How standards can impact on the advocacy role and service

Local authorities will need to consider these needs to ensure that the information and advice services are accessible. The aim of the duty to provide advocacy is to enable people who have substantial difficulty in being involved in these processes to be involved as fully as possible, and where necessary to be represented by an advocate who speaks on their behalf. The Equality Act , requires that reasonable adjustments should be made to ensure that disabled people have equal access to information and advice services.

Provision of such adjustments, information in different formats for example, may reduce or remove a substantial difficulty a person may have in being involved. This needs to be just as true for those who are the subject of a safeguarding enquiry or SAR. The role of the independent advocate is to support and represent the person and to facilitate their involvement in the key processes and interactions with the local authority and other organisations as required for the safeguarding enquiry or SAR.

In general, a person who has substantial difficulty in being involved in their assessment, plan and review, will only become eligible for an advocate where there is no one appropriate to support their involvement.

People must be involved fully in decisions made about them and their care and support or where there is to be a safeguarding enquiry or SAR. Therefore the local authority must help people to understand how they can be involved, how they can contribute and take part and sometimes lead or direct the process. People should be active partners in the key care and support processes of assessment, care and support and support planning, review and any enquiries in relation to abuse or neglect.

This applies in all settings, including people living in the community, in care homes or, apart from safeguarding enquiries and SARs, in prisons. Local authorities must form a judgement about whether a person has substantial difficulty in being involved with these processes.

If it is thought that they do, and that there is no appropriate individual to support and represent them the local authority must arrange for an independent advocate to support and represent the person. Many people who qualify for advocacy under the Care Act will also qualify for advocacy under the Mental Capacity Act The same advocate can provide support as an advocate under the Care Act and under the Mental Capacity Act.

This is to enable the person to receive seamless advocacy so that they do not have to repeat their story. Whichever legislation the advocate is acting under, they should meet the appropriate requirements for an advocate under that legislation.

The local authority must consider, for each person, whether they would have substantial difficulty in engaging with the local authority care and support processes. The Care Act defines four areas in any one of which a substantial difficulty might be found, which are set out below.

Both the Care Act and the Mental Capacity Act recognise the same areas of difficulty, and both require a person with these difficulties to be supported and represented, either by family or friends, or by an independent advocate or independent mental capacity advocate in order to communicate their views, wishes and feelings. From the point of first contact, request or referral including self-referral for an assessment, the local authority must involve the person.

They must consider the most appropriate and proportionate way of involving the person in the assessment processes. At the start of the assessment process, if it appears to the local authority that a person has care and support or support needs, and throughout any subsequent part of the process, the local authority must judge whether a person has substantial difficulty in being involved with the assessment, the care and support planning or review processes.

The identification of a potential need for advocacy may arise through the process, from the person themselves, carers or family. Where an authority has outsourced or commissioned all or some of this process, the authority will maintain overall responsibility for making this judgement. Where the local authority considers that a person does have substantial difficulty in engaging with the assessment process, then they must consider whether there is anyone appropriate who can support the person be fully involved.

This might for example be a carer who is not professionally engaged or remunerated , a family member or friend. If there is no one appropriate, then the local authority must arrange for an independent advocate. The advocate must support and represent the person in the assessment, in the care and support planning, and the review.

As part of the assessment and the care and support plan, the local authority must have regard to the need to help protect people from abuse and neglect, assisting the person to identify any risks, how to manage them and how much risk they can manage.

Restrictions should be carefully considered and frequently reviewed. Any potential deprivation of liberty must be authorised, either by a Deprivation of Liberty Authorisation by the local authority or the Court of Protection under the Deprivation of Liberty Safeguards in the Mental Capacity Act see Deprivation of Liberty Safeguards and Mental Capacity. These processes and arrangements are sometimes difficult for individuals, their carers, family or friends, to understand and be involved in.

Effective joint commissioning arrangements would involve:. Those people who do not retain a right to an IMHA, whose care and support needs are being assessed, planned or reviewed should be considered for an advocate under the Care Act, if they have substantial difficulty in being involved and if there is no appropriate person to support their involvement.

With regard to participation in formal proceedings, people who access support also reported having a greater knowledge and understanding of the processes involved and the language used, as well as their rights, leading to a greater sense of empowerment Featherstone et al, This sense of empowerment can result in an increase in self-reported well-being, as well as increased self-efficacy and improved confidence Palmer et al, People who access support also report high levels of satisfaction when they receive help and support.

These include practical tasks such as interpretation and translation of information, help to apply for housing and benefits and to gain social support Newbigging et al, The provision of moral support has been highlighted as being important, particularly during formal proceedings, which can be viewed as intimidating by people who access support Featherstone et al, The relational aspect of advocacy cannot be underestimated as it appears to be a key indicator of satisfaction across different types of advocacy provision Palmer et al, Self-advocacy, peer advocacy and citizen advocacy in particular are thought to offer great potential to promote social networks and support individuals to build relationships by offering individuals a safe and stable environment.

The development of a trusting relationship between the person who accesses support and the advocate is essential and requires frequent face-to-face contact and communication, particularly in the early stages of the relationship Palmer et al, Indeed, it is thought that higher levels of trust promotes higher levels of participation more generally Palmer et al, Lawton, writing specifically around self-advocacy, identifies a number of good practice points for supporters of self-advocates to consider.

