An inspectorate of the Department for Work and Pensions.

Report

Charter Mark - Awarded for excellence

Processing of Claims

Fig. 4.1: Results of BFI’s assessment for Processing of Claims

Source: BFI inspection assessment

For an explanation about how to read this radar chart see Strategic Management.

4.1 HB and CTB are vital payments made to help people on low incomes. Claims should be dealt with quickly and accurately.

Backlog of work

4.2 mAt the time of the first inspection, London Borough of Harrow had a backlog of work that comprised 2 main elements:

4.3 We reported, in September 2000, that London Borough of Harrow had 2,000 items of post awaiting scanning and indexing and 4,000 cases available for processing. In the first report, we made recommendations aimed at improving the management and control of the backlog.

4.4 During our follow-up inspection, London Borough of Harrow no longer had any backlog of post waiting to be scanned and indexed but still had a backlog of claims awaiting processing. Details of the backlog of work as at 11 March 2003 are shown in Figure 4.2.

Fig. 4.2: Outstanding work as at 11 March 2003

Type of case

Number of cases assigned to
Benefit Assessors

Number of cases not yet assigned to Benefit Assessors

Total number of cases outstanding

New claim

696

984

1,680

Renewal claim

558

1,335

1,893

Urgent correspondence

133

33

166

Other work

362

1,707

2,069

Total

1,749

4,059

5,808

Source: BFI analysis

4.5 In an internal report in April 2002, London Borough of Harrow estimated that it received an average of 850 cases for processing each week. Using the same figure, we estimated that there was a backlog of almost 7 weeks work on 11 March 2003. This was the same level that we found in February 2000.

4.6 Prior to our inspection, London Borough of Harrow provided us with copies of management information reports showing the number of cases waiting to be processed during the period from July 2002 to December 2002. Figure 4.3 provides a monthly summary of that information.

Fig. 4.3: Outstanding work during the period July 2002 – December 2002

Date

Total numbers of cases outstanding

Key items included in overall backlog

July 2002

4,733

1,942 new claims, 1,633 renewal claims

August 2002

5,499

1,882 new claims, 1,991 renewal claims

September 2002

5,735

2,145 new claims, 1,792 renewal claims

October 2002

4,977

1,752 new claims, 1,792 renewal claims

November 2002

4,899

1,664 new claims, 1,644 renewal claims

December 2002

4,601

1,608 new claims, 1,223 renewal claims

Source: BFI analysis

4.7 Our analysis revealed that the average number of cases waiting to be processed between July 2002 and September 2002 was 5,074. The number of cases outstanding on 11 March 2003 was 14% greater than the average for the period shown in Figure 4.3 and 23% greater than it had been in July 2002.

4.8 The failure by London Borough of Harrow to adopt the recommendations from our first report and reduce the number of cases waiting to be processed has affected its ability to reach Standard or achieve its own targets for speed of processing across all aspects of benefit administration.

New claims – speed of processing

4.9 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 Council Tax Benefit at regulation 66(3) of the Council Tax Benefit (General) Regulations 1992, which also requires first payment of any CTB to be made within 14 days of receipt of the claim or as soon as reasonably practicable thereafter.

4.10 In addition to the statutory requirements the Best Value regime also requires local authorities to measure and report the average time for processing new claims and sets a target of 36 days, a target that should be achieved by all local authorities by 2005/06.

4.11 London Borough of Harrow was not at Standard in this element because our sampling found:

14-day performance

4.12 At the time of the first inspection, London Borough of Harrow was deciding less than 50% of new claims within 14 days of it receiving all the necessary information.

4.13 London Borough of Harrow completed a self-assessment against this Standard and reported to us in December 2002 that it decided around 75% of cases within 14 days against the Standard of 90%. Its reported performance for the period from 1999/2000 to 2001/02 is shown in Figure 4.4 and confirms that performance fell short of the Standard for processing new claims.

Fig. 4.4: Percentage of new claims decided within 14 days

Claim type

1999/2000
%

2000/01
%

2001/02
%

HB

57

50

71

CTB

59

50

73

Source: London Borough of Harrow

4.14 We examined a sample of new claims, decided between 1 October 2002 and 31 December 2002, which showed that 83% of HB claims and 43% of CTB claims were decided within 14 days. Details of our findings are shown in Figure 4.5.

Fig. 4.5: Sample of new claims decided within 14 days

Type of case

Number of claims decided

Decided within 14 days

Number

%

Rent Rebate

4

3

75

Rent Allowance

19

16

84

CTB only

7

3

43

Total

30

22

73

Source: BFI analysis

4.15 Figure 4.5 shows that the current level of performance, when compared to the reported performance in 2001/02, had improved in respect of HB claims but had deteriorated for CTB claims.

36-day performance

4.16 In its self-assessment, London Borough of Harrow said that its average time to decide new claims was greater than the 36 calendar days required by Standards, averaging around 60 days. We examined a sample of 35 new claims, including 5 claims where London Borough of Harrow decided that the customers were ineligible for benefit because they failed to provide information that had been requested. Our findings are shown in Figure 4.6.

Fig. 4.6: New claims sample – average number of days to decide a claim

Case type

Average number of days

Rent Allowance

57

Rent Rebate

124

CTB only

108

Total

78

Source: BFI analysis

4.17 Figure 4.6 confirms that London Borough of Harrow was not at Standard for the time taken to decide any type of new claim.

Exception reporting

4.18 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 Harrow told us that it produced exception reports on claims not meeting the 14-day processing Standard but not for claims not meeting the 36-day processing Standard.

4.19 To demonstrate what can be achieved by using exception reports, we analysed the delays in respect of the 35 new claims that we examined. Our analysis is shown in Figure 4.7.

