Consultation on A New Future for Social Security:
Social Security in Scotland October 2016
If you would like to download this Consultation you can do so here:
In March 2016, the Scottish Government published, ‘A New Future for Social Security in Scotland’. In that paper, the Scottish Government made a commitment to work with people across Scotland to determine how best to use the new social security powers which will be devolved by the Scotland Act 2016.
This consultation represented the next step in facilitating this participation. This consultation was an opportunity for people and organisations in Scotland to be involved in shaping legislation around the new social security powers.
For more information about the consultation, see https://consult.scotland.gov.uk/social-security/social-security-in-scotland
Who we are?
Scottish Care is the representative body for independent social care services in Scotland. This encompasses private and voluntary sector providers of care home, care at home and housing support services across the country. Scottish Care counts over 400 organisations as members, which totals over 830 individual services. Scottish Care is committed to supporting a quality orientated, independent sector that offers real choice and value for money. Our aim is to create an environment in which care providers can continue to deliver and develop the high quality care that communities require and deserve.
In relation to older people’s care, this sector provides 89% of the care home places in Scotland and over 50% of home care hours. There are more older people in care homes any night of the week than in hospitals – as at 31st March 2016 there were 873 care homes for older people providing support to 33,301 residents any night of the year, with 89% of these residents located within the independent sector.
- Fixing the Principles in Legislation
Which way do you think principles should be embedded in the legislation?
- As a “Claimant Charter”?
- Placing principles in legislation?
- Some other way, please specify
Scottish Care has for some time been promoting the adoption of a human rights based approach to health and social care delivery and supports and would see the merit in both the development of a claimant’s charter and of placing the principles in legislation. The former would aid accessibility, communication and information. The latter would help to embed the principles and also enable recourse and redress if it were necessary.
It will be important that the Charter is developed alongside individuals who are likely to use the services being described. Older persons use most of the services provided by Scottish Care’s membership and we would argue that it is very important that any Charter developed is appreciative of the distinctive communication needs of older individuals. In particular there must be sensitivity to issues of visual impairment, diminishing capacity etc. The Charter must have a degree of robustness so that individuals have a recourse to action where there may be instances where they feel that the rights described therein have not been met or respected.
Scottish Care believes that there is an obvious connection between the principles described in the consultation and those which will shortly underpin health and social care service delivery through the National Care Standards. It will be imperative that these are not only in a Charter but that they are embedded throughout the legislation. It will be important that these principles are meaningful to individuals who both use social security services and deliver these. Their development should be inclusive of those who use services with an emphasis upon the inclusion of hard to reach individuals.
Scottish Care would argue that current legislation on social care and health (such as the Adults with Incapacity, Adult Support and Protection, Self Directed Support Acts) provide a clear human rights articulation of the key principles which should underpin any public service. Such principles would include:
- Maximising the choice for an individual
- Enabling the greatest degree of control
- Treating all individuals with respect and dignity
- Fostering participation
- Developing strong communication and information
- Making information accessible
- Ensuring consistency
- Embedding equal treatment and non-discrimination
- Focusing upon quality improvement and adaptability
- Being responsive and flexible
However, merely articulating principles on their own will not be sufficient for achieving the outcomes which are desired. It will be important that once articulated there are clear processes by which the embedding and achievement of these principles in practice can be identified and assessed. To do so there must be a process by which duties are placed upon those with responsibility to enact the legislation and principles in practice.
- Outcomes and the user experience
How can the Scottish social security system ensure all social security communications are designed with dignity and respect at their core?
Many of the individuals who access the services of our members are in receipt of social security support, We know from engagement with these individuals that many letters from the DWP are often inaccessible because of format, insensitive in the language used and complex in comprehension. Many of our staff have to support individuals who receive letters to help them understand their content and this is an unfortunate intrusion into the privacy and dignity of individuals.
We would recommend that the Scottish Government establish a working group of stakeholders to ensure that fully accessible information is provided, at all stages of the process, in a format that suits the individual. There should not be a presumption that all older individuals require exactly the same level of accessibility.
With whom should the Scottish Government consult, in order to ensure that the use of language for social security in Scotland is accessible and appropriate?