The introduction of legislatively mandated access to advocacy has the potential to create a two-tier system of support, with those subject to compulsory measures under mental health legislation being more likely than others to access advocacy Atkinson et al, For example, a local authority in Scotland has a statutory duty to provide advocacy services for those subject to compulsory measures under the Mental Health Care and Treatment Scotland Act, There is no statutory duty under the Adults with Incapacity Scotland Act, or the Adult Support and Protection Scotland Act, , although this would be considered good practice.

A further unintended consequence of this may be that other important aspects of daily living such as the promotion of social inclusion and social networks are not prioritised Rapaport et al, A general concern, therefore, relates to the availability of advocacy across Scotland.

In relation to mental health advocacy for example, the patchy availability of professionally trained advocates across Scotland has been well documented Scottish Government, , leading to concerns over the development of a 'postcode lottery'. These issues are even more prevalent when considering very specialist forms of advocacy such as for those with mental health problems from BME Communities where there are serious gaps in provision Newbigging et al, Similar concerns exist with regard to citizen advocacy and peer advocacy.

A number of difficulties in the recruitment of peer advocates has been documented in the literature Children's Bureau, These relate to peer advocates lacking the confidence to undertake the role, as well as not wishing to be associated with others who have a similar label for fear of stigma and discrimination.

Advocates must possess an appropriate level of skills and expertise in order to perform their role effectively and be taken seriously Carlisle, For those operating as citizen or volunteer advocates or for those acting in the capacity of self or peer advocate, this involves a high level of commitment, alongside the availability of appropriate support and training.

Providing this support on an ongoing basis can be a challenge for organisations that are often dependent on short-term funding.

There is a key tension between representing the views of an individual and empowering them to reduce the power imbalances that they are likely to face. This dilemma is particularly problematic when there has been a fundamental lack of understanding about the role and purpose of advocacy from the beginning of the process.

Fazil and colleagues , in their study of families from Bangladeshi and Pakistani families with severely disabled children, identified a key lack of understanding of the advocacy role.

Advocates were viewed as problem solvers who could achieve what families could not. There are also particular issues when it comes to working with people with complex support needs. SCIE found evidence of assumptions being made around the capacity and capability of people who access support to make decisions. Self-advocacy has the potential to challenge such assumptions by emphasising choice and control for people who access support Fazil et al, However, this often leads to the isolation of self-advocates from the organisations they seek to challenge.

There is very little evidence about whether or not advocacy is cost-effective. McNutt argues that because there is little robust evidence about the effectiveness of advocacy in terms of improvement outcomes for individuals, it is not possible to ascertain whether or not it is worth the cost.

However, McNutt further acknowledges that this is principally due to the fact that advocacy, in particular its costs effectiveness, can be difficult to evaluate. The evidence indicates that effective advocacy requires long-term and preferably independent funding, otherwise, it is a challenge to deliver the key advocacy principles of independence, loyalty to the person or partner and a commitment to justice and empowerment, while at the same time balancing obligations to a funding body. Manthorpe and colleagues have recommended a number of ways in which these issues around funding and conflict of interest can be overcome:.

From the evidence presented it is possible to identify the following features that are essential for good advocacy practice. Before considering these, it is important to bear in mind that the model of advocacy used and the length of the intervention will depend on a number of factors such as the presenting issue, the needs of the individual, the level of specialist knowledge required and the availability of appropriate resources.

A trusting relationship built up over time promotes increased participation. Continuity, familiarity and consistency are crucial to this Townsley et al, ; Palmer et al, This has specific implications for short-term work, focusing on a single event that will require trust to be built up quickly. Similarly, advocates will require a clearly defined role which includes a number of key components relating to specific and specialist skills, knowledge and experience Townsley et al, To support this, training and ongoing support, which enables advocates to understand the role, develop a relevant knowledge base and develop their own skills and confidence National Children's Bureau, , is essential.

Cultural sensitivity is crucial in order to provide an understanding of and ability to begin to address some of the key issues faced by particular groups Newbigging et al, Separating out advocacy for carers from that of people who access support is essential to ensure conflicts do not arise DSDC, Specialist provision is necessary for some service user groups with particular support or communication needs.

Such provision should draw on innovative ways of working, including multi-media advocacy and storytelling group work and life-story work SCIE, Where specialist provision is developed, specific training requirements need to be addressed, for example, legal training for those working with people experiencing dementia and children's rights training for those working with children Boylan and Dalrymple, Advocates must be independent and not constrained by the organisations that fund them.

Independence from public services remains an important advocacy principle but many advocacy schemes are reliant on public funding. The National Advocacy Standards Advocacy is led by the views and wishes of young people. Advocacy champions the rights and needs of children and young people.

Advocacy services have clear policies to promote equality issues and ensure no young person is discriminated against. Advocacy is well publicised, accessible and easy to use.

Advocacy gives help and advice quickly when they are requested. Advocacy works exclusively for children and young people. The Advocacy service works to a high level of confidentiality.

Advocacy listens to the views and ideas of young people in order to improve the service provided. The advocacy service has an effective and easy to use complaints procedure. Advocacy is well managed and gives value for money. Advocacy for LAC in the East Riding The service is confidential and nothing will be done or said without the young persons consent unless of course that young person is in danger and even then no action will be taken without them knowing. What can advocacy help with?

Issues around contact. If a young person does not feel listened to.