Coronavirus UPDATