Independent Case Examiner for the Department of Communities (NI): annual report 1 April 2023 to 31 March 2024
Published 6 January 2025
Applies to Northern Ireland
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About The Independent Case Examiner (ICE) Service
Our Purpose
We provide an independent review service for customers of the Department for Communities (DfC) and organisations delivering contracted DfC services (for example those providing work programmes or health assessments). Our main objectives are:
- to deliver a tailored service to people bringing complaints to us and make fair evidence-based decisions
- to influence DfC service improvements by providing valuable insight from what we see
Our Mission
To investigate complaints thoroughly ensuring rules, guidance, and standards have been applied correctly and fairly, based on evidence from both sides. We explain things clearly, so people understand our decisions.
Our Vision
To continue delivering a high-quality complaint handling service which adapts and improves and which shapes DfC services improvements by helping them learn from complaints.
1. Our approach to Casework
When we receive a complaint, we first establish if we can accept it for examination; the complaint must be about maladministration (service failure) and the customer must have had a final response to their complaint from the relevant DWP business within the last six months.
Withdrawn Cases
Complaints can be withdrawn for several reasons. For example, some customers decide to withdraw their complaint when we explain the appeal route for legislative decisions. Occasionally people also withdraw their complaint because the business addresses their concerns after they came to us.
Resolved Cases
Once we accept a complaint, we initially attempt to broker an agreement (resolution) between the customer and the business that satisfies the customer, without having to request evidence to inform an investigation.
Investigations
If we are unable to resolve a complaint, the complaint is allocated to an investigator who examines the facts of the case and establishes if the business complained about fairly and consistently applied its published standards. During their examination the investigator will contact customers to ask for information.
If a complaint can be settled
After reviewing the evidence, they may be able to agree actions between the customer and the business that satisfy the customer that their complaint has been settled. We will only settle a complaint with a customer’s full agreement. Once they’ve have given that, the Investigator will confirm the agreed action in writing and explain when that will be complete. We aim to complete settlements within 15 weeks of the case being allocated to the Investigator.
If a complaint cannot be settled
If the Investigator is unable to settle the complaint, they will conduct an investigation and then reach a decision on the complaint. There are a number of possible outcomes from an investigation. Where we find that the complaint has merit which wasn’t properly recognised before it was escalated to the Independent Case Examiner’s Office, we’ll recommend appropriate redress (for example an apology, corrective actions and/or a consolatory payment).
If we find there were service failures or errors by the Business which were put right before the complaint was brought to us, we’ll explain what went wrong and how we have seen things were put right.
Where we find that the Business handled a case as we would expect to see, we’ll explain why no fault or error was found.
We will send the customer a report which tells them the outcome, timescales for any recommended actions, and what to do next. We aim to conclude our investigation within 20 weeks of the complaint being allocated to an Investigator.
2. Northern Ireland Social Security Benefits
Context
The DfC administers and provides guidance on a range of social security benefits and pensions to the people of Northern Ireland and has contracts with private organisations to deliver some services on their behalf, most notably health assessments. In the event that the customer is dissatisfied, the DfC will provide a final response, and then the customer can bring their complaint to my office.
This financial year the 6 cases we investigated varied in nature and related to matters including, amongst other things, correspondence, incorrect advice and the health assessment process.
Northern Ireland Social Security Benefits Statistical Information 1 April 2023 to 31 March 2024
Complaints Received
The number of complaints received and accepted for examination, during the reporting period are detailed below (we didn’t accept 10 complaints as they were either outside of my jurisdiction or the customer hadn’t received a final response).
| Number | |
|---|---|
| Received | 11 |
| Accepted | 2 |
Case Clearances
The table below details the number of cases cleared during the reporting period.
| Number | |
|---|---|
| Resolution | 2 |
| Settlement | 0 |
| Investigation Report from the ICE | 4 |
| Withdrawn | 0 |
| Total | 6 |
Outcomes
ICE investigation report findings are detailed below.
| Number | |
|---|---|
| Fully upheld | 2 |
| Partially upheld | 0 |
| Not upheld | 2 |
| Total | 4 |
Live caseload
As at 31 March 2024 there were no cases outstanding.
Case examples
Case Study 1
Customer A escalated their complaint to the ICE office as they believed that the DfC hadn’t provided appropriate responses to correspondence sent by them and their adult child (B) since May 2022.
In the middle of 2021 DfC received an allegation of fraud in respect of A’s entitlement to Personal Independent Payment (PIP) and began to investigate this at the beginning of 2022. In order for DfC to correspond with someone other than the customer about their claim, the customer needs to have given consent for them to do so. There was no evidence that A had done this.