Fig. 4.7: New claims processing – days taken for each stage in the process

Work step

Average days

Range of days

Date of receipt at designated office to date of first action

32

0 – 140

Date of first action to all information or evidence available

22

0 – 92

Date of all information or evidence available to date of decision

25

0 – 195

Total days from claim received to decision

78

5 – 317

Source: BFI analysis

4.20 Figure 4.7 shows that there were delays at each stage of the process which undermined London Borough of Harrow’s ability to reach Standard.

4.21 Figure 4.7 shows that London Borough of Harrow took an average of 22 days to obtain all information or evidence. In our new claims sample of 35 cases, there were 20 cases where a letter was sent to the customer requesting further information before the claim could be decided. In 12 of these cases, the claim form had been handed in at the reception and no action had been taken to request the missing information at the time.

4.22 London Borough of Harrow will achieve Standard if it:

Recommendations

We recommend that London Borough of Harrow:

· introduces and monitors procedures to ensure that it meets the 14-day and 36-day processing Standards

· develops an exception report that identifies claims not reaching the 36-day Standard and investigates the length and reason for the delay.

Payments on account

4.23 Regulation 91(1) of the Housing Benefit (General) Regulations 1987 requires a local authority to make a payment on account, if:

4.24 Payments on account should only be made when necessary and for as brief a period as possible, as they are not intended as a substitute for making a full decision and correct payment on a claim.

4.25 London Borough of Harrow was not at Standard in this element because it did not have procedures in place to identify claims where a payment on account should be made.

4.26 Our sampling during the first inspection revealed that payments on account were not being made where appropriate. In this inspection sampling showed that progress had been made and:

4.27 Our sampling in this inspection revealed that payments on account were not being made in all appropriate cases. In our sample of 35 new claims, 22 were Rent Allowance claims. The majority of these claims had been delayed by the backlog of work and we examined them to see whether payments on account were appropriate. Our findings are shown in Figure 4.8.

Fig. 4.8: Analysis of payments on account – performance in sample cases
 

Number

%

Number of Rent Allowance cases where a payment on account was appropriate

5

100

Number of Rent Allowance cases where a payment on account was appropriate but not made

2

40

Number of payments on account made

3

60

Source: BFI analysis

4.28 Figure 4.8 shows that payments on account were appropriate in 5 cases in our sample but payments on account were not made in 2 (40%) of these cases.

4.29 In our first report, we recommended that all appropriate cases awaiting assessment should be identified and payments on account made. London Borough of Harrow still had no process in place to monitor Rent Allowance cases to identify potential payment on account cases and this was confirmed by its self-assessment against Performance Standards.

4.30 To achieve Standard in this element, London Borough of Harrow should ensure that it has procedures in place to identify cases for payment on account.

Recommendations

We recommend that London Borough of Harrow:

· introduces procedures that ensure that appropriate payment on account cases are quickly identified and payments made.

Reported changes of circumstances

4.31 Between July 1997 and October 2001 sections 111A 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.

4.32 From 18 October 2001, sections 111A (c) to (d) and section 112(1A) have been replaced by sections 111A(1A) to (1G) and 112(1A) to (1F). These sections create 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.

4.33 The Best Value regime requires local authorities to measure and report the average time for processing notifications of changes of circumstances.

4.34 London Borough of Harrow was not at Standard in this element because it did not identify or prioritise reported changes of circumstances to ensure that it met the 9 calendar day processing Standard. It did, however:

4.35 We examined 16 cases selected at random from decision letters issued while we were on-site and looked at the 30 cases in our overpayment sample. There is more information about the overpayment sample in Overpayments.

4.36 The notifications of changes of circumstances came from various sources. Figure 4.9 gives details.

Fig. 4.9: Changes of circumstances – sources of notification

Source of notification

Number

% of sample

Jobcentre Plus

20

43

Customer

16

35

Landlord

1

2

Other

9

20

Total

46

100

Source: BFI analysis

4.37 The overall average times taken to process the changes for the 2 different types of cases in our sample are shown separately and jointly in Figure 4.10.

Fig. 4.10: Average number of days to process reported changes of circumstances

Sample type

Number of cases

Average number of days from receipt of reported change to decision

Overpayment

30

78

Decision letter

16

20

Total

46

58

Source: BFI analysis

4.38 Figure 4.10 shows that the overpayment cases, on average, took almost 4 times longer to process than the sample selected from the decision letters. Further examination of the overpayment cases showed that 16 of these cases required further enquiries to be made before a decision could be made. The average time taken to decide those cases was 132 days.

4.39 London Borough of Harrow set a target as part of its Best Value improvement plan for 2002/03 to process all notifications of changes of circumstances within 10 calendar days. We examined the time taken to process each case in our sample to establish how many cases were either processed within London Borough of Harrow’s own target or within Standard. The findings from our analysis are shown in Figure 4.11.

Fig. 4.11: Time taken to process changes of circumstances

Days

Number

%

0 – 9

16

35

10

2

4

11 – 15

5

11

16 or over

23

50

Total

46

100

Source: BFI analysis

4.40 Figure 4.11 shows that only 35% of changes of circumstances sampled met the Standard of 9 days and only 39% achieved London Borough of Harrow’s internal target of 10 days.

4.41 To achieve Standard, London Borough of Harrow needs to ensure that it processes reported changes of circumstances within 9 calendar days of being notified of the change.

Recommendations

We recommend that London Borough of Harrow:

· introduces procedures to identify and prioritise reported changes of circumstances and monitors action taken to ensure that it meets the Standard of 9 calendar days.

