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Council Services:

Someone to speak on your behalf

Advocacy means having someone who will express your views and represent your interests.

An advocate can help you gather the information you need to make choices and decisions about your own health and social care and can speak up on your behalf.

Advocates can help you to access information and services, support you to explore options and make difficult decisions, help you to make sure your rights and wishes are respected, and aid your involvement in the main processes and interactions with the local authority and other organisations.

In general terms, an advocate must not be someone who is employed to provide care or treatment to you. This means that your GP, nurse, social worker or care and support worker cannot be your advocate.

Your advocate can be a non-paid carer, family member or friend. Some people are not able to fulfil this role easily. For example, an unsuitable informal advocate would be:

  • a family member who lives far away and only has contact with you occasionally
  • someone who has strong opinions of their own, which do not take into account your opinions
  • someone who does not wish to be your advocate
  • someone who you do not want to be your advocate
  • someone who works for the local authority or any other organisation that is commissioned to carry out assessments, care and support plans or reviews for the local authority

If you do not have the capacity to consent to a person acting as your informal advocate, the local authority must be satisfied that being represented and supported by that person is in your best interests.

If you do not want anyone to be your informal advocate or there is no-one suitable, you can look for a formal advocate. Advocacy is completely independent from the organisations that provide social care services.

Local authority and health service duties

Adult social care and adult mental health services have a statutory duty to provide independent advocacy under the Care Act (2014), the Mental Capacity Act (2005) and the Mental Health Act (1983).

In accordance with the duties, advocates must be qualified to provide the type of advocacy required. The types of advocates covered under the Acts are:

  • Independent advocate
  • Independent Mental Capacity Advocate (IMCA)
  • Independent Mental Health Advocate (IMHA)

Adult Care commissions Total Voice Lincolnshire to provide advocacy under these duties. Adult Care may also ask Total Voice Lincolnshire to provide you with advocacy for reasons which do not fall under their legal duties.

The Council’s Public Health department commissions POhWER to provide advocacy services for people who want to complain about the care or treatment they have received from the NHS, and who need help to express their concerns.

Total Voice Lincolnshire and POhWER can also provide advocacy services to people who are not covered by the duties of the Acts. You do not need to be referred by Adult Care to receive their support.

Under the Care Act

The local authority must arrange for an independent advocate to support you if you do not have appropriate informal support and you would find it very difficult to engage with:

  • your assessment
  • the preparation of your care and support plan
  • the review of your care plan
  • safeguarding enquiries
  • a safeguarding adult review

The Care Act refers to this as ‘substantial difficulty’, and defines four areas which might cause you to have substantial difficulty:

  • Understanding relevant information
  • Keeping information in the memory
  • Weighing up the pros and cons of different options
  • Sharing how you feel, what you think and what you want

The local authority must arrange for an independent advocate under this duty whether you are a carer or a person being cared for, and regardless of your age.

Under the Mental Capacity Act

If you have been assessed as not having the capacity to make specific decisions, an Independent Mental Capacity Advocate (IMCA) must be involved to represent you:

  • with Best Interest decisions
  • if the decision may result in serious medical treatment being provided, withheld or stopped
  • if you are moving into hospital care for more than 4 weeks
  • if you are moving into residential care for more than 8 weeks
  • if you are moving to a different hospital or care home
  • during safeguarding proceedings
  • if your care and support is being reviewed
  • if you do not have an appropriate informal representative

The local authority may also ask an IMCA to represent you if

  • family members or professionals disagree about Best Interest decisions
  • you are already in touch with an advocate
  • the proposed action may lead to the use of restraints or there is a concern about your safety
  • under the Deprivation of Liberty Safeguards (DoLS)

Under the Mental Health Act

If you are a ‘qualifying patient’, you are entitled to the help and support of an Independent Mental Health Advocate (IMHA).

The request for an IMHA can be made by the patient, a relative, an approved mental health clinician, or a responsible clinician. However, the patient can refuse the support if they do not want it.

The Mental Health Act defines a qualifying patient as:

  • someone detained under the Act, even if you are currently on leave of absence from hospital
  • conditionally discharged restricted patients
  • subject to guardianship
  • supervised community treatment patients
  • someone being considered for a treatment to which section 57 applies

Independent Mental Health Advocates work alongside any other support or advocacy service that you are receiving. They will support you to make decisions about your care and treatment, and will help you to get information about:

  • your rights under the Act
  • the rights of other people, such as your relatives, under the Act
  • which parts of the Act apply to you
  • any conditions or restrictions to which you are subject
  • any medical treatment that you are receiving or might be given, including the reasons and the legal authority for providing that treatment

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Last updated: 10 February 2017

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