INDEPENDENT ADVOCACY: Purpose, principles, access and involvement

Individuals that are receiving care services may not always have the knowledge, understanding or confidence to ensure that their voice is heard when decisions are being made about them.

To promote and uphold such an individual’s rights, independent advocacy services may be used.

What is advocacy?

An advocate is someone that speaks up for an individual and ensures that their views and wishes are taken into account. An advocate will only have the best interests of the individual in mind and so should not have an existing relationship with any agencies that provide healthcare services because it could create a conflict of interest.

An advocate’s remit is to establish the needs, wishes and preferences of an individual by communicating with them and identifying what is important to them. They will then ensure that these views are expressed whenever the individual is unable to do so themselves as well as keeping the individual informed of what is happening. They will also help individuals to understand all of their options when they have decisions to make.

It is important to understand that it is not an advocate’s role to make decisions on behalf of individuals or influence them with their own personal views.

Statutory advocacy

The Care Act 2014 puts a responsibility on local authorities to arrange a care and support advocate for an individual in certain situations such as when they are being assessed for services, when their care plan is being reviewed or when there is a safeguarding issue. To be eligible for an advocate, an individual must be deemed to have ‘substantial difficulty’ in being fully involved in the process without one and there should be no other individual such as a friend or family member that can undertake this role. Paid professionals that work with the individual such as support workers may not take on the advocate role (although they may advocate for individuals in certain situations, such as when upholding their rights).

‘Substantial difficulty’ is defined as being unable to understand or retain information given, being unable to weigh up the information given or being unable to communicate their views.

Other statutory advocacy services are Independent Mental Health Advocates (IMHAs), who support individuals receiving treatment under the Mental Health Act 1983 and Independent Mental Capacity Advocates (IMCAs), who support individuals that lack the capacity to make their own decisions under the Mental Capacity Act 2005.

Other advocacy

As well as statutory advocacy services referred by the local authority and health organisations, an individual may wish to engage an independent advocate to support them in other areas of their lives. Advocacy services can be paid or unpaid and they can represent both individuals and groups. Self-advocacy is when an individual gains the knowledge, skills and support to speak up for themselves.

Accessing advocacy services

Statutory advocacy services will be provided when certain conditions are met:

• Care and support advocates – referral by the local authority, care representatives of self-referral
• IMHA – if detained under the mental health act or subject to a community treatment order
• IMCA – referral by a health professional

Other independent advocacy services can be accessed whenever they may be required. Reasons for appointing an independent advocate can include:

• To assist with a care plan review
• There is a risk of an individual’s rights not being upheld
• Request from an individual or their family
• An individual is unable to or has difficulty speaking up for themselves

It is important to understand that advocates should only be used when there is a real need for them – advocates should not be used if an individual is able to speak up for themselves.

If you believe that an individual would benefit from advocacy services, you should speak to your manager about it. You should also document your concerns and follow your organisation’s agreed ways of working. You can then approach organisations that provide these services.

There are many organisations that provide advocacy services. Some provide general services, whilst others specialise in particular groups (such as individuals with learning disabilities) or situations (such as housing). The local authority should be able to supply a list of advocacy providers and charities such as MENCAP and MIND can also offer advice and services.