Renewal claims

4.42 Regulation 72(14) of the Housing Benefit (General) Regulations 1987 and regulation 62(15) of the Council Tax Benefit (General) Regulations 1992 require local authorities to invite a customer to make a claim for a further award of benefit when a benefit period:

4.43 The Best Value regime requires local authorities to measure and report the percentage of renewal claims processed on time.

4.44 London Borough of Harrow was not at Standard in this element as it:

8-week renewal target

4.45 Our sampling of 30 renewal claims confirmed that London Borough of Harrow invited further claims by sending out renewal claim forms between 8 and 9 weeks before the expiry of the current benefit period.

Monitoring and control of the renewal claims process

4.46 London Borough of Harrow issued bar-coded renewal claim forms. The receipt of these forms was automatically logged onto the benefits IT system when the Scanning and Indexing team scanned them on to the document image processing system.

4.47 Potential customers were told in the claim form about obtaining assistance with the completion of the form if they were housebound. They were told to telephone the office and arrangements would be made for a Visiting Officer to call. London Borough of Harrow provided us with information that showed it had made 135 welfare visits for benefit purposes during the 3 months that ended on 31 December 2002.

4.48 A report was generated from the benefits IT system 4 weeks before the end of the current benefit period, identifying cases where the renewal claim form had not been received. London Borough of Harrow used that report to issue a reminder to the customer.

4.49 The reminder gave the customer the opportunity to contact London Borough of Harrow. Procedures could be improved in Rent Allowance cases where benefit is paid direct to the landlord. A copy of the reminder could have been sent to the landlord to indicate that the benefit award was about to expire and that the renewal claim form had not been completed. This would have encouraged the landlord to make contact with the tenant and resulted in the earlier completion of the claim form.

4.50 If no renewal claim form was received by the end of the benefit period, the claim expired and an appropriate decision letter was issued to the customer. Staff told us that details of these cases were referred to the Investigations team to follow up. We were pleased to note that London Borough of Harrow was taking action to follow up the non-return of renewal claim forms as we had recommended this in our first report. We had concerns about the action taken by the Investigations team on these cases which we report on in Counter-fraud.

Extending benefit periods

4.51 Regulations permit the extension of benefit periods only in certain limited circumstances. But this only applies if the customer or partner:

4.52 All the benefit periods that had been set in our renewal claim were less than 60 weeks.

4.53 However, we found that London Borough of Harrow had incorrectly extended the maximum 60-week benefit period permitted by regulations in a small number of cases.

4.54 We were provided with an exception report covering the period 1 April 2002 to 10 March 2003, listing 60 cases where the benefit period exceeded
60 weeks. Examination of a sample of these cases showed that the benefit periods had originally been set for 58 weeks and had subsequently been extended for the purposes of avoiding the need to renew these cases in specific weeks in the year. The benefit periods in these cases had not been extended in accordance with the regulations.

Clearance time targets

4.55 At the time of the first inspection, London Borough of Harrow was only deciding 40% of renewal claims before the end of the current benefit period.

4.56 London Borough of Harrow self-assessed itself as meeting the Standard of deciding 83% of renewal claims before the end of the current benefit period. It reported a performance of 85.8% for 2001/02 and set a target of 90% for 2002/03 as part of its Best Value improvement plan. Our analysis of the method used to calculate its performance for 2001/02 revealed that the authority had incorrectly reported its performance. We have reported on this earlier in Strategic Management.

4.57 We examined 30 renewal claims and found that only 47% of these claims were decided on time. Our findings are shown in Figure 4.12.

Fig. 4.12: Renewal claims decided before the expiry of the benefit period

Type of case

Number of claims decided

Decided before the expiry of the benefit period

Number

%

Rent Rebate

9

5

56

Rent Allowance

14

3

21

CTB only

7

6

86

Total

30

14

47

Source: BFI analysis

Exception reporting

4.58 London Borough of Harrow did not produce an exception report, showing the length and reasons for the delays for renewal claims that were returned but not decided before the end of the current benefit period.

4.59 The results of our analysis of a sample of renewal claims showing the average times taken for each stage of the renewal claims process are shown in Figure 4.13.

Fig. 4.13: Sample renewal claims processing – days taken for each stage in the process

Work step

Average days

Range days

Date of receipt to date of first action

32

0 – 91

Date of first action to all information or evidence available when claim incomplete on receipt

16

0 – 100

Date of all information or evidence available to date of decision

16

0 – 64

Total days from claim received to decision

47

8 – 127

Source: BFI analysis

4.60 Figure 4.13 shows that the longest delays occurred at the start of the process where the average delay between receipt of the claim form and first action was 32 days. It follows that, if London Borough of Harrow reduced or cleared its backlog of benefits administration work, it would be better placed to reach Standard for the clearance of renewal claims.

London Borough of Harrow would achieve Standard in this element if it:

Recommendations

We recommend that London Borough of Harrow:

· sends to direct payment landlords a copy of the invitation to renew the claim

· ceases the practice of extending benefit periods beyond 60 weeks unless permitted by the regulations

· introduces and monitors procedures to ensure that it meets the renewal claims clearance time Standard

· introduces an exception report for renewal claims that are not decided before the end of the current benefit period and investigates the length and reasons for the delay.

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 appropriate authority to determine that person’s entitlement to housing benefit...

4.63 There is a similar provision in regulation 63 (1) of the Council Tax Benefit Regulations 1992.

4.64 London Borough of Harrow was not at Standard in this element because of its failure to:

4.65 The Verification Framework requires an authority to be able to show that a trained officer accepted and verified any original documents that were seen. London Borough of Harrow met these requirements. However, it did not meet Standard for certifying and stamping original documents because Standards require that individual photocopies need to be certified and stamped as copies of an original document.

4.66 In this inspection, we confirmed London Borough of Harrow’s self-assessment that it was not at Standard in this element. Although XXXX XXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX and it did not stamp and certify photocopies of original documents.

