to-end time for processing new claims, from receipt of the claim to decision, and sets a target of 36 days.
4.8 London Borough of Bromley was not at Standard in this element because:
· it did
not meet the target of processing 90% of new claims within
14 calendar days of receiving all information
· it did not process new claims, on average, within 36 calendar days
· although
it produced an exception report for claims not reaching the
36-day processing target, the report was not used to implement preventative
action for the future.
4.9 At the time of our second inspection London Borough of Bromley was making month-on-month improvements in the speed of processing by introducing its e-benefit process and reducing the claims processing backlog. London Borough of Bromley demonstrated its commitment to reaching upper quartile performance by setting targets exceeding those required by the Best Value regime and Performance Standards.
14-day performance
4.10 At the time of our first inspection London Borough of Bromley was deciding only 45% of new claims within 14 days of receiving all information.
4.11 London Borough of Bromley completed a self-assessment in July 2003 using performance data for the period April - June 2003. It reported that it decided 69% of cases within 14 days against the Standard of 90%.
4.12 Figure 4.2 shows the 14-day performance for each month for the period from April - November 2003.
|
Fig. 4.2: Percentage
of new claims decided within 14 days from |
|
|
Month/Year |
% |
|
April 2003 |
43 |
|
May 2003 |
55 |
|
June 2003 |
62 |
|
July 2003 |
60 |
|
August 2003 |
71 |
|
September 2003 |
77 |
|
October 2003 |
68 |
|
November 2003 |
70 |
Source: London Borough of Bromley
4.13 We examined a sample of 30 new claims, where a decision had been made between 1 June - 31 October 2003, to establish the number of new claims processed within 14 days of receipt of all information. We found 24 cases (80%) were decided within 14 days. When compared to the findings from our first report this confirmed London Borough of Bromley’s performance had significantly improved.
36-day performance
4.14 Following our first inspection, District Audit amended London Borough of Bromley’s reported new claims performance to 120 days for 2000/01 which covered the on-site phase of our first inspection. The Standard is to process claims from receipt to decision within 36 days.
4.15 London Borough of Bromley completed a self-assessment in July 2003, using performance data for the period between April - June 2003. It reported that it took, on average, 94 days to process claims.
4.16 During our second inspection London Borough of Bromley had set a target of 45 calendar days for 2003/04. The time taken to decide claims from the date of receipt had gradually improved over the months since April 2003. Figure 4.3 details London Borough of Bromley’s reported performance for each month for the period April - November 2003. The year-to-date performance for this period was reported as 81 days.
|
Fig. 4.3: Average number
of days to decide a claim from |
|
|
Month/Year |
Average number of days |
|
April 2003 |
92 |
|
May 2003 |
87 |
|
June 2003 |
94 |
|
July 2003 |
85 |
|
August 2003 |
82 |
|
September 2003 |
73 |
|
October 2003 |
81 |
|
November 2003 |
58 |
Source: London Borough of Bromley
4.17 During our second inspection we examined our sample of 30 new claims and found the average time for processing new claims was 50 days.
4.18 London
Borough of Bromley introduced the e-benefit process, described earlier in
the Customer Services section. This had a positive effect on the
36-day target. Figure 4.4 shows London Borough of Bromley’s reported performance
for e-benefit claims for each month for the period from
July - November 2003.
|
Fig. 4.4: Average number of days to process e-benefit claims from July to November 2003 |
|
|
Month |
Number of days |
|
July 2003 |
15 |
|
August 2003 |
11 |
|
September 2003 |
11 |
|
October 2003 |
7 |
|
November 2003 |
5 |
Source: London Borough of Bromley
4.19 Figures 4.3 and 4.4 show a marked difference in e-benefit processing times compared to overall processing times in the London Borough of Bromley.
4.20 Figure 4.4 shows that, between July - November 2003, the time taken to process new claims using the e-benefit process:
· improved each month, apart from September 2003 when it remained static
· exceeded the requirements of Performance Standards
· exceeded London Borough of Bromley’s target of 45 days.
Exception reporting
4.21 For
a local authority to be at Standard it should produce exception reports on
claims not meeting both the 14-day and 36-day new claims processing Standards.
The authority should then investigate the length and reasons for any delays.
London Borough of Bromley produced an exception report on claims not meeting
the 36-day processing Standard but not the
14-day processing Standard.
4.22 London Borough of Bromley told us that it did not use this exception report to investigate the length and reasons for any delays.
4.23 To demonstrate what can be achieved by using exception reports, we analysed the delays in our new claims sample. Our analysis is shown in Figure 4.5.
|
Fig. 4.5: New claims processing sample – average days taken for each stage in the process |
||
|
Work step |
All claims |
Range days |
|
Date of receipt to date of first action |
17 |
0 - 210 |
|
Date of first action to all information available |
21 |
0 - 123 |
|
Date of all information available to date of decision |
12 |
0 - 147 |
|
Date of decision to date of first payment |
2 |
1 - 9 |
|
Total days from to date of receipt to first payment |
52 |
3 - 272 |
Source: BFI analysis
4.24 Figure 4.5 shows the average time taken from receipt of claim to decision was 50 days and that there were delays in deciding claims once all information was received.
