Independent Care Advocacy
Why is this new service being provided?
On a regular basis the department of Health and Social Services are considering and reviewing the needs of individuals who require significant levels of care and support. As far as possible, each person who receives care should be included in the process of making these major decisions. The Care Advocacy service is being provided to support individuals who have a complex condition which affects their capacity to take part in or make complicated decisions and are in receipt of significant care packages; this could include learning disability, brain injury, mental disorder, or developmental disabilities which affect how people communicate and interact with the world, such as autism.
Whilst the UK Care Act is not replicated in Jersey law, local service providers wish to follow Best Practice by embracing the fundamental principle that “everyone in care is a human being with wants and needs.”
Role of the Independent Care Advocate
The role of the Care Advocate is to:
- support the person to understand their rights;
- support the person to be fully involved in an assessment of their care needs, a care review, care; and
- support planning or safeguarding process.
The care advocate does this by listening and supporting the person to:
- understand the information and weigh up their options;
- articulate their needs, and express their wishes and feelings;
- exercise a level of choice and control; and
- make a decision about whether to accept the services offered.
What are the Referral Criteria?
A referral should be made to an independent care advocate in the following situations:
- a needs assessment; and/or
- the preparation of a care or support plan; and/or
- support with accommodation needs; and/or
- a review of a care or support plan; and/or
- a safeguarding enquiry; and/or
- a safeguarding adult review,
without support, the person will have substantial difficulty being involved
there are no appropriate, able and willing family or friends to support the person’s active involvement.
a) Substantial difficulty
Statutory service providers must consider whether the person is likely to have substantial difficulty in engaging with the care and support process. The Capacity and Self Determination law defines four areas where people may experience substantial difficulty. These are:
- understanding relevant information;
- retaining information;
- using or weighing information; and
- communicating views, wishes and feelings.
b) Who is an ‘appropriate individual’ to assist a person’s involvement?
If the person being supported doesn’t want that person to support them, that’s not an appropriate adult.
In general, a person who has substantial difficulty in being involved in their assessment, plan or review, will only become eligible for an independent care advocate where there is no one else appropriate to support their involvement. This could be because they do not have any family members or friends who:
- know them very well;
- agree to offer this support;
- are able to offer this support (for instance they themselves could have learning difficulties or dementia which prevents them from offering support);
- are appropriate (for instance they are suspected of abusing the person); and/or
- are able to help the person put forward their view (for instance they have strong views on what the decision should be and do not support the person to express their aspirations).
The main thing to consider is whether the ‘appropriate individual’ would be able to facilitate the person’s active involvement in the process. With the appropriate individual’s support, would the person be able to be an active partner in the process and be involved in decisions made about them and their care and support? It is not sufficient to know the person well or to love them deeply – the role of the appropriate individual is to support the person’s active involvement with the H&SS processes. Some people will not be able to fulfil this role easily, for instance:
- a family member who lives at a distance and who only has occasional contact with the person; or
- a partner who also finds it difficult to understand the H&SS processes.
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; and/or
- 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.
All completed referral forms should be sent via email by a Social Worker or team leader to firstname.lastname@example.org
The form sets out the specific criteria for referral and ensures that adequate information is received at the outset. My Voice will then determine the appropriateness and urgency of the referral.
How Advocacy Will Deliver the Service?
An advocate will meet with the individual and seek to engage as far as possible, using a range of communication methods.
The advocate may also consult with others including family, friends and care providers who it is felt may be in a position to comment on the individual’s wishes, beliefs or values.
The advocate will attend meetings with or on behalf of the individual, will speak up for, raise concerns and challenge where necessary to ensure the individual remains at the centre of the decision making process.
The advocate will regularly review their role and the decision making process with the individual to ensure the person feels empowered and feels that their views are being accurately represented.