Furnishing original documents as supporting evidence

4.67 London Borough of Harrow had the policies, procedures and practices in place to ensure that customers furnished the original documents that were necessary to support applications for benefit and notifications of changes of circumstances. In particular we noted that:

Authentication of verification evidence

4.68 The Department’s Verification Framework requires local authorities to be able to show that any documents that were seen were accepted by a trained officer as being original.

4.69 London Borough of Harrow told us that all benefits, reception and scanning staff had received training to recognise original documents as part of their induction training.

4.70 London Borough of Harrow told us that it had not XXXX XXXX XXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX received in the post since implementing the Department’s Verification Framework in March 1999. It cited health and safety reasons for this course of action but could not substantiate the reasons for this. Customer Advisors had access to an ultra violet scanner that was held on the Investigations Team but its use was limited.

4.71 London Borough of Harrow told us that it had ceased the authentication of individual documents, submitted in support of claims and other notifications, in May 2000. In place of that practice, it introduced the use of cover sheets to accompany photocopied documents, listing which documents had been submitted.

4.72 In our sampling of new and renewal claims, we saw 3 types of cover sheet:

4.73 Pre-October 2002 counter receipts were present in 31 out of 60 cases sampled. In these cases, the verification of evidence based on the photocopy documents did not meet the requirements set out in the Verification Framework.

Cross-checking

4.74 At the time of the first inspection, cross-checks against the records on other London Borough of Harrow computer systems were seldom made when appropriate.

4.75 At the time of this inspection, London Borough of Harrow used the management control sheet recommended in the Verification Framework for the purposes of recording checks made in the course of the assessment of claims. On that control sheet there was provision for Benefit Assessors to record that all cross-checks had been completed.

4.76 Staff told us that cross-checks would typically have covered residency and, in the case of Rent Rebate cases, liability to pay rent. Management control sheets were present in 54 (90%) of the new and renewal claims sampled. In all of those cases, the sheet had been certified to show that all cross-checks had been completed.

4.77 London Borough of Harrow received some assurance through management checks that cross-checks with previous claims and other council systems had been made. However, they did not include a check to ensure that residency had been confirmed.

Management check of verification

4.78 The Verification Framework provides for management checks of the verification process and in particular that the:

4.79 London Borough of Harrow incorporated this aspect into the management check of HB and CTB assessments and recorded its findings on a combined quality-checking sheet.

4.80 Figure 4.14 provides a summary of our findings of the verification practices at London Borough of Harrow.

Fig. 4.14: Verification practices adopted

Verification work area

% of cases where verification was complete in our sample of new and renewal claims

BFI comments

National Insurance Number for customer and partner

79

Training notes instructed staff to confirm National Insurance Numbers by requesting documents containing the National Insurance Number of the customer and partner.

In our sample of 60 new and renewal claims the National Insurance Number of the customer had been verified for 44 (73%) claims. XXXX XXXX X XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX X XXXX X

 

Verification work area

% of cases where verification was complete in our sample of new and renewal claims

BFI comments

Identity for customer and partner

77

Training notes for Verification Framework instructed staff to confirm identity by requesting the documents listed in the claim form, such as:

· Passport

· Birth certificate

· Driving licence

· utility bill for the last quarter.

Copy documents not individually authenticated to show originals seen and old style counter receipt did not confirm that original documents had been seen.

In our sample of 60 claims the identity of the customer had been verified in only 41 (68%) of the claims. XXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX

Liability to pay rent and residency

83

Confirmation of liability to pay rent and residency in Rent Rebate cases was certified on the management control sheet. In Rent Allowance cases, customers provided documentary evidence of liability to pay rent and residency was confirmed through certified management control sheets, supporting documents or at a visit.

In 11 of the 39 cases in our sample the counter receipt for documents received before October 2002 did not show that original documents had been seen.

Liability to pay Council Tax

90

In 54 cases of our new and renewal claims samples, Benefit Assessors had certified that all cross-checks, including Council Tax liability, had been completed.

 

Verification work area

% of cases where verification was complete in our sample of new and renewal claims

BFI comments

Receipt of IS and JSA(IB)

82

In our sample of 60 new and renewal claims 39 (65%) claims were linked by entitlement to IS or JSA(IB). Verification in 14 (93%) out of 15 new claims met the standard required by the Verification Framework, but in 6 (25%) of the 24 renewal claims, entitlement to IS or JSA(IB) had not been correctly verified.

Sampling showed that entitlement was verified using:

· an IS order book

· an IS or JSA(IB) decision notice

· a Remote Access Terminal check.

Income and capital

29

In our sample of 60 new and renewal claims:

· 21 cases required income to be verified

· 20 cases required capital to be verified

XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX XX

XXXX XXXX XXXX XXXX XXXX XXX XXXX XXXX XX

Documents received at the counter before October 2002 were not verified to the standard of the Verification Framework.

Non-dependants’ circumstances

0

In our sample of new and renewal claims, 5 cases required proof of the income of non-dependants.

In one case (20%), the customer did not provide proof and the highest rate of deduction was applied. In the remaining 4 cases (80%) documents were not verified to Verification Framework standards as there was no confirmation that original documents had been seen.

Source: BFI analysis

4.81 Figure 4.14 reflects the adverse effect that the use of the pre-October 2002 counter receipt had on the verification practices at London Borough of Harrow. Although the authority was using a new style counter receipt at the time we were on-site, the use of this receipt means that London Borough of Harrow did not meet Standard because individual photocopies need to be certified and stamped as copies of an original document.

4.82 To achieve Standard London Borough of Harrow should:

Recommendations

We recommend that London Borough of Harrow:

· re-introduces the stamping and certification of photocopy documents to show that original documents have been seen

· XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX

Verification of identity

4.83 Since 6 September 1999, sections 1(1A) and 1(1B) of the Social Security Administration Act 1992 (as amended) requires HB and CTB customers and any partner included in a claim to provide:

4.84 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 to them.

4.85 London Borough of Harrow was not at Standard in this element because it did not certify and stamp photocopied documents as originals.

4.86 In many cases in our sample of new and renewal claims, London Borough of Harrow did not meet the requirements of the Verification Framework when verifying National Insurance Numbers and/or identity. This was due entirely to the use of the pre-October 2002 version of the counter receipt, which provided no indication that original documents had been seen. Our findings are in Figures 4.15 and 4.16.

Fig. 4.15: Verification of National Insurance Numbers in sampled new and renewal claims

Type of case

Number of cases requiring verification

Verification satisfactory

Number

%

New claims – customer

30

20

67

Renewal claims – customer

30

24

80

New claims – partner

6

3

50

Renewal claims – partner

9

3

33

Source: BFI analysis

Fig. 4.16: Verification of identity in sampled new and renewal claims

Type of case

Total cases

Verification satisfactory

Number

%

New claims – customer

30

17

57

Renewal claims – customer

30

24

80

New claims – partner

6

2

33

Renewal claims – partner

9

3

33

Source: BFI analysis

4.87 London Borough of Harrow was no longer using the pre-October 2002 version of the counter receipt at the time of our on-site inspection. The current versions of both cover sheets that were in use certified, where appropriate, that original documents had been seen.

4.88 Since the introduction and use of the current version of the counter receipt, London Borough of Harrow had met the requirements of the Verification Framework for the verification of identity. In all cases that we sampled, where the current versions of the cover sheets were used, benefits staff had obtained sufficient evidence to verify the identity for customers and partners.

4.89 London Borough of Harrow would achieve Standard if it certified and stamped photocopied documents to show that they were copies of an original document.

Verification of residency and liability to pay rent

4.90 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.

4.91 Similarly, section 131(3) of the Social Security Contributions and Benefits Act 1992 provides for CTB:

4.92 These sub-sections mean 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.

4.93 London Borough of Harrow was not at Standard in this element because:

4.94 In the first inspection, there were significant weaknesses in recording the evidence that checks had been made to confirm rent liability and residency.

4.95 In our sample of new and renewal claims, liability to pay rent was not confirmed in 16 cases because the evidence did not reach the requirements of the Verification Framework. In all of these cases, London Borough of Harrow used its old style counter receipt and did not show that original documents had been seen. Our findings are shown in Figure 4.17.

Fig. 4.17: Verification of rent liability in sampled new and renewal claims

Type of case

Number of cases requiring verification

Verification satisfactory

Number

%

Rent Rebate – new claims

4

4

100

Rent Rebate – renewal claims

9

9

100

Rent Allowance – new claims

19

9

47

Rent Allowance – renewal claims

14

8

57

Total

46

30

65

Source: BFI analysis

4.96 During this inspection staff told us that Benefit Assessors confirmed residency either by completing cross-checks with other systems in London Borough of Harrow or through the supporting documents that provided an indication that the customer resided at the address from which they were claiming. Our findings from our new and renewal claims sample are shown in Figure 4.18.

Fig. 4.18: Verification of residency in sampled new and renewal claims

Type of case

Number of cases requiring verification

Verification satisfactory

Number

%

Rent Rebate – new claims

4

4

100

Rent Rebate – renewal claims

9

9

100

Rent Allowance – new claims

19

18

95

Rent Allowance – renewal claims

14

13

93

CTB only – new claims

7

7

100

CTB only renewal claims

7

7

100

Total

60

58

97

Source: BFI analysis

4.97 Figure 4.18 shows that London Borough of Harrow’s performance in recording checks on residency has improved since our first inspection. It does, however, need to obtain assurance through its management check of HB and CTB assessments that the cross-checks to confirm residency have been carried out.

4.98 Our new and renewal claims samples included 14 CTB only cases. Benefit Assessors checked Council Tax liability through London Borough of Harrow’s Council Tax records and recorded the completion of the cross-check on the management control sheet. Management control sheets had, however, not been completed in 2 new claims that we examined. Our findings are in Figure 4.19.

Fig. 4.19: Verification of Council Tax liability in sampled new and renewal claims

Type of case

Number of cases requiring verification

Verification satisfactory

Number

%

CTB only – new claims

7

5

71

CTB only – renewal claims

7

7

100

Total

14

12

86

Source: BFI analysis

4.99 London Borough of Harrow would achieve Standard if it certified and stamped photocopies of original documents and extended its management checks to include a check on residency.

Recommendations

We recommend that London Borough of Harrow:

· revises and extends the scope of its management check of HB assessments to include residency.

Verification of receipt of IS and JSA(IB)

4.100 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).

4.101 London Borough of Harrow was not at Standard in this element because it did not certify and stamp photocopies of original documents.

4.102 In our sample of new and renewal claims, there were 39 (65%) cases where the customer was in receipt of IS or JSA(IB). In 32 (82%) cases, satisfactory evidence was held on file to confirm entitlement to IS or JSA(IB). In all but one of the remaining 7 cases, some evidence of entitlement was held on file but London Borough of Harrow did not show that original documents had been seen. This was because it had used pre-October 2002 counter receipts to record the receipt of the supporting evidence. Our findings are shown in Figure 4.20.

Fig. 4.20: Verification of IS/JSA(IB) entitlement in sampled new and renewal claims

Type of case

Number of cases requiring verification

Evidence as required by the Verification Framework held on file

Number

%

New claim

15

14

93

Renewal claim

24

18

75

Total

39

32

82

Source: BFI analysis

4.103 London Borough of Harrow would achieve Standard in this element if it certified and stamped photocopies of original documents.

