Action for Advocacy’s Response to Caring for our Futures

Action for Advocacy (a4a) is an organisation dedicated to ensuring a strong and equal voice for all citizens. a4a is the central point of information on independent advocacy in England and Wales. Our membership includes over 400 independent advocacy providers and we have built a reputation as the leading authority on the development of effective advocacy services.

Action for Advocacy shares many of the aspirations and recognises many of the problems highlighted in Caring for our Futures. This response will centre mainly on the area of Increased personalisation and choice, with particular regard to the role of independent advocacy in achieving this. However we strongly believe that achieving this aim would have a significant impact on the areas of Ensuring services are better integrated around people’s needs and Supporting greater prevention and early intervention.

Advocacy providers work with those people who find the current system unfair and confusing; those who need care most and may be at the greatest risk of neglect, abuse or poor services. Too often people have felt that they have no power over their care and that they are made to fit into the requirements of services or professionals. We agree that we need to put power back into the hands of the people who need care.

We entirely agree that people should “expect better standards of care .....[and] need to be protected from poor care, to have the support to choose the care that best meets their needs and to be able to speak out if there are problems. Current experience is that this is not possible in too many cases. We have seen in too many cases the experiences of those who have been abused and the belated calls for greater advocacy provision. Winterbourne View was simply one more example of a long line of failures in care. Even where safeguarding procedures are instigated, the focus falls to frequently on the abuse and not on the person affected. The independent nature of advocacy services can help ensure that the process serves the person, not vice versa.

We also agree that there is a need for greater access to information, advice and advocacy to support people in defining and controlling their care needs. “A Vision for Social Care” states that older people, people with learning disabilities, autism and those with complex needs disabled people may need more support in accessing personalised support. Further, it states that people in residential care homes should have the same entitlement to choice and control over care and support as anyone else. a4a wholeheartedly agrees. We believe that independent advocacy has a role to play in making choice and control a reality in these situations.
We therefore find the statement that “Councils should: …. focus on improving the range, quality and accessibility of information, advice and advocacy available for all in their communities – regardless of how their care is paid for – to support their social care choices” commendable.
 
Independent advocacy is clearly part of a spectrum of rights based services, but we believe there is a need for a more clearly defined role for advocacy. However the reality is that when information, advice and advocacy are talked of together, advocacy often becomes the poor relation. Too often, where advocacy has been funded as part of the information and advice spectrum, the proportion of funding for the advocacy component has made it appear like an afterthought. Even within A Vision of Social Care and Caring For Our Futures, advocacy appears and disappears within this rights based spectrum. This cannot be supportable for a service which delivers choice, control and safeguarding for the most vulnerable members of our society.
Advocacy is instrumental in creating a culture where the expectations of the Mental Capacity Act are realised; both through actively supporting the choice of individuals and being a catalyst to create cultures of dignity and respect in care settings. We welcome the recognition that advocacy “helps people express views and receive the services they want as a result”. We believe that advocacy also
• helps people to be confident of greater dignity in care
• provides an active and preventative safeguard against abuse and neglect
• leads to better information in care planning
• creates more cost effective care
• actively relocates power from the hands of professionals back into those of the service user
and
• provides a means by which people’s autonomy can be better realised in a culture that too often tries to manage risk out of people’s lives.

The calls for access to independent advocacy come from numerous sources outside the advocacy sector. A Vision for Adult Social Care (4.9) states that councils should, “focus on improving the range, quality and accessibility of information, advice and advocacy available for all in their communities”.

In its report “From Safetynet to Springboard”, the Equalities and Human Rights Commission called for the availability of independent advocacy outwith the personal budgets system to ensure that personalisation did not inadvertently widen health inequalities.

The Law Commission Report on Adult Social Care (Law com no 326) stated “Advocacy is, therefore, seen as a vital component of achieving independent living and full citizenship for disabled people” and made the recommendation that “The right to advocacy contained in the Disabled Persons (Services, Consultation and Representation) Act 1986 should be retained in the statute, with a power for the Secretary of State and Welsh Ministers to implement the right and modify it to bring it into line with modern understandings.” a4a wholeheartedly supports this view and urges Government to enforce this right to advocacy.

Action for Advocacy welcomes the widespread recognition of the importance of independent advocacy, but there is a discrepancy between rhetoric and people’s local reality. Our contact with advocacy providers makes it clear that the availability of independent advocacy is decreasing. This decrease is particularly dramatic in advocacy for which there is not a specific statutory requirement.

Our report “Advocacy in a Cold Climate” shows that funding is insufficient to cover the demand for advocacy. Statutory Mental Health and Mental Capacity Advocacy are being afforded limited protection from cuts - but even these services are struggling. 63 per cent of advocacy services say that they will be able to help fewer people in future. If this continues it will deny thousands of vulnerable people the right to a voice and to high quality care and support.

Somewhere between policy documents, national strategy and local implementation, access to independent advocacy is being lost. The Government's stated vision of 'nothing about me without me' will simply not be achieved without timely access to local independent advocacy. Action for Advocacy calls on the government to ensure that independent advocacy is a specific and separate area to be identified and reported on within Joint Strategic Needs Assessments. We believe this is the minimum requirement to ensure that there is local recognition of how many people need support from independent advocacy to make choice, voice and control a reality, and of scrutinizing the real level local provision.