4.25 We further analysed our sample and found:
· better performance in respect of rent allowance cases than Non-Housing Revenue Account or CTB cases
· delays in deciding claims once all information was received, particularly in respect of Non-Housing Revenue Account claims.
|
Recommendations |
|
We recommend that London Borough of Bromley: |
|
· introduces and monitors procedures to ensure it meets the 14-day and 36-day processing of claims Standards · introduces an exception report for claims not reaching the 14-day processing of claims Standard · uses the 36-day and recommended 14-day exception report to investigate the length and reasons for any delays. |
Payments on account
4.26 Regulation 91(1) of the Housing Benefit (General) Regulations 1987 requires local authorities to make a payment on account, if:
· they are unable to decide a rent allowance claim within 14 days of receipt of the claim, and
· that inability has not arisen out of the customer’s failure to provide the necessary information, which the local authority has requested, whether on the claim form or otherwise
· the customer has failed to provide the requested information with good cause.
4.27 Payments on account should only be made when necessary and for as brief a period as possible. They are not intended as a substitute for making a full decision and correct payment on a claim.
4.28 London Borough of Bromley was not at Standard in this element because it did not:
· monitor rent allowance claims to identify cases where payments on account were required
· make payments on account for rent allowance claims in accordance with regulation 91(1) of the Housing Benefit (General) Regulations 1987
· produce a monthly age-analysis report, which identified payments on account that had been in payment for more than 4 weeks.
4.29 However, London Borough of Bromley:
· had procedures that described its payment on account process
· monitored payments on account to ensure that either full decisions were made, or payments ceased by setting diary dates.
4.30 During
our first inspection we were concerned that, from
April 1997 - March 2000, the number of payments
on account had reduced significantly, even though the number of rent allowance
claims determined within 14 days of receipt of all information was under 50%.
4.31 We reported that London Borough of Bromley did not consider payments of account in all appropriate cases. There were also delays and a failure to monitor and review payments on account to ensure London Borough of Bromley complied with the law.
4.32 At the time of our second inspection London Borough of Bromley had 2 experienced officers dedicated to making payments on account. However, claims were not monitored to see if a payment on account was appropriate. They were only made when Benefit Assessors identified individual cases.
4.33 We examined our sample of new rent allowance claims and found in all 6 cases, where a payment on account was appropriate, no payment had been made. In addition, all 6 cases showed delays in requesting information and subsequent delays in deciding the claim.
4.34 London Borough of Bromley told us it had only started to make payments on account for all appropriate cases from October 2003, due to problems with the Benefit IT system.
4.35 London Borough of Bromley introduced 2 targets to ensure the 14-day regulatory requirement was met and payments on account were made in appropriate cases:
· to take action on a new claim within 5 days of receipt
· to make payments on account within 8 days, if the required information was not requested in this time.
4.36 A report was generated detailing claims where the number of days from receipt was greater than 8 days.
4.37 London Borough of Bromley’s written guidance included the requirement not to exclude housing associations from payments on account. Payments on account were cancelled after 4 weeks if additional information requested from customers was not received. This did not apply if payments were made because of delays in obtaining Rent Officer determinations.
|
Recommendations |
|
We recommend that London Borough of Bromley: |
|
· ensures that - all rent allowance claims are monitored for appropriate payment on account cases - it makes payments on account for rent allowance claims in accordance with regulation 91(1) of the Housing Benefit (General) Regulations 1987 · improves its control of payments on account by producing a monthly age-analysis report which identifies cases that have been in payment for more than 4 weeks. |
Reported changes of circumstances
4.38 Between July 1997 - October 2001 Sections 111(A) and 112(1A) of the Social Security Administration Act 1992 (as amended) created specific legal offences relating to social security benefits. These sections made it an offence to fail, dishonestly or without reasonable excuse, to notify a change of circumstances prescribed in regulations under the Act.
4.39 From 18 October 2001, sections 111A(c) and (d) and section 112(1A) have been replaced by sections 111A(1A) - (1G) and 112(1A) - (1F). These sections created offences of dishonestly or knowingly failing to notify changes of circumstances affecting entitlement to benefit or other payment or advantage under the social security legislation, (certain changes of circumstances are excluded by regulations). These offences can extend to landlords.
4.40 The Best Value regime requires local authorities to measure and report the average time for processing notifications of changes of circumstances.
4.41 London Borough of Bromley was not at Standard in this element because it did not:
· process changes of circumstances, on average, within 9 calendar days of notification of a change
· in all communications with customers:
– make explicit the consequences of not reporting changes of circumstances
– use a standard form of words to make those references.
4.42 However, London Borough of Bromley:
· reminded customers of the need to report changes of circumstances
· set a target of 25 days to process changes of circumstances
· provided written guidance to staff on changes of circumstances, effective dates and tailoring of benefit periods
· reminded landlords to report changes of circumstances through its decision letters
· applied the correct effective date for changes of circumstances
· required customers to provide the same level of supporting evidence for changes of circumstances as for new and renewal claims
· provided a changes of circumstances form.