Verification of income and capital

4.104 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.

4.105 London Borough of Harrow was not at Standard in this element as there were cases in our new and renewal samples where income and capital had not been verified. In our first inspection, there were some weaknesses in the verification of income and capital. We found similar failures in this inspection.

4.106 London Borough of Harrow’s use of its old style counter receipts again affected the results of our sampling. To illustrate the effect on the verification Standard, the results are shown in separate Figures. Figure 4.21 shows where some evidence was held on file and includes cases where London Borough of Harrow did not show that original documents had been seen. Figure 4.22 shows our findings where the evidence on file fully met the requirements of the Verification Framework.

Fig. 4.21: Verification of income in sampled new and renewal claims – some evidence held on file

Type of case

Number of cases requiring verification

Some evidence held on file

Number

%

New claim

15

13

87

Renewal claim

6

6

100

Total

21

19

90

Source: BFI analysis

Fig. 4.22: Verification of income in sampled new and renewal claims – evidence required by the Verification Framework

Type of case

Number of cases requiring verification

Evidence as required by the Verification Framework held on file

Number

%

New claim

15

8

53

Renewal claim

6

1

17

Total

21

9

43

Source: BFI analysis

4.107 The difference between the findings in Figure 4.21 and Figure 4.22 clearly demonstrates the effect of London Borough of Harrow not being able to show that confirmation of income met the requirements of the Verification Framework.

4.108 Our findings on the verification of capital by London Borough of Harrow have been similarly separated to illustrate the verification effort in cases where some evidence was held but the evidence did not fully meet the requirements of the Verification Framework. Figure 4.23 shows our findings.

Fig. 4.23: Verification of capital in sampled new and renewal claims – some evidence held on file

Type of case

Number of cases requiring verification

Some evidence held on file

Number

%

New claim

14

11

79

Renewal claim

6

6

100

Total

20

17

85

Source: BFI analysis

4.109 In our new and renewal claims samples, the verification of 13 (65%) cases was adversely affected by London Borough of Harrow being unable to show that original documents had been seen. Our findings on the verification of capital against the requirements of the Verification Framework are shown in Figure 4.24.

Fig. 4.24: Verification of capital in sampled new and renewal claims – evidence required by the Verification Framework

Type of case

Number of cases requiring verification

Evidence as required by the Verification Framework held on file

Number

%

New claim

14

3

21

Renewal claim

6

1

17

Total

20

4

20

Source: BFI analysis

4.110 Figure 4.23, when compared to Figure 4.24, clearly demonstrates the effect of not verifying evidence to the requirements of the Verification Framework.

4.111 London Borough of Harrow would achieve Standard if it certified and stamped copies of original documents and verified income and capital to the standard required by the Verification Framework.

Recommendations

We recommend that London Borough of Harrow:

· ensures that income and capital is verified to, at least, the standard required by the Verification Framework in all appropriate cases.

Verification of non-dependant’s circumstances

4.112 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.

4.113 London Borough of Harrow was not at Standard in this element because it did not certify and stamp copies of original documents.

4.114 In our new and renewal claims samples, London Borough of Harrow requested and obtained evidence of the income of non-dependants. The evidence held on file in 4 cases did not, however, meet the requirements of the Verification Framework because London Borough of Harrow did not show that original documents had been seen. In the remaining case, proof of income had been requested but not provided by the customer. London Borough of Harrow correctly applied the highest relevant deduction in that case. Figure 4.25 shows our findings.

Fig. 4.25: Verification of non dependant’s circumstances in sampled new and renewal claims

Type of claim

Number of cases requiring verification

Verification satisfactory

Number

%

New claim

1

1

100

Renewal claim

4

0

0

Total

5

1

20

Source: BFI analysis

4.115 London Borough of Harrow would achieve Standard if it certified and stamped copies of original documents to verify non-dependant’s circumstances.

Management checks

4.116 Effective management checks provide information about:

4.117 The Audit Commission, in Countering Housing Benefit Fraud - a Management Handbook, recommends that local authorities quality check at least 10% of claims as a way to prevent errors entering the process at the beginning. The check should take place before a decision notice is sent to a person affected.

4.118 London Borough of Harrow was not at Standard because it did not check 10% of assessments and did not check assessments before the decision letters were sent to the persons affected by the decision.

4.119 At the time of the first inspection, London Borough of Harrow did not have a programme of regular management checks in place. We recommended that the authority developed a process and range of management checks on security and quality issues to ensure greater security to the gateway to benefits. At the time of this inspection, this weakness had been addressed and London Borough of Harrow now carried out regular management checks of HB and CTB assessments.

4.120 Staff told us that a dedicated officer from the Quality, Systems and Development team carried out management checks.

4.121 We were provided with a copy of the quality checking procedures, which had been produced by the Quality, Systems and Development Team in August 2001. Those procedures provided for a check of 5% of assessments to be carried out after the decision notices had been issued. Staff told us, however, that this had never been achieved.

4.122 We looked at a summary record of the numbers of management checks made between July 2002 and December 2002 and found that 20 (1.5%) checks of assessments had been made each week compared to the 10% recommended by Performance Standards.

4.123 The checking officer selected 20 cases from a report that was generated from the document image processing system. The report listed all cases where work had been completed in the previous week and identified the type of case and the officer who completed the work. The selection included:

4.124 The results of the management checks were fed back individually to Benefit Assessors and Assistant Benefits Managers. Weekly summary reports were made to the Assistant Benefits Managers, Housing Benefits Manager and the Quality, Systems and Development Team Manager. The Housing Benefits Manager also received a monthly summary report.

