Commissioning Care Act Advocacy: A work in progress
Advocacy has a long history and is rooted in a belief that disabled people should be able to determine what matters to them and the support they need to enjoy a good quality of life. It is broadly defined as enabling people to express their views and preferences, including supporting people and/or family carers to advocate for themselves as well as representing their views. Having an advocate to support and represent individuals’ views, can increase self-determination, inclusion and the way that services are offered, thereby supporting empowerment, independent living and full citizenship Access to advocacy is specifically required when people’s needs are not well understood, placing them at risk of further marginalisation and social disadvantage by their views being discounted, as consistently noted in relation to people with learning disabilities, people with ongoing mental health issues and frail older people6.
Under the Care Act 2014, which came into force in April 2015, Local Authorities have a duty to promote wellbeing in everything they do and the statutory guidance highlights the importance of advocacy in achieving this. Section 3.9 of the guidance defines advocacy as ‘supporting a person to understand information, express their needs and wishes, secure their rights, represent their interests and obtain the care and support they need’. However complex people’s needs are, Local Authorities must ensure people are supported to express their views and helped to consider what options they have, which increases individuals’ control and self-determination. The Care Act, therefore, places a duty on Local Authorities to offer support from an independent advocate, if required, to enable people to be involved in decisions about them and their care and support.
The duty to provide independent advocacy applies from first point of contact with the Local Authority and at all stages of assessment, planning, review, and in the case of a safeguarding enquiry or review. Local Authorities have to make a judgement as to whether an individual has substantial difficulty in being involved, reflecting on any reduced capacity for decision-making, and secondly, if there is an appropriate individual to support them. If not and the condition of substantial difficulty is met, an independent advocate must be offered if the individual is involved in any of the following processes described in the Act:
- an adult’s needs assessment
- a carer’s assessment
- the preparation and/or review of an adult’s care and support or support plan
- a child’s needs assessment as they transition towards adult care
- a child’s carer’s assessment (therefore some people below 16 years of age)
- a young carer’s assessment
- a safeguarding enquiry or safeguarding adults review
- an appeal against a Local Authority decision under Part 1 of the Care Act (from April 2016).