As stated above Scottish Care believes that working directly with representative groups especially older persons groups would assist in the development of the most accessible and appropriate information.
What are your views on how the Scottish Government can ensure that a Scottish social security system is designed with users using a co-production and co-design approach?
For co-production to be an effective approach there must be appropriate capacity building and support put in place to enable participants, especially older individuals, to fully maximise their contribution and capacity. Appreciation needs also to be given for allowing appropriate time for reflection and consideration and for adequately resourcing already stretched support organisations.
- Delivering Social Security in Scotland
Should the social security agency administer all social security benefits in Scotland?
We have no view on this question as we are representative of a membership with diverse perspectives.
Should the social security agency in Scotland be responsible for providing benefits in cash only or offer a choice of goods and cash?
Please explain you answer.
Scottish Care would argue that the majority of older persons who use our member services and supports would instinctively and normally be more comfortable with cash payments.
How best can we harness digital services for social security delivery in Scotland?
Digital services can be a positive intervention and support. However there must be recognition of the reality of digital poverty and exclusion which is especially experienced by older Scots. We would cite the recent Scottish Household Survey, published in September 2016 which shows that older people face continuing barriers in their ability to participate in the digital world.
For example, the survey reveals that older people are more likely to be sidelined by the digital revolution.
- Although 82% of adults regularly use the internet, this rate substantially reduces with age (only 69% of those aged 60–74 do, and this drops to 30% among the 75+ age group).
- Older people who do use the internet use it less often, are less likely to use sites which request personal or financial information (such as for online banking and shopping), and are less likely to take recommended security measures such as using unpredictable passwords and changing them frequently.
- They are also less likely to use digitally enabled devices such as tablets and smartphones (88% of 16–34-year-olds use their smartphones to access the internet, but only 36% of those aged 65–74 and 19% of those aged 75+ do).
It will be very important that the use of digital services in social security does not result in unequal and discriminatory behaviour to older citizens.
Should social security in Scotland make some provision for face-to-face contact?
Please explain you answer.
Older citizens find contact by telephone or online to be less accessible and less inclusive. We would very much welcome a more personal, face-to-face response and contact. However such contact must be undertaken by individuals sensitive to age-related communication barriers and challenges and in a manner which was inclusive, transparent and dignified.
- How can the Scottish Government improve its partial EqIA so as to produce a full EqIA to support the Bill?
Scottish Care recognises that the conduct of a collaborative and fully participative equality impact assessment is critical to enabling the full access and inclusion of older people and enabling their voice to be heard in the delivery of the new system. However we would suggest that on its own such a process does not go far enough in that it potentially only includes the existing protected characteristics and may struggle to address the cross-cutting areas of discrimination often experienced by older people on low incomes, older people who access health and social care services and others. We would recommend the undertaking of an equality and human rights impact assessment which is more inclusive and extensive. Social security legislation and practice impacts across areas which may not fall within the gamut of the existing equality legislation and a human rights based approach in impact assessment would be profitable and progressive. There already exists positive guidance for public bodies on the benefits of such an approach and the mechanism for achieving positive outcomes. See http://www.scottishhumanrights.com/eqhria
- Independent Advice and Scrutiny
Do you think that there is a need for an independent body to be set up to scrutinise Scottish social security arrangements?
Please explain your answer.
The experience of Scottish Care members in the delivery of health and social care services has highlighted the benefits of having an independent body established to enable scrutiny and appropriate inspection of the delivery of any public service. This would help, to hold the regulations under an on-going microscope, ensure appropriate guidance is being implemented and resolve any systemic challenges and difficulties that may arise in what is a significant systemic change in practice.
However the experience of our membership especially those engaged in mental health supports would also lead us to suggest that a right to independent advocacy should be at the heart of the provisions being developed.
- Disability Benefits
What is right with DLA/PIP? What is wrong with DLA/PIP?
