PowerPoint Presentation on the statutory requirement to for local authorities to arrange independent advocacy for people who have 'substantial difficulty in being involved/engaged'. Presentations was delivered by Lucy Bonnerjea at 'Personalisation and the Care Act consultation events' hosted by TLAP, Department of Health, the Local Government Association (LGA) and Association of Directors of Adult Social Services (ADASS) on Monday 21st July 2014 in London and 23 July 2014 in Manchester. Simon Medcalf is Deputy Director of Social Care Policy and Legislation at Department of Health and Kevin Kitching is Personalisation Policy Manager Social Care, Local

1. Advocacy and the Care Act
Lucy Bonnerjea, Department of Health,

2. • We have statutory advocacy under the Mental Capacity Act for
people who lack capacity
• We have statutory advocacy under the Mental Health Act for people
who are detained in hospitals or on a CTO
• We have some statutory advocacy for NHS complaints
• We have non statutory advocacy – locally commissioned and locally
determined
• And we will have new statutory advocacy under the Care Act!
Currently

3. New Statutory advocacy
• The Act requires local authorities to involve people in
assessments, care and support planning, and reviews.
• In order to facilitate the involvement and engagement of
people who would otherwise have difficulty, it introduces
a new requirement to arrange independent advocacy for
people…
• A) who have substantial difficulty in being involved/
engaged in these processes and
• B) where there is no one available to help facilitate this
involvement and engagement.

4. This means
• It is not universal – it is targeted
• It is not to do with mental capacity
• It is not to do with vulnerability
• It is not defined in relation to a condition (LD or dementia)
• The key issue is: substantial difficulty in being
involved/ engaged. Being engaged is an active role.
• It is targeted at those who have no-one to help them to
be involved/ be engaged.

5. Duty to arrange
• For assessments – NEW!
• For Care and support planning
• For Reviews
• For Safeguarding
• (Also applies in prisons)

6. Who benefits?

8. What do you need to
do?
1. Commission an independent advocacy service
2. Map out which staff need to refer people to them and
ensure they are trained to know who to refer and
how to refer

9. Commisssioning
• Means procurement..
• Doing a spec..
• Deciding on evaluation criteria…
• Balancing quality with cost…
• Thinking about flexibility (no one knows how many people
will qualify…)
• Running a tender..
• Who will evaluate? Can you involve service users?
• Possibly extending an existing contract?
• Considering how it interfaces with the IMCA contract..
Can your IMCA provider provide both?

10. Risk factors
• You commission something that is too small - and it runs
out half way through the year
• You commission something that is poor quality, with no
quality indicators
• You commission something without ensuring that staff
know when to refer and who to refer – so people who are
eligible do not get the help..
• You don’t monitor entitlement
• Legal challenges.. This is an entitlement for some people

11. Assessment
• This is the tricky part –
- how do you involve advocates if assessment is by
phone?
- how do contact centre staff assess whether someone
has substantial difficulty in engaging?
- How do you do urgent assessments if someone is
entitled to an advocate?
- How do you balance speed with thoroughness?
- How do you prevent people who have significant difficult
in engaging from being turned down without an
assessment and without an advocate?

12. Care Planning and
Reviews
• Less difficult as you already know about people’s needs
• If possible use the same advocate for continuity

13. Safeguarding
The national experience in safeguarding is that many
people do not get an IMCA when they are entitled to one–
LAs need better procedures, training and better monitoring

14. Resources
£ millions
in 15/16
prices
15/16 16/17
Total
recurring
costs
14.5m 34.6m

15. Any views?
• Will this work?
• What problems can you
envisage?
• What benefits can you see?

16. SCIE
• Developing Practice Guidance
• The Social Care Centre of Excellence (SCIE) has been engaged to
work on developing resources to support the implementation of the
Care Act 2014, including:
• good practice guide for commissioners to ensure fulfilment of
advocacy duties laid out in the Care Act 2014
• an ‘at-a-glance’ summary
• a self-assessment tool for local authority use

17. Question
We would welcome views on whether this
covers most situations where a person
needs an advocate, or whether there are
other situations and circumstances where
advocacy would be important. For example
continuing care? Also whether you see any
problems.