1. CARE ACT SEMINAR ADVOCACY Correct as at March 2015

2. WHAT IS ADVOCACY? Advocacy in all its forms seeks to ensure that people, particularly those who are most vulnerable in society, are able to: – Have their voice heard on issues that are important to them. – Defend and safeguard their rights. – Have their views and wishes genuinely considered when decisions are being made about their lives. Advocacy is a process of supporting and enabling people to: – Express their views and concerns. – Access information and services. – Defend and promote their rights and responsibilities. – Explore choices and options

3. ADVOCACY FOR ADULTS IN NEL Independent Mental Health Advocacy (IMHA) – Specific to Mental Health Act Independent Mental Capacity Advocacy (IMCA) – Specific to Mental Capacity Act Generic Advocacy – Supporting people to have a say in decisions Cloverleaf Advocacy Rethink

4. TYPES OF ADVOCACY Self advocacy Group advocacy Peer advocacy Citizen advocacy Professional advocacy Non-instructed advocacy

5. INDEPENDENT ADVOCACY UNDER THE CARE ACT DUTY TO INVOLVE Local authorities must involve people in decisions made about them and their care and support. No matter how complex a person’s needs, local authorities are required to:- help people express their wishes and feelings support them in weighing up their options, and assist them in making their own decisions.

6. WHEN DOES ADVOCACY DUTY APPLY? a needs assessment a carer’s assessment the preparation of a care and support or support plan a review of a care and support or support plan a child’s needs assessment a child’s carer’s assessment a young carer’s assessment a safeguarding enquiry a safeguarding adult review an appeal against a local authority decision under Part 1 of the Care Act (subject to further consultation) First point of contact, and every stage – Assessment, Planning, Care Review

7. DECISION PATH AT POINT OF CONTACT Does Person have Care Needs? Does Person have Substantial Difficulty being involved? Is there an appropriate individual to support? Appoint an Independent Advocate Carry on with next part of the process Yes No Yes No Yes

8. JUDGING SUBSTANTIAL DIFFICULTY Understanding Relevant Information Many people can be supported to understand relevant information, if it is presented appropriately and if time is taken to explain it. Some people, however, will not be able to understand relevant information, for example if they have mid-stage or advanced dementia. Retaining Information If a person is unable to retain information long enough to be able to weigh up options and make decisions, then they are likely to have substantial difficulty in engaging and being involved in the process. Using Or Weighing The Information As Part Of The Process Of Being Involved A person must be able to weigh up information, in order to participate fully and express preferences for or choose between options. For example, they need to be able to weigh up the advantages and disadvantages of moving into a care home or terminating an undermining relationship. If they are unable to do this, they will have substantial difficulty in engaging and being involved in the process Communicating Their Views, Wishes And Feelings A person must be able to communicate their views, wishes and feelings whether by talking, writing, signing or any other means, to aid the decision process and to make priorities clear. If they are unable to do this, they will have substantial difficulty in engaging and being involved in the process.

9. WHO IS AN ‘APPROPRIATE INDIVIDUAL’? The appropriate individual cannot be: already providing care or treatment to the person in a professional capacity or on a paid basis someone the person does not want to support them someone who is unlikely to be able to, or available to, adequately support the person’s involvement someone implicated in an enquiry into abuse or neglect or who has been judged by a safeguarding adult review to have failed to prevent abuse or neglect Under the Care Act the appropriate individual’s role is to facilitate the person’s involvement, not merely to be consulted about it (as in MHA)

10. EXCEPTIONS TO APPROPRIATE INDIVIDUAL Where a placement is being considered in NHS- funded provision in either a hospital (for a period exceeding four weeks) or in a care home (for a period of eight weeks or more), and the local authority believes that it would be in the best interests of the individual to arrange an advocate Where there is a disagreement between the local authority and the appropriate person whose role it would be to facilitate the individual’s involvement, and the local authority and the appropriate person agree that the involvement of an independent advocate would be beneficial to the individual

11. WHAT ARE THE DIFFERENCES UNDER NEW CARE ACT? Care Act focuses on involvement in Care Assessment, Planning, and Review as a minimum The standards for delivery are higher – Higher trained advocates – Provider Quality Performance Mark The level of eligibility is lower – More people expected to use advocacy

12. OUR APPROACH Review Current Advocacy Provision – against Care Act requirements – Capacity and delivery – Skill levels & development – Listening to stakeholders – Considering longer term picture – prepare for the steady growth in demand for the service, as well as a potential 'spike’ in demand for advocacy from April 2016, when the funding reforms come into force

13. MOVING FORWARD – Monitoring demand through 2015 – Single provider preference Reduce duplication Same Support ‘along the pathway’ where possible Enable “Interchangeability” of ‘advocacy hours’

14. DISCUSS... Are there any ‘game-stoppers’ identified herein? What is best way to access advocacy? How does this affect your way of working/situation? What needs to be in place to enable this?

15. Presented by: Leigh Holton Service Project Lead, Care & Independence (NELCCG) For further comments / queries: NELCCG.workforce-FAQ@nhs.net NELCCG.workforce-FAQ@nhs.net