4.43 London
Borough of Bromley’s reported performance from
April - October 2003 set out in Figure 4.6
shows that performance improved marginally over this period but still fell
well short of the Performance Standard of 9 days and London Borough of Bromley’s
target of 25 days.
|
Fig. 4.6: Average number of days to process changes of circumstances from April - October 2003 |
|
|
Month/Year |
Average number of days to process changes of circumstances |
|
April 2003 |
47 |
|
May 2003 |
46 |
|
June 2003 |
57 |
|
July 2003 |
55 |
|
August 2003 |
58 |
|
September 2003 |
44 |
|
October 2003 |
26 |
|
November 2003 |
44 |
Source: London Borough of Bromley
4.44 We examined a random sample of 20 changes of circumstances cases and looked at 20 cases from our overpayment sample. This is also covered later in the report under Overpayments. Figure 4.7 details our findings from the analysis of our samples.
|
Fig 4.7: Analysis of time taken for London Borough of Bromley to take action on changes of circumstances |
||
|
Range of days |
Number |
% |
|
0 – 9 |
25 |
63 |
|
10 – 25 |
5 |
13 |
|
26 – 50 |
3 |
7 |
|
51 – 100 |
4 |
10 |
|
Over 100 |
3 |
7 |
|
Total |
40 |
100 |
Source: BFI analysis
4.45 The average number of days to process changes of circumstances was 25 days in our sample, meeting London Borough of Bromley’s target but still well short of the Performance Standard of 9 days. Figure 4.7 shows that only 76% of sampled changes of circumstances met London Borough of Bromley’s target and only 63% met the changes of circumstances Standard of 9 days.
4.46 London Borough of Bromley encouraged customers to report changes of circumstances by several means:
· the notes accompanying the HB and CTB claim form referred to the need to report changes of circumstances promptly and explained the consequences of not reporting changes
· decision letters reminded customers and landlords receiving direct payments to report changes of circumstances, but did not explain the consequences of not reporting changes
· the changes of circumstances form also referred to the need to report changes of circumstances and explained the consequences of not reporting changes.
4.47 London Borough of Bromley did not use a standard form of words to make these references. For example:
· the claim form notes and changes of circumstances form each had a different list of notifiable changes
· the claim form notes requested notification immediately, but the changes of circumstances form stated changes were to be reported within one calendar month of the change.
4.48 Changes of circumstances should be reported promptly and as soon as practicable following the change. The wording on the changes of circumstances form should therefore be revised to ensure a standard form of words has been used in all correspondence and that customers report changes of circumstances straight away.
4.49 London Borough of Bromley should standardise the wording in its communications referring to changes of circumstances. It has the opportunity to do this when, as part of the implementation of the Verification Framework, it revises its communications to request original documentation.
4.50 Although not achieving the 9-day Standard, London Borough of Bromley applied the correct effective date in all cases in the changes of circumstances we sampled, including those cases that resulted in overpayments.
4.51 Customers were required to provide the same level of supporting evidence for changes of circumstances as for new and renewal claims. For example, we saw correspondence sent to a customer requesting information to verify their partner had moved out of the property.
|
Recommendations |
|
We recommend that London Borough of Bromley: |
|
· introduces and monitors procedures to ensure it meets the 9-day change of circumstances Standard · revises the wording about reporting changes of circumstances on all customer and landlord correspondence to ensure that it: - is clear that original documentation is required - makes explicit the consequences of not reporting changes of circumstances - uses a standard form of words to make these references. |
Renewal claims
4.52 Regulation 72(14) of the Housing Benefit (General) Regulations 1987 and regulation 62(15) of the Council Tax Benefit (General) Regulations 1992 required local authorities to invite a customer to make a claim for a further award of benefit when a benefit period:
· exceeding 16 weeks was due to end within the next 8 weeks and no claim had been received
· was
brought to an early end because entitlement or receipt of IS or
JSA(IB) had stopped.
4.53 However, the HB and CTB (State Pension Credit) Regulations 2003 abolished benefit periods for pensioners from October 2003 and for all other customers from April 2004.
4.54 The Best Value regime requires local authorities to measure and report the percentage of renewal claims processed on time.
4.55 London Borough of Bromley was not at Standard in this element because:
· it did not identify and support customers who needed help in completing their renewal forms
· it decided less than 83% of renewal claims before the expiry of the current benefit period
· it did not send a reminder to customers, at least 2 weeks before the expiry of the current benefit period
· although it produced an exception report which showed the length of time since receipt of the claim, the report did not show the reasons for delays.
4.56 However, London Borough of Bromley:
· set a target to process 65% of renewal claims before the expiry of the current benefit period
· invited further claims by sending out claim forms within 8 weeks of the expiry of the current benefit period
· logged receipt of completed claim forms
· only extended benefit periods where the customer or partner:
– was receiving IS or JSA(IB)
– fulfilled the conditions for a disability premium, higher pension premium or a severe disability premium
· produced an exception report containing the length of time since receipt of the claim.
8-week renewal target
4.57 London Borough of Bromley’s self-assessment stated that it invited further claims by sending out renewal claim forms 8 weeks prior to the expiry of the current benefit expiry period. In addition, London Borough of Bromley issued reminders to the customer immediately following the expiry of the current benefit period if the customer had failed to respond to the original request.
Monitoring and control of the renewal claims process
4.58 London Borough of Bromley introduced a revised Visiting Strategy with effect from 1 August 2003 and recruited a Visiting Officer, primarily to support vulnerable customers. Although visits were made on request from vulnerable customers, London Borough of Bromley was not proactive in identifying customers who required support.
4.59 We
were provided with visiting statistics for the period
1 August - 16 October 2003. There were 68 successful
visits and 19 unsuccessful visits during this period. However, only 2 of the
successful visits were to support a vulnerable customer.
Extending benefit periods
4.60 London Borough of Bromley provided written guidance to staff on the extension of benefit periods and produced an Aged Benefit report, detailing claims where the benefit period extended beyond 60 weeks.
Clearance time targets
4.61 London Borough of Bromley’s self-assessment stated that, for the period April - June 2003, it decided 42% of renewal claims before the expiry of the current benefit period, against the Standard of 83%. London Borough of Bromley reported its year-to-date performance to 30 November 2003 as 65%.
