1. Advocacy under the Care Act

2. Supporting a person’s involvement Assessments Care and / or support planning Care reviews Safeguarding enquiries Safeguarding adult reviews (SARs) Additionally, information and advice

3. Supporting a person’s involvement - duty Eligibility for advocacy  Duty to arrange for independent advocate Is there an ‘appropriate individual’ that can facilitate their involvement?  Agree ‘appropriate individual’  Provide support and make adjustments Yes No Might this person have difficulty in being involved? Can they be better supported to enable their involvement? Yes Do they still have ‘substantial difficulty’ in being involved? Yes

4. ‘Substantial difficulty’ Understanding relevant information Retaining information Using or weighing the information Communicating their views wishes and feelings

5. Appropriate Person Considerations Who is appropriate to support and represent the person? Is a family member or friend an appropriate individual? Who is appropriate to support and represent the person? Is a family member or friend an appropriate individual? Must Be able to facilitate the individual’s active involvement with the process The person who is supported must agree to the suggested ‘appropriate individual’ Be able to facilitate the individual’s active involvement with the process The person who is supported must agree to the suggested ‘appropriate individual’ Must NOT Be someone who is already providing care or treatment professionally or paid Be someone who is implicated in neglect or abuse Be someone who is already providing care or treatment professionally or paid Be someone who is implicated in neglect or abuse

6. Independent advocacy where there is an appropriate individual When: A placement is being considered in NHS funded provision (Hospital for 4 weeks or more OR Care home for 8 weeks or more) There is a disagreement between the local authority and the appropriate individual AND They BOTH agree that an advocate would be in the best interests AND The local authority believes an advocate would be in the best interests

7. The role of an advocate under the Care Act Understanding Communicating Decision Making Challenging Rights Meetings Records Consulting

8. Safeguarding An advocate would typically support the person to: Understand concerns identified and communicate views Weigh up pros & cons to consenting / communicate Understand the process and how they can be involved Understand how the enquiry will be undertaken Identify and communicate views about the enquiry Identify and communicate ways to keep them safe Understand written information about them (enquiry plan / protection plan) Raise any concerns

9. Representation

10. What does this mean for front line practice? Assessment First point of contact Care & Support planning Care Review Safeguarding & SAR Substantial difficulty? Appropriate person? Advocate Yes No An appeal ( delayed ) Continuing Health Care Assessments LA discretion for individuals outside normal eligibility criteria

11. How do I make a referral? Referral Form 0300 222 5948 careadvocacy@voiceability.org

12. Advocacy in the Care Act & MCA Assessment Care / Support Planning Care Review Discretionary Mandatory DoLS Safeguarding Discretionary irrespective of f/f Mandatory no f/f Discretionary with f/f Key : MCA = Mental Capacity Act f/f = friends or family Eligibility similar, but NOT identical © VoiceAbility Care Act Change of Accommodation Decision SMT Decision MCA Mandatory Part of the Care / Support planning or Review

13. MCA Care Act Lacks Capacity Substantial Difficulty Eligibility Specific Decisions Range of Circumstances Timing Discretionary Mandatory Safeguarding Able to be consulted Able to facilitate involvement Appropriate Individual Advocacy under the Care Act and MCA

14. Independent Mental Capacity Advocate Independent Advocate (Care Act) NHS / LA accommodation (12 weeks+) Nobody considered appropriate to consult AND Individual lacks capacity to make decision about care arrangements. NHS/LA consider IMCA involvement will benefit NHS / LA accommodation (12 weeks+) Nobody considered appropriate to consult AND Individual lacks capacity to make decision about care arrangements. NHS/LA consider IMCA involvement will benefit Substantial Difficulty in being involved. Nobody appropriate to facilitate involvement. OR Somebody appropriate but they disagree with the LA. Both agree advocate involvement will benefit. Substantial Difficulty in being involved. Nobody appropriate to facilitate involvement. OR Somebody appropriate but they disagree with the LA. Both agree advocate involvement will benefit. Care Act and MCA – Care Reviews

15. Independent Mental Capacity Advocate Independent Advocate (Care Act) NHS / LA protective measures Individual lacks capacity to consent to protective measures NHS / LA considers IMCA involvement will benefit NHS / LA protective measures Individual lacks capacity to consent to protective measures NHS / LA considers IMCA involvement will benefit Individual subject of a safeguarding enquiry or review Substantial difficulty in being involved Nobody appropriate to support and represent Individual subject of a safeguarding enquiry or review Substantial difficulty in being involved Nobody appropriate to support and represent Care Act and MCA – Safeguarding

16. Advocates under the Care Act and the Mental Health Act (MHA) 1983 Qualifying patients Section 117 Aftercare Joint assessment Care and support plan Care and support review Eligible for Advocacy under the Care Act IF No longer eligible for IMHA Substantial difficulty Nobody appropriate to support involvement

17. Advocates under the Care Act and the Children and Families Act Shared goals: Wellbeing Access to information Support for carers Person centred and joined up planning Care Act CFA Children’s Services Assessments Eligible for Advocacy under the Care Act IF Subject to a child’s needs assessment, a young carers assessment or a child carers assessment (before 18) Substantial difficulty Nobody appropriate to support involvement Eligible for Advocacy under the Care Act IF Subject to a child’s needs assessment, a young carers assessment or a child carers assessment (before 18) Substantial difficulty Nobody appropriate to support involvement

18. Discussion We’re happy to answer questions Discuss example cases Review any information