Scottish Care would not wish to add to what has already been indicated both in the Guidance to this consultation and elsewhere about the experience of those who access either of these payments. However given the significant percentage of older people who access social security support we would concur with many commentators that the current system has been unhelpful in instilling in individuals as sense of being treated with dignity, respect, transparency and maturity. Older individuals have been less likely to access the supports and payments that are theirs by right because the system at times has been felt to be cumbersome, challenging and excluding. With other organisations our members have heard from those they support about the at times unresponsive and non person-centred manner in which assessments for benefits have taken place with little support especially for older people. In particular some processes, we have been informed, have excluded individuals who have accompanied an older person from inclusion and support. There has also clearly been a lack of flexibility around the conduct of assessments in an individual’s home which directly impacts upon older people.
We believe it is possible to design a system where the needs for appropriate audit and safeguards are balanced with the need for accessibility and ease of use.
How should the new Scottish social security system operate in terms of:
- A person applying for a disability related benefit
- The eligibility criteria set for disability related benefits
- The assessment/consideration of the application and the person’s disability and/or health condition
- The provision of entitlements and awards (at present cash payments and the option of the Motability Scheme)
- The review and appeal process where a person isn’t content with the outcome
With this in mind, do you think that timescales should be set for assessments and decision making?
Our engagement with those who use older people services and supports has highlighted for us that whatever process is developed it must be one which does not serve to effectively deter applications from older people but actively seeks to encourage these. It will be important to offer alternative methods and approaches to assessment including home visits, paper based applications and face-to-face interviews and assessments. For older individuals assessments should not be unduly long, as informal and relaxed as possible, should be completed and communicated in as short a timeframe as possible and should be conducted by individuals who are appropriately qualified and critically independent.
What evidence and information, if any, should be required to support an application for a Scottish benefit?
Undoubtedly many older individuals feel that a paper application alone is not sufficient for communicating all the issues about their condition or illness that they would want to communicate, thus desiring a face-to-face assessment opportunity. Regardless of this there needs to be a real connectivity between different elements of the assessment so that people are not made to feel that they are telling their story continuously to different people.
Should the individual be asked to give their consent (Note: consent must be freely given, specific and informed) to allow access to their personal information, including medical records, in the interests of simplifying and speeding up the application process and/or reducing the need for appeals due to lack of evidence?
Scottish Care has made it clear in other areas of our work that information sharing whilst critical to effective care and support can and must be premised on a basis of permission and consent. The sharing of personal data has to be handled especially carefully when the individual may have reduced or diminishing capacity. There should always be a default presumption that information is private until it has been agreed to be shared and that such a sharing should be time-limited, context specific and for named individuals alone.
If the individual has given their permission, should a Scottish social security agency be able to request information on their behalf?
If no, please explain why
As already indicated there should be flexibility to enable such sharing but it should be carefully monitored and protected.
Entitlement differs across the age range, and those under 16 (DLA), of working age (PIP), and over the state pension age (AA), are entitled to different benefits. There are also other rules for care home stays and hospital stays, which determine how long people, can stay in these places before their benefits are suspended. For people who have been certified by a medical professional as having less than six months to live, special rules mean they automatically qualify for some elements of PIP, AA or DLA.
Do you agree that the impact of a person’s impairment or disability is the best way to determine entitlement to the benefits?
Whilst the language of impairment is loaded and potentially negative we accept that there needs to be some criteria on which society chooses to base its support for those who require additional support. We consider that the current eligibility for disability benefits is necessarily determined by taking the care (or daily living) and mobility needs of an individual as proxies for the impact of their condition and the additional costs they are likely to incur.
Currently there are only special rules for the terminally ill but should there be others?
Whilst it may be valuable to consider the extension of such flexibility we see it as very important that the current process is protected and indeed potentially extended in that the nature of palliative and end of life care has changed since the current time frame was first developed.
What do you think are the advantages and disadvantages of automatic entitlement?
Would applicants be content for their medical or other publicly held records, for example prescribing and medicines information or information held by HMRC, to be accessed to support automatic entitlement where a legal basis existed to do this?
There are potential positive impacts in developing a process of automatic entitlement particularly in situations where an individual’s condition is life-long, progressive or terminal. We believe that there should be flexibility in terms of the willingness for individuals to share confidential material and that an unwillingness to do so should not be considered negatively.
Do you agree that the current UK-wide PIP and AA process for supporting people with terminal illnesses is responsive and appropriate?
If yes, should this approach be applied to all disability-related benefits for people with a terminal illness?