4.125 Staff told us that, in addition to the regular management checks, the same officer from the Quality, Systems and Development team checked all cases where payments were £1,500 or above. These cases averaged 5 per day and were checked before the payments were issued.

4.126 While we were on-site, discussions took place between the Housing Benefits Manager and the Quality, Systems and Development team about possible changes to the level and timing of the management checks. These discussions were not completed by the end of the on-site stage of our inspection.

4.127 A description of the checking activity is detailed in Figure 4.26.

Fig. 4.26: Management checks conducted

Type of management check

Management check undertaken

Yes/No

BFI comments

The claim form is complete.

Yes

Checks completed by the Benefit Assessor and by the checking officer from the Quality Systems and Development team (referred to as the checking officer)

All required original documents are available for verifying:

· compliance with Section 1 (1A) and 1 (1B) of Social Security Administration Act 1992 (as amended)

Yes

Documents provided in support of applications for HB and CTB were copied and returned to customers. The copies were not individually authenticated to show that original documents had been seen. Cover sheets were prepared on receipt of the documents to show which documents had been submitted with the claim form. Current copies of the cover sheets indicated which of the documents submitted were original documents but, prior to October 2002, cover sheets prepared by Customer Advisors did not distinguish between original and photocopy documents. All further comments in this table relate to the current practice

Checks were made by Benefit Assessor and checking officer to confirm that original documents had been provided to verify the National Insurance Number belonged to the customer/partner.

· identity of customer and partner, if applicable

Yes

Checks were made by Benefit Assessor and checking officer to confirm that original documents had been provided to confirm the identity of the customer/partner.

· liability to pay rent and residency

Yes

The Benefit Assessor and the checking officer made checks to confirm that proof of liability to pay rent was supported by original documents. The Benefit Assessor confirmed residency through cross-checks with the Council Tax and/or Housing Rent systems and recorded completion of the check on the management control sheet. The checking officer did not provide any assurance on the completion of the residency check.

· receipt of IS or JSA(IB), in applicable cases

Yes

Checks were made by the Benefit Assessor and the checking officer.

· for non-IS or JSA(IB) claims, full verification of all income

Yes

Checks were made by the Benefit Assessor and the checking officer.

· for non-IS or JSA(IB) claims, full verification of all capital

Yes

Checks were made by the Benefit Assessor and the checking officer.

 

Type of management check

Management check undertaken

Yes/No

BFI comments

· income of non-dependants

Yes

Checks were made by the Benefit Assessor and the checking officer.

· a valid Rent Officer decision exists.

Yes

Checks were made by the Benefit Assessor and the checking officer.

That any decision to pay the landlord direct is based on application of the fit and proper person test.

No

Benefit Assessor or checking officer made no checks before paying the landlord direct.

The decision on the benefit period has taken into account all known or anticipated changes of circumstances.

Yes

Check was made by checking officer to confirm that length of benefit period took account of known or anticipated changes of circumstances.

A risk criterion has been correctly applied.

Yes

Check was made by checking officer to confirm that correct risk criterion had been applied.

The calculation of benefit is correct, taking into account all known income, capital and rent liability.

Yes

Check was made by checking officer to confirm that calculation was correct.

Monitor outcome to ensure continuous improvement.

No

Findings and results from management checks were reported regularly to the Housing Benefits Manager but were not used to monitor continuous improvement.

Maintain audit trail of all management checks.

Yes

The checking officer maintained an audit trail from the point of selection through to the acceptance and correction of any error detected.

Source: BFI analysis

4.128 Figure 4.26 shows that London Borough of Harrow had a comprehensive management checking process in place but there were 2 aspects that were not covered in the scope of the check.

4.129 We were provided with a copy of the quarterly summary report of quality checks made by the Quality, Systems and Development team during the period 30 September 2002 to 20 December 2002. The report was originally made to the Housing Benefits Manager and showed that out of 248 cases checked, 56 (23%) cases had at least one financial error and 26 (10%) cases had at least one non-financial error.

4.130 The quarterly summary report also provided a short narrative on the error trends found during the period. The Housing Benefits Manager told us that the trends were not used for group training or personal development purposes.

4.131 London Borough of Harrow would achieve Standard in this element if it:

Recommendations

We recommend that London Borough of Harrow:

· increases the level of management checks of HB and CTB assessments to 10% to meet Standard

· introduces procedures to select and carry out management checks of HB and CTB assessments before decision letters are issued

· reviews its quality checking procedures to ensure that the checks are made to confirm application of the fit and proper person test

· uses the trends and patterns from the results of management checks to inform changes in working practices and corrective training for individuals and groups of assessment staff.

Tailoring of benefit periods

4.132 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.

4.133 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.

4.134 As well as taking risk groups into consideration, the legal requirements on benefit periods mean that local authorities must also take account of potential or known changes of circumstances that could affect entitlement to benefit.

4.135 London Borough of Harrow was not at Standard in this element. To reach Standard, it needs to introduce procedures to ensure that benefit periods are only extended in accordance with the regulations.

4.136 We did not find any benefit period exceeding 60 weeks in our new and renewal claims samples. In addition, Benefit Assessors had a good understanding of the need to limit the period of the HB and CTB award to match the customer’s circumstances. The range of benefit periods set in our claims samples was between 13 and 58 weeks.

4.137 There were controls in place within the benefits IT system to ensure that Benefit Assessors did not set benefit periods to exceed 60 weeks. We were provided with an exception report for the period from 1 April 2002 to
10 March 2003, which listed 60 cases where benefit periods had exceeded 60 weeks. We examined a sample of these cases and found that benefit periods had been extended for an average of 5 weeks. The benefit periods had originally been set for 58 weeks but had been extended to align them with dates for renewing the claims. The benefit periods in these cases had not been extended in accordance with the regulations.