Verification policies and procedures
4.62 Local authorities must verify information supplied by customers to determine entitlement to benefit. This is an essential part of securing the gateway to the HB and CTB systems. Regulation 73(1) of the Housing Benefit (General) Regulations 1987 requires that:
…a person who makes a claim shall furnish such certificates, documents, information and evidence in connection with the claim…as may be reasonably required by the relevant authority to determine that person’s entitlement to housing benefit…
There is a similar provision in regulation 63(1) of the Council Tax Benefit Regulations 1992.
4.63 London Borough of Bromley was not at Standard in this element because it accepted photocopies, as well as original documents, to support claims and did not ensure that:
· XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX
· photocopies of original documents were stamped and certified as such
· all staff were trained on the latest evidence requirements, including identifying false documents.
4.64 However, London Borough of Bromley:
· had an up-to-date Verification Policy and procedural guidance
· ensured that discrepancies identified through crosschecking of information were followed up, resolved and the reasons documented.
4.65 Following our first inspection we recommended that London Borough of Bromley implemented the Verification Framework by December 2003. London Borough of Bromley was not Verification Framework compliant by the time of our second inspection. It planned to implement the Verification Framework commencing 1 February 2004 with the visiting module, moving to full compliance by May 2004.
4.66 While we were on-site, a notice to customers was put up in reception, informing them of the planned move to the Verification Framework. The notice explained the changes and, in particular, the requirement for original documents.
4.67 XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX X XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX XXX
4.68 London Borough of Bromley had a clear Verification Policy. A Standards of Evidence document and procedural guidance was available on the intranet, detailing the evidence requirements and how to identify false documents. XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX X
4.69 There is an opportunity, with the proposed implementation of the Verification Framework, for London Borough of Bromley to ensure that all staff and relevant landlords are re-trained on the latest evidence requirements, including identifying false documents.
4.70 The majority of documents in our sample were stamped original seen or original not seen. However, there were 2 claims (7%) in our sample of 30, where some documents were not stamped at all. One member of staff, who accepted evidence from Broomleigh Housing Association, did not have an original seen stamp. This was rectified during the inspection.
4.71 The Standards of Evidence document stated that crosschecks should be performed to ensure:
· signatures on all claim forms and tenancy agreements matched
· the name of the customer was the same as that on the Remote Access Terminal and the rent account
· the customer’s name, date of birth and National Insurance number provided on the claim form matched those on the evidence supplied to support the claim.
4.72 Sampling confirmed that crosschecking of evidence was of a high standard. For example, Benefit Assessors used a locally produced form, known as the Section 19 form, to record the evidence accepted for identity, National Insurance number and comparison of signatures. In addition, for all Broomleigh Housing Association claims, a rent account screen print was used to verify liability to pay rent and residency.
4.73 However, these crosschecks and verification of residency were not included on the quality checking sheet.
4.74 London Borough of Bromley did not insist on original documents to support claims as it was not compliant with the Verification Framework at the time of the on-site phase of our inspection. When this failing is addressed London Borough of Bromley’s standard of verification will be good. Figure 4.8 summarises our findings on verification at London Borough of Bromley.
|
Fig. 4.8: Results of BFI sample of evidence provided in support of claims |
|||||
|
Verification item |
Number requiring verification |
Number verified to Verification Framework Standard |
% verified to Verification Framework Standard |
Number verified including use of photocopies |
% verified including use of photocopies |
|
Customer National Insurance number |
30 |
25 |
83 |
30 |
100 |
|
Partner National Insurance number |
5 |
2 |
40 |
5 |
100 |
|
Customer identity |
30 |
5 |
17 |
29 |
97 |
|
Partner identity |
5 |
0 |
0 |
5 |
100 |
|
Rent liability |
29 |
20 |
69 |
29 |
100 |
|
Council Tax liability |
1 |
1 |
100 |
1 |
100 |
|
Residency |
30 |
20 |
67 |
30 |
100 |
|
IS/JSA(IB) |
21 |
20 |
95 |
21 |
100 |
|
Customer income |
9 |
5 |
56 |
9 |
100 |
|
Partner income |
1 |
0 |
0 |
1 |
100 |
|
Customer capital |
5 |
2 |
40 |
4 |
80 |
|
Partner capital |
1 |
0 |
0 |
1 |
100 |
|
Non-dependants |
1 |
1 |
100 |
1 |
100 |
|
Total |
168 |
101 |
60 |
166 |
99 |
Source: BFI analysis
|
Recommendations |
|
We recommend that London Borough of Bromley: |
|
· ensures it accepts only original documents as evidence in support of: - identity and National Insurance number - liability to pay rent and residency - income and capital - non-dependants’ circumstances · ensures that all staff are re-trained on the requirement to accept only original documents in support of a claim · implements the Verification Framework as intended, commencing February 2004 with full compliance from May 2004 · XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX · XXXX XXX - XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX - all photocopies of original documents, used for verification of a claim, are stamped and certified as such. |
Verification of identity
4.75 Since 6 September 1999, sections 1(1A) and 1(1B) of the Social Security Administration Act 1992 (as amended) require HB and CTB customers and any other person in respect of whom benefit is claimed to provide:
· a statement of their National Insurance number and information or evidence establishing that the number has been allocated to them, or
· information or evidence enabling the National Insurance number allocated to them to be ascertained.
4.76 If a person does not have a National Insurance number, they should apply for one and provide all the necessary information or evidence to enable such a number to be allocated.