If no, how could the approach could be improved?
Should there be additional flexibility, for example, an up-front lump sum?
As an organisation whose members spend a considerable amount of time supporting people in their own homes or in residential care at the end of their lives we believe it is very important that flexible and sensitively responsive approaches are taken through the PIP and AA processes. We would be happy to see the extension of such practice to disability-related benefits for people with a terminal illness. The granting of a lump sum would enable the development of appropriate person-centred end of life planning for individuals and enable flexibility in terms of choice.
- Carer’s Allowance
Do you agree with the Scottish Government’s overall approach to developing a Scottish Carer’s Benefit?
Please explain why
Scottish Care supports the proposal to develop a Scottish Carer’s Benefit. We recognise the immense contribution given to Scottish society by informal carers, acknowledging that many also undertake paid care. We recognise the disproportionate number of women on low incomes engaged in caring roles and would hope to see a system developed which was flexible and responsive to a diverse range of needs.
- Winter Fuel and Cold Weather Payments
Do you have any comments about the Scottish Government’s proposals for Winter Fuel and Cold Weather Payments?
Could changes be made to the eligibility criteria for Cold Weather Payments?
For example, what temperature and length should Cold Weather Payments be made on in Scotland?
We commend the on-going commitment of the Scottish Government to reduce fuel poverty. Those who work for our organisations continually tell us about the unwillingness of older individuals to use their heating to their optimum and the potentially negative impacts this behaviour has on health and wellbeing. Over the last few years we have evidenced significant and positive results from the implementation of Cold Weather Payments and would wish to see these continue.
We would commend further work in addressing issues such as wind chill, geographical variation etc. to take greater cognisance of Scottish weather patterns.
- Funeral Payments
How can we improve the process for identifying whether someone is responsible for the funeral and should receive the funeral payment?
In terms of the Scottish Funeral Payment, are there any qualifying benefits (e.g. Pension Credit) that you would add to or take away from the current qualifying benefit list?
Scottish Care members experience first hand the distressing situations caused as a result of funeral poverty and would warmly commend any developments of this system which would make them more automatic and predictable in nature. The current measures linked as they are to existing benefit claimants and to payment after expenditure can act as a deterrent for some. One measure which would assist this would be an automatic base payment given to all older individuals escalating with the age of the deceased, as there is some evidence that funeral poverty increases with age.
Which of these elements do you think should be paid for by the Funeral Payment?
Are there other elements that you think should be included or explicitly excluded?
What are your views on the options for speeding up and simplifying the payment?
We have found the nature of this question to be singularly unhelpful. Whilst recognising that there must be limits upon the amount of monies allocated for a funeral, we do not consider it either person centred or helpful to itemise a funeral experience in the manner in which the question proposes. How does one select whether to pay for the removal of the remains of the deceased over and against paying for the hire of a church for the conduct of the funeral etc? We would rather that it was determined what an average funeral cost (inclusive of all elements) and a decision be made to pay a proportion of that sum. So there is merit in the suggestion to pay a fixed amount to contribute to funeral expenses rather than checking actual expenses with an upper limit.
Is the three month application window for a Funeral Payment sufficient time for claimants to apply?
We do not consider that a three-month time period is adequate. Our experience over a considerable time is that a six to nine month period would be much more supportive and effective.
Which services should promote awareness of the funeral payment to ensure that claimants know about it at the relevant time?
Are there any other points that you would like to raise in connection with the new Scottish Funeral Payment?
When the precise parameters and nature of the Scheme is determined we would advise the development to a national information campaign. We would suggest that staff in social security agencies worked closely with older people’s groups, with care homes and other providers to ensure maximum awareness and uptake. Scottish Care as a national body would be very happy to assist this process.
- Advice, representation and advocacy
Do you think that Independent Advocacy services should be available to help people successfully claim appropriate benefits?
Please explain why
As we have indicated above Scottish Care has previously supported the role of independent advocacy as positive in enabling empowerment, control and maximising choice. We would particularly value such a role for older individuals who may have especial difficulty in navigating a new benefits system and achieving all they can from their entitlements.
For More Information
Becca Gatherum, Policy and Research Manager, Scottish Care