4.138 London Borough of Harrow would achieve Standard in this element if it introduced procedures to ensure that benefit periods were only extended in accordance with the regulations. We have made a recommendation for this area earlier in this part of the report.

Risk assessing and checking claimants’ circumstances

4.139 Estimates in the second Housing Benefit Review: Main Stage Report, 1998 indicate 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:

4.140 London Borough of Harrow was not at Standard in this element because it did not complete all visits to check customers’ circumstances within the timescales set out in the Verification Framework.

4.141 The Standards require an authority to:

4.142 In our first report we recommended that London Borough of Harrow ensured that benefit periods took account of Verification Framework risk groups and the customer’s circumstances. Our sampling for this inspection found that:

4.143 Figure 4.27 shows the breakdown of the HB and CTB caseload by Verification Framework risk categories with the number of visits required to be made each year.

Fig. 4.27: HB and CTB caseload, as at November 2002, by Verification Framework risk category

Risk category

HB

CTB

Visits each year

A

385

1

386

B

84

16

50

C

3,187

355

1,771

D

3,407

657

1,355

E

2,915

2,348

1,754

Totals

9,978

3,377

5,316

Source: London Borough of Harrow and BFI analysis

4.144 Based on the figures in Figure 4.27, London Borough of Harrow would need to conduct a minimum of 5,316 verification visits in one year to meet the guidelines set out in the Verification Framework. London Borough of Harrow’s records showed that it carried out only 628 Verification Framework visits in the quarter ended 31 December 2002.

4.145 In August 2001, Internal Audit conducted a study to check that high-risk (category A) cases were being visited in accordance with the Verification Framework requirements. Internal Audit found that, due to deficiencies in the selection process and maintenance of records, it was not possible to confirm that all high-risk cases were visited.

4.146 In its service plan monitoring report for December 2002, Financial and Exchequer services reported that it had not completed all check visits within the timescales set out in the Verification Framework due to staff vacancies in the Visiting team.

4.147 To achieve Standard London Borough of Harrow should ensure that it conducts checks on customers’ circumstances in accordance with the requirements of the Verification Framework.

Recommendations

We recommend that London Borough of Harrow:

· ensures that it conducts checks on customers’ circumstances in accordance with the requirements of the Verification Framework.

Requirement to refer to Rent Officer

4.148 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.

4.149 London Borough of Harrow was not at Standard in this element because it did not:

4.150 London Borough of Harrow had some strengths in this area, including:

4.151 The council provided us with a copy of its written procedures for making referrals to the Rent Officer. The procedures provided staff with comprehensive guidance on all aspects of the referral process, including:

4.152 In our first report we recommended that London Borough of Harrow ensured that all appropriate cases were referred to the Rent Officer. In our sample of 60 new and renewal claims for this inspection, there were 12 cases where a referral to the Rent Officer was required and 8 of these had been made. The 4 remaining cases related to claims from housing association properties where the council’s procedures indicated that the rent level should have been discussed with an Assistant Benefits Manager prior to any referral. Our findings are shown in Figure 4.28.

Fig. 4.28: Rent Officer determinations
 

Number of cases requiring Rent Officer determination

Rent Officer determinations obtained

% of Rent Officer determinations obtained

New claims – housing association properties

1

0

0

New claims – other landlords

6

6

100

Renewal claims – housing association properties

3

0

0

Renewal claims – other landlords

2

2

100

Total

12

8

67

Source: BFI analysis

4.153 From our new and renewal claims samples, it was apparent that the process of obtaining and implementing Rent Officer determinations took far too long. The primary reason for the delay was the failure by London Borough of Harrow to identify appropriate cases held up in the backlog of work. Our findings are shown in Figure 4.29.

Fig. 4.29: Analysis of time taken to process claims needing referral to the Rent Officer in sample cases
 

Average working days taken

Time taken to refer claim to Rent Officer

69

Time taken between referral and determination by Rent Officer

6

Time taken between determination by Rent Officer and receipt at local authority

2

Time taken for London Borough of Harrow to process Rent Officer decision

8

Total time taken

85

Source: BFI analysis

4.154 Figure 4.29 shows the long delay in identifying cases that needed to be referred to the Rent Officer. London Borough of Harrow had no arrangements in place to sift incoming claims to identify those that needed to be referred to the Rent Officer.

4.155 Rent Officer referrals were completed by Benefit Assessors and recorded on the benefits IT system. The individual referral forms were passed to a dedicated officer who was the liaison contact with the Rent Service. That officer produced a daily summary sheet of referrals, which was sent to the Rent Service together with the referrals. A copy of the summary sheet was used by the liaison contact to monitor the return of the Rent Officer determinations.

4.156 A current service level agreement existed between London Borough of Harrow and the Rent Service. Some targets in it did not comply with the timescales contained in regulations 12A (3) and 12A (4) of the Housing Benefit (General) Regulations 1987. For example, the service level agreement says:

4.157 Neither London Borough of Harrow or the Rent Service monitored performance against the targets set out in the service level agreement.

4.158 The Rent Service Team Manager at Harrow was only appointed late in 2002 but described the working relationship with London Borough of Harrow as satisfactory. Quarterly liaison meetings took place between the 2 organisations.

4.159 To reach Standard, London Borough of Harrow should:

Recommendations

We recommend that London Borough of Harrow:

· reviews and implements changes, as necessary, to its monitoring arrangements to ensure that action on Rent Officer determinations is taken as soon as practicable after receipt

· ensures that referrals are made to the Rent Officer in all appropriate cases including housing association properties

· ensures that the service level agreement with the Rent Service is monitored and incorporates the statutory requirements.

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