4.77 London Borough of Bromley was not at Standard in this element because its verification procedures and practices did not ensure that only original documents were used to confirm a customer’s identity and National Insurance number.
4.78 However, London Borough of Bromley:
· verified identity by concentrating on the whole picture presented by the customer
· showed, through its management checks, that it was satisfied that the customer was eligible to receive HB or CTB before making a decision on a claim
· followed up discrepancies identified through crosschecking of information and recorded the actions taken
· demonstrated good practice with use of the Section 19 form.
4.79 Our first inspection found that London Borough of Bromley’s verification of identity for new claims was poor and verification of National Insurance numbers was good.
4.80 Our second inspection found that, although 100% of customer and partner National Insurance numbers were verified, this verification was not always supported by original documentation. Remote Access Terminal checks were used to confirm National Insurance number in 24 cases in the new claims sample. In the remaining 11 cases only 3 (27%) were supported by original documentation.
4.81 Similarly 97% of our new claims sample were verified for identity, but only 5 (14%) were supported by original documentation.
4.82 There was evidence of crosschecking for identity and National Insurance numbers in our sample, including:
· the use of crosschecking of signatures with previous claims and tenancy agreements, which were recorded on the Section 19 form
· a request for further information to provide proof of a partner’s National Insurance number, which was not included on the claim form.
4.83 In 29 of the 30 new claims sampled a Section 19 form had been completed and scanned onto the Document Management system. The form was used to record the evidence accepted as verification of identity and National Insurance numbers and also to capture the types of documents used for a comparison of the customer’s signature.
4.84 In 8 of the 29 cases the Section 19 form related to a previous claim and had not been replaced with a new form reflecting the new evidence received. In addition, one newly completed Section 19 form did not detail all the evidence provided to support verification of identity.
|
Recommendations |
|
We recommend that London Borough of Bromley: |
|
· verifies identity for all customers and partners, where applicable · fully completes a Section 19 form for every claim, including those claims where a previously completed Section 19 form is held on file. |
Verification of residency and liability to pay rent
4.85 Section 130(1)(a) of the Social Security Contributions and Benefits Act 1992 provides that a person is entitled to HB if:
...he is liable to make payments in respect of a dwelling in Great Britain which he occupies as his home.
4.86 Similarly, section 131(3) of the Social Security Contributions and Benefits Act 1992 provides for CTB:
The main condition for the purposes of subsection (1) above is that the person concerned –
(a) is for the day liable to pay Council Tax in respect of a dwelling of which he is resident.
4.87 This means that, before a local authority can award benefit, it has to be satisfied about both residency and liability to pay either rent or Council Tax.
4.88 The most secure way to verify residency is to visit a customer at the dwelling. However, other methods may be useful, such as:
· sight of utility bills
· internal records such as parking permits
· effective liaison with landlords.
4.89 None of these methods in isolation prove residency, but will add to the overall picture which, when considered in relation to the claim and other evidence, supports the customer’s application.
4.90 London Borough of Bromley was not at Standard in this element because its:
· policies and practices did not ensure that only original documents were used to verify the customer’s liability to pay and residency
· management checks did not confirm that the customer’s residency had been verified. We make a recommendation about this under Management checks.
4.91 However, London Borough of Bromley:
· had procedures and practices to ensure that the customer was:
– liable to make payments in respect of a dwelling normally occupied by them as their home
– resided at the address provided on the claim form
· confirmed liability to pay rent through its management checks
· followed up and resolved discrepancies identified through crosschecking of information and recorded the actions taken as a result
· linked its residency checks with its housing records and the work of its Housing Officers
· demonstrated good practice, by using the rent account screen prints for Broomleigh Housing Association claims.
4.92 Our first inspection found that London Borough of Bromley’s verification of residency was poor for new claims and verification of liability to pay rent was good. During our second inspection we sampled 30 new claims for verification of residency and liability to pay rent or Council Tax.
4.93 In our sample there were 12 cases for Broomleigh Housing Association. London Borough of Bromley used a screen print of the rent account to confirm rent and residency in all these cases.
4.94 The remaining 18 cases in our sample included one CTB-only case, for which liability to pay Council Tax was verified using a Council Tax bill. We found that 7 (41%) of the remaining 17 new claims verified for residency and 8 cases (47%) verified for liability to pay rent were supported by original documentation.
4.95 There was evidence of crosschecking for residency and liability to pay rent, including requests for further information, to provide:
· proof of succession of tenancy, following the death of a customer’s partner
· missing pages of a tenancy agreement
· a missing signature on a tenancy agreement.
4.96 London Borough of Bromley’s Visiting Strategy stated that visits should be used as an alternative method of collecting further information. Under its plan to implement the Verification Framework, London Borough of Bromley intended to recruit 4 further Visiting Officers. However, the plan did not include the impact on verification of residency or the use of Visiting Officers to conduct residency checks.
4.97 London Borough of Bromley’s Verification Policy stated that where discrepancies arise regarding a customer’s residency, the claim should be referred to the Anti-Fraud team for investigation. Interviews with staff confirmed this process was followed.
4.98 London Borough of Bromley had monthly meetings with the Homeless Persons’ Unit, at which issues were discussed and resolved. While we were on site London Borough of Bromley relocated 2 Benefit Assessors to the Homeless Persons’ Unit to encourage better communication between the departments and to confirm residency quicker. Housing Officers also had read-only access to the Benefit IT system.