A claimant will be invited to attend an Interview Under Caution (IUC) during which they’re told what the allegation is and given the opportunity to explain any issues or irregularities identified. Three attempts need to be made to conduct the IUC before DfC will consider referring the case to the Public Prosecution Service (PPS). An IUC would normally be held at the Jobs and Benefit Office (JBO) closest to the customer’s home. However, due to the Coronavirus pandemic, DfC needed to complete risk assessments before a JBO was classed as suitable for face-to-face meetings, such as an IUC.
In early May 2022 DfC wrote to A, inviting them to attend an IUC. As all JBOs hadn’t been risk assessed, A was asked to attend the closest JBO to their home which had been assessed – this was just under 10 miles from their home.
Between that point and July 2022 B sent numerous emails on A’s behalf to DfC – their correspondence included: asking for the IUC to be moved to a JBO closer to A’s home, then saying the IUC didn’t need to go ahead and DfC should move straight to the PPS and eventually complaining that DfC weren’t responding to B , but were responding to A. After considering the evidence, which included the responses sent to A, I didn’t uphold the complaint – the responses appropriately addressed all the queries raised by A and B.
Case Study 2
Customer C escalated their complaint about DfC and a health assessment provider to this office – they weren’t happy with the processes that DfC or the provider were following during the PIP process. They also weren’t happy with how the provider’s Healthcare Professional had completed their assessment.
After reviewing the complaint and evidence that C had provided, we contacted them and explained that the majority of their complaints related to legislation that DfC had to follow and it wasn’t within my remit to consider complaints about policy or legislation.
We also discussed their complaint about how their PIP assessment had been dealt with and explained that we aren’t able to provide medical opinions or challenge the medical opinion of the Healthcare professional. We also explained that as the PIP assessment hadn’t been audio recorded we were unable to determine what had been said or done during that assessment. After considering our explanation C agreed that there wasn’t any further action for us to take and agreed that this had resolved their complaint.
3. Child Maintenance Service
Context
The Child Maintenance Service (CMS) (formerly known as the Child Support Agency and latterly the Child Maintenance and Enforcement Division) operates within the same legislative framework as the Child Maintenance Group in other parts of the United Kingdom. It also administers Child Support applications originating from some parts of England.
The 2012 Child Maintenance scheme was introduced in November 2013 – there are differences in the administration of this scheme to earlier versions, most notably the introduction of charges for both parties if the collection service is used – paying parents pay an amount in addition to their maintenance liability and receiving parents receive a reduced amount of maintenance.
This financial year, we investigated 2 cases of varying nature, which included failures to secure payments and correspondence/complaint handling.
Child Maintenance Service Statistical Information 1 April 2023 to 31 March 2024
Complaints Received
Complaints received and accepted during the period are given in the table below.
| Number | |
|---|---|
| Received | 4 |
| Accepted | 2 |
Case Clearances
The table below details the number of cases cleared during the reporting period.
| Number | |
|---|---|
| Resolution | 2 |
| Settlement | 0 |
| Investigation Report from the ICE | 1 |
| Total | 3 |
Outcomes
ICE investigation report findings are detailed below.
| Number | |
|---|---|
| Fully upheld | 1 |
| Partially upheld | 0 |
| Not upheld | 0 |
| Total | 1 |
Live caseload
As at 31 March 2024, there was 1 case outstanding which was under investigation.
Case example
Case study 3
Customer D complained to my office that CMS had not been able to secure consistent payments of maintenance since 2017.
CMS use two different service types for payments: Direct Pay, in which they are only responsible for calculating the maintenance liability and creating a payment schedule; and Collect and Pay in which they will also collect the calculated maintenance, pay it out to the Receiving Parent and take any necessary enforcement action (this type of action can’t be taken when a case is Direct Pay).
Between 2017 and 2021 D’s case was Direct Pay; but in September 2021, following reviews being completed on the case, D contacted CMS and asked for the case to change to Collect and Pay as they hadn’t received the correct payment from the Paying Parent. This change was completed in October 2021; however, the Paying Parent continued to make payments (of an incorrect amount) directly to D and not to CMS as they should.
In March 2022, the Paying Parent notified CMS that they’d been making payments directly to D. CMS contacted D to discuss this and told them that as they were accepting the direct payments, the service type should be changed to Direct Pay and that if D wanted the case to stay Collect and Pay, they needed to refuse to accept the payments. D agreed to change the case back to Direct Pay but told CMS that they wanted the outstanding arrears (of just under £59,000) to be collected – D was told this would be investigated. However, this wouldn’t be possible whilst the service type was Direct Pay and it was due to this incorrect information that I upheld D’s complaint. I recommended that DfC apologise and make a consolatory payment of £125 for making a commitment they could not act on and raising D’s expectations.