What is Advocacy?
Advocacy helps people to be listened to and to have their rights and choices respected. Advocates work alongside individuals and are on that person’s side. There are many different types of advocacy, both statutory and non-statutory, which all follow the same key principles including independence, empowerment, equality and accessibility.
Advocacy is important because it helps individuals understand what is happening, access services and challenge when things don’t go the way they want them to
There are two types of statutory advocacy within safeguarding adults; Independent Mental Capacity Advocacy (IMCA) which is defined by the Mental Capacity Act 2005, and secondly Care Act Advocacy as defined by the Care Act 2014.
IMCA Advocate +
The Mental Capacity Act says that people who are aged over 16 and who lack capacity to make certain decisions should have an Independent Mental Capacity Advocate (IMCA) appointed to represent them and protect their interests.
An advocate will be appointed where a person lacks capacity and has no family or friends who can be consulted about the decision.
The decisions involved include:
- Serious medical treatment
- Change of accommodation
- Adult Safeguarding Procedures
- Care Reviews
- Deprivation of Liberty Safeguards
IMCA’s are independent, qualified and work within the framework of the Mental Capacity Act.
An IMCA will work under the instruction of the person who will make the decision on the person’s behalf. This is called the decision maker who is usually a social worker, doctor or health professional. The IMCA will gather the person’s feelings, wishes, values and beliefs, review relevant records and consult with others involved in the person’s care (as directed and agreed by the Safeguarding Manager) with regards to proposed protective measures or protective measures already taken. The IMCA will then report to the Decision Maker who then has a duty to consider the IMCA’s findings when making their decision.
Care Act Advocate +
Care Act Advocacy is a statutory service available for people who may have substantial difficulty in being fully involved with decisions made about them and their care and support. This includes:
- needs assessments and reviews
- carer assessments and reviews
- care and support planning
- safeguarding processes
In order to be eligible for advocacy support a person must also have no one else who is willing and deemed appropriate who could support or represent them through the processes. If these criteria are met the local authority has a duty to arrange for an independent advocate. This duty applies in all settings including the community, care homes or prisons.
Role of a Care Act Advocate +
An advocate will support a person to:
- Understand and be involved in a process
- Communicate their views, wishes and feelings
- Understand their options and make decisions about their care and support
- Understand and secure their rights
- Appeal against a decision they are unhappy about
What is substantial difficulty? +
The Care Act defines four areas where substantial difficulty might be found:
- Understanding relevant information
- Retaining that information
- Using or weighing that information as part of engaging
- Communicating their views, wishes and feelings
People can experience substantial difficulty without having a cognitive impairment
Communicating a decision about an appropriate individual +
It is the responsibility of the local authority to decide whether someone can or cannot act as an appropriate individual and to communicate the decision to the person’s friends and family.
It is the responsibility of the local authority to provide information for family on the role and expectations of the appropriate individual within care and support planning processes.
The local authority must ensure that family are notified if they have made a referral for a Care Act advocate and communicate the reasons for this.
Exceptions to appropriate individual guidelines +
There are two exceptions where both an appropriate individual and an advocate should be appointed:
- When a placement is being considered in an NHS-funded provision in either a hospital (for four weeks or more) or care home (for eight weeks or more) and the local authority believes that it would be in the best interests of the person to arrange an advocate
- Where there is a disagreement between the local authority and the appropriate individual whose role it would be to facilitate a person’s involvement and both agree that the involvement of an independent advocate would be beneficial to the person.
Making a Care Act Advocacy referral +
Referrals should be made as soon as it is clear that a person will have substantial difficulty being involved and no appropriate individual has been identified to support them.
Advocacy should be considered at the earliest possible stage of a process. However referrals can be made at any subsequent stage of the care and support process.
In addition a referral can be made if the situation changes and where advocacy had previously been deemed as not appropriate.
It is essential that all information in relation to consent is completed on the referral form.
Advocates must obtain consent from someone who has the capacity to give it in relation to accessing records, consultation and challenging.
Where a person lacks capacity around these issues the Care Act requires advocates to access records and consult as appropriate.
For further information and details of the referral process access Warrington speak up website
If you are uncertain as to whether a person is entitled to an advocate please contact the duty advocate on 01925 246 888 to discuss further.