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Recommendations |
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We recommend that London Borough of Bromley: |
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· uses visits as an additional method of confirming residency, where appropriate · revises its Verification Framework Implementation plan to include its impact on the verification of residency. |
Verification of receipt of IS and JSA(IB)
4.99 The Housing Benefit (General) Regulations 1987, Schedule 3 (paragraph 10), Schedule 4 (paragraph 4) and Schedule 5 (paragraph 5), provide that when the customer receives IS or JSA(IB) the local authority must disregard a customer’s income, earnings and capital. There are similar provisions in the Council Tax Benefit (General) Regulations 1992. Before a local authority can assume the customer has no income or capital, it must obtain confirmation from Jobcentre Plus or The Pension Service that the customer is in receipt of IS or JSA(IB).
4.100 London Borough of Bromley was at Standard in this element because it:
· confirmed entitlement to IS or JSA(IB) prior to deciding a customer’s entitlement to HB and CTB
· verified, through its management checks, that confirmation of IS or JSA(IB) was obtained
· followed up and resolved discrepancies identified through crosschecking of information and recorded the actions taken as a result.
4.101 During our first inspection verification of entitlement to IS and JSA(IB) was good. During our second inspection, 100% of relevant new claims sampled were verified for receipt of IS and JSA(IB), although one case was not verified using original documentation.
4.102 There were 21 claims that required verification of IS and JSA(IB). London Borough of Bromley confirmed proof of receipt of IS and JSA(IB) using the Remote Access Terminal in 18 cases and in the remaining 3 cases by letters of confirmation from Jobcentre Plus.
Verification of income and capital
4.103 In cases when HB and CTB customers are not in receipt of IS or JSA(IB), the local authority must verify the income and capital of the customer and any partner.
4.104 London Borough of Bromley was not at Standard in this element because:
· it did not have policies and practices to ensure that it accepted only original documents to confirm the customer’s financial position
· it did not verify capital in all appropriate cases.
4.105 However London Borough of Bromley:
· verified, through its management checks, that confirmation of income and capital was obtained
· followed up and resolved discrepancies identified through crosschecking of information and recorded the actions taken as a result.
4.106 In our first inspection verification of income and capital was poor. Our sampling showed that only 24% of income and capital was verified in appropriate new and renewal claims.
4.107 In our second inspection verification had improved. There were 10 cases in our new claims sample that had income and 6 had capital. All 10 cases had been verified for income and 5 out of the 6 (83%) had been verified for capital. However, only 5 (50%) of the 10 claims verified for income and 2 (33%) of the 6 claims verified for capital were supported by original documents.
4.108 Our new claims sampling revealed evidence that discrepancies were followed up during verification of income and capital. In one case, a Benefit Assessor found evidence of an undeclared bank account and an undeclared Retirement Pension.
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Recommendations |
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We recommend that London Borough of Bromley ensures that capital is fully verified in all appropriate cases. |
Verification of non-dependants’ circumstances
4.109 HB
and CTB are reduced for each non-dependant normally living with the customer.
It is in the customer’s interests to provide details of
non-dependants because the amount of any deduction depends upon the circumstances
of the non-dependant and, if they are in remunerative work, that person’s
gross income. If a customer does not provide details of a
non-dependant’s income the highest relevant deduction must be applied.
4.110 London Borough of Bromley was not at Standard in this element because its verification policy and procedures did not meet at least the standards of the Verification Framework by accepting only original documents to confirm non-dependants’ circumstances.
4.111 However London Borough of Bromley:
· requested income details for all non-dependants in the customer’s household
· applied
the highest relevant deduction when evidence of a
non-dependant’s income was not provided by the customer
· showed, through its management checks, that it was satisfied that the customer was eligible to receive HB or CTB before making a decision on a claim
· followed up discrepancies identified through crosschecking of information, and recorded the actions taken.
4.112 Our new claims sample included one claim with a non-dependant. A request for proof of the non-dependant’s income was made and correctly verified.
Management checks
4.113 Effective management checks provide information about:
· the integrity and security of benefit processes
· the quality of work such as the evaluation of performance against legislative and other requirements
· training and development needs of staff
· weaknesses in processes.
4.114 London Borough of Bromley was not at Standard in this element because its pre-notification quality checks did not include checking that:
· the claim form was complete
· all required original documents were available
· any decision to pay the landlord was based on application of the fit and proper person test.
4.115 However, London Borough of Bromley had many good practices, including:
· undertaking pre-notification quality checks on at least 10% of assessments to confirm that the assessment was lawful and benefit calculation correct
· ensuring that quality checks examined that:
– a valid Rent Officer determination existed
– the calculation of the benefit period took into account all known or anticipated changes of circumstances, as well as income, capital and rent liability
– the risk criteria had been correctly applied
· undertaking a 100% quality check for trainee assessors
· performing accuracy checks across its caseload
· setting and monitoring targets for continuous improvement in accuracy
· maintaining an audit trail of all management checks
· analysing the results of management checks
· using the resultant trends and patterns to amend working practices and training.
4.116 At the time of our first inspection management checking was weak on both the client and Service Provider side. There was also an overreliance on the client-side determination team to assure the accuracy of payments.
4.117 We recommended that London Borough of Bromley:
· immediately introduced management checks by both Service Provider and client-side
· designed and implemented a range of management checks that brought together and supported all components of the government’s Fraud Strategy
· introduced a target for all operational managers that ensured checks were performed, and results reported into a corporate performance system on a monthly basis.
4.118 Our second inspection found the following strengths:
· London Borough of Bromley and the Service Provider both performed management checking
· fraud management checks were built into the new partnership with the Anti-Fraud team
· controls were in place to ensure that management checks were performed and the results used to ensure continuous improvement.
4.119 Service Provider management checking was performed by Quality Assessors. The checks performed included:
· 10% check on all claims assessed
· 100% check on trainees
· 100% check on returned cheques and cheques over £1,000.
4.120 The Service Provider did not share the results of quality checks with London Borough of Bromley but used them to inform Service Provider management of assessment error rates, staff performance and individual and team training needs.
4.121 Benefits Monitoring Officers conducted management checking for London Borough of Bromley. The checks included:
· a minimum 10% check on all claims assessed
· 100% check on all payments over £1,000.
4.122 London Borough of Bromley told us that its Monitoring Officers checked about 60% of assessed claims. This high level of checking was evident in our sample of 30 new claims. The client-side had checked 21 cases (70%), of which 14 (67%) were made before a notification was sent to the customer.
4.123 London Borough of Bromley discussed the results of checks performed by the Benefits Monitoring team with the Service Provider at operational meetings. XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX XXXX XXXX XXXX X
4.124 London Borough of Bromley reported an 11% overall error rate, including administrative errors, for September 2003. There was an increased error rate of 13% for October 2003 and an error rate of 11% for November 2003. The most common errors concerned:
· the correct use of effective dates
· verification of income and capital
· verification of rent details and Rent Officer referrals.
4.125 The Service Provider supplied Benefit Assessors with revised procedures on effective dates and Rent Officer referrals to help reduce the error rates for these areas.
4.126 The Service Provider’s Quality Assessors and London Borough of Bromley’s Benefits Monitoring Officers did not have their own procedures to follow. They referred to a new and renewal quality checking sheet when performing checks but did not complete the sheet.
4.127 There were no management checks performed on the work of the Benefits Monitoring team or the Service Provider’s Quality Assessors.
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Recommendations |
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We recommend that London Borough of Bromley: |
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· improves its quality checking sheet to include the crosschecks specified in its Standards of Evidence document and includes a check that: - the claim form is complete - all required original documents are available - any decision to pay the landlord is based on application of the fit and proper person test - the decision letter is accurate and timely - the customer’s residency has been verified · ensures that: - the results of quality checking performed by the Service Provider are shared with London Borough of Bromley - the quality checking sheet is completed for every claim where a quality check is performed · provides written guidance to staff undertaking quality checks · ensures that management checks are performed on the work of the Service Provider’s Quality Assessors. |
Tailoring of benefit periods
4.129 Regulation 66 of the Housing Benefit (General) Regulations 1987 and regulation 57 of the Council Tax Benefit (General) Regulations 1992 require that awards are to be for a fixed period, which, when originally determined, must not exceed 60 weeks. Paragraph (2) of each of those regulations requires that:
The benefit period shall be such number of benefit weeks, as the relevant authority shall determine having regard in particular to any relevant circumstances that the…relevant authority reasonably expects may affect entitlement in the future.
4.130 These legal requirements on benefit periods take priority over any generalised risk categorisation procedures followed. However, when they have been applied, the Verification Framework gives guidance on the length of benefit periods that should be allocated to customers in different risk groups. The legal requirements on benefit periods mean that, as well as taking risk groups into consideration, local authorities must also take account of potential or known changes of circumstances that could effect entitlement to benefit.
4.131 The abolition of benefit periods for pensioners from October 2003, and for all other customers from April 2004, means there will be no requirement for renewal claims. As these changes had not come into effect at the time of our inspection, our report reflects London Borough of Bromley’s performance in November 2003.
4.132 London Borough of Bromley was at Standard in this element because it:
· had procedures to ensure that:
– benefit periods did not exceed 60 weeks
– benefit periods were only extended in line with the regulations
· tailored benefit periods to take account of known or anticipated changes of circumstances
· produced an exception report for all relevant cases exceeding 60 weeks.
4.133 London Borough of Bromley had clear instructions on the extension of benefit periods and the tailoring of benefit periods to customers’ circumstances. Although London Borough of Bromley was not Verification Framework compliant, Benefit Assessors followed Verification Framework guidelines on the setting of benefit periods.
4.134 The Benefit IT system did not allow claims to be set with a benefit period which exceeded 60 weeks.
4.135 In our sample of 30 new claims, there were 19 claims where a benefit period was appropriate and had been set. There were no cases where the benefit period extended beyond 52 weeks.
Pension Credit
4.136 As part of its strategy to eradicate pensioner poverty, the government has introduced Pension Credit.
4.137 Pension Credit came into effect from 6 October 2003. The key elements of Pension Credit are:
· guarantee credit, to ensure a minimum level of income to those customers aged 60 and over
· savings credit which will, from age 65, provide an additional income for pensioners who have made some provision for their retirement by having, for example, a small second pension or savings.
4.138 Local authorities need to work closely with The Pension Service in dealing with HB or CTB claims that are linked to Pension Credit.
4.139 Where a customer is entitled to guarantee credit or guarantee credit and savings credit, The Pension Service will notify the local authority, and the customer will automatically receive full HB or CTB.
4.140 When guarantee credit is in payment local authorities will award full HB or CTB for as long as entitlement to the guarantee credit continues. If the customer is entitled to savings credit only they will have to claim HB or CTB.
4.141 Local authorities are required by legislation to use The Pension Service’s assessment of the pensioner’s income and capital (the Assessed Income Figure). This means that for HB or CTB claims where savings credit only is in payment, local authorities will not need to collect details of a pensioner’s income and capital. Instead they will rely on the figure provided by The Pension Service. Pensioners will not need to report changes of circumstances, apart from those that are tenancy related, to the local authority.
4.142 We found that London Borough of Bromley had provided training to all staff on Pension Credit. We were told London Borough of Bromley had not experienced any major issues with the introduction of Pension Credit.
Tax Credit
4.143 Following on from Working Families' Tax Credit and Disabled Persons’ Tax Credit the government introduced a new system of tax credits in April 2003. There are 2 new tax credits:
· Child Tax Credit
· Working Tax Credit.
4.144 The introduction of new tax credits means that the Inland Revenue and local authorities share a joint customer base of HB and CTB customers who also receive tax credits. It is important that both parties work together to meet the needs of their common customers and to effectively administer HB and CTB to customers receiving tax credits.
4.145 To achieve this a national Business Partnership Agreement was agreed in April 2003. This set out the minimum standards to be achieved by each party.
4.146 London Borough of Bromley had provided training to all staff on new tax credits and had not experienced any issues with the introduction of tax credits.
Risk assessing and checking customers’ circumstances
4.147 Estimates in the second Housing Benefit Review: Main Stage Report, 1998 indicated that around 70% of fraud and error occurs as a result of customers or landlords failing to report changes of circumstances. It is essential therefore that local authorities carry out checks on customers’ circumstances. The frequency and type of check may be determined by a number of factors, such as:
· the risk associated with the type of claim
· whether or not HB was linked to IS or JSA(IB) entitlement
· the method used to pay benefit.
4.148 London Borough of Bromley was not at Standard in this element because it did not:
· have a risk management process for the setting of risk groups that at least met the Standard of the Verification Framework
· conduct checks on customers’ circumstances to at least the requirements of the Verification Framework.
4.149 However, London Borough of Bromley assessed the risk of fraud and error according to customers’ circumstances and the history of the claim, and maintained a record of the outcome of all checks on customers’ circumstances.
Requirement to refer to Rent Officer
4.150 The Housing Benefit (General) Regulations 1987 require a local authority to refer certain rent allowance claims to the Rent Officer for a determination to be made on the level of rent eligible for HB and to make this referral within 3 working days, or as soon as is practicable. The regulations also provide for an application to be made for a pre-tenancy determination.
4.151 London Borough of Bromley was not at Standard in this element because it did not:
· refer applications to the Rent Officer within 3 working days of receiving claims or notifications of changes relating to rent allowance claims
· make decisions on claims, on receipt of Rent Officer determinations, within 2 working days of receipt
· have a current signed service level agreement with the Rent Service and did not monitor the timeliness of determinations returned from the Rent Officer.
4.152 However, London Borough of Bromley:
· had procedures which identified appropriate cases for referral to the Rent Officer
· ensured that determinations were returned from the Rent Officer
· referred pre-tenancy determinations to the Rent Officer within 2 working days of receiving the requests from customers
· included in its management checking that, where appropriate, a Rent Officer referral was made
· had a good relationship with the Rent Officer and attended quarterly liaison meetings, during which any quality issues were discussed.
4.153 In our first report, London Borough of Bromley had a signed service level agreement with the Rent Service, met regularly with the Rent Officer and made referrals in appropriate cases. However, we were concerned that London Borough of Bromley:
· did not monitor the service level agreement with the Rent Service
· did not meet the legal requirements for referring claims to the Rent Officer.
4.154 During our second inspection, the service level agreement between London Borough of Bromley and the Rent Service did not include all the relevant targets and was not signed. In addition, London Borough of Bromley did not monitor the service level agreement.
4.155 However, although London Borough of Bromley did not undertake monitoring of the service level agreement we found claims were controlled by the Benefit IT system to ensure that determinations were returned from the Rent Officer.
4.156 During our new claims sampling, we examined rent allowance claims to establish if London Borough of Bromley made Rent Officer referrals in all appropriate cases. In our sample of 30 new claims there were 4 cases (13%) where a referral was appropriate. Referrals had been made in all cases.
4.157 We also analysed our sample to establish the time taken during the Rent Officer referral process. Figure 4.9 shows there were delays throughout the process.
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Fig. 4.9: New claims sample - analysis of time taken to administer claims involving a referral to the Rent Officer |
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Process |
Average working days taken |
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Time taken to refer claim to Rent Officer |
18 |
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Time taken between referral and determination by Rent Officer |
9 |
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Time taken between determination by Rent Officer and receipt at London Borough of Bromley |
1 |
|
Time taken between receipt at local authority and decision by London Borough of Bromley |
7 |
|
Total time taken |
35 |
Source: BFI analysis
4.158 In
our sample there were 4 cases where the customer requested a
pre-tenancy determination. In all cases the pre-tenancy determination was
referred to the Rent Officer within the statutory 2 days.
4.159 The Rent Service had an unquantified backlog of referrals from November 2002 - September 2003. During this time, London Borough of Bromley worked with the Rent Service to prioritise urgent referrals.
4.160 As a result of the good relationship between London Borough of Bromley and the Rent Service, the Rent Officer requested that London Borough of Bromley trial an electronic Rent Officer referral process from December 2003. This should help speed up the referral process.
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Recommendations |
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We recommend that London Borough of Bromley: |
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· ensures that it meets the timescales for: - referring claims to the Rent Officer - making decision on claims, on receipt of Rent Officer determinations · ensures that the current service level agreement between London Borough of Bromley and the Rent Service is finalised and signed · monitors the requirements set out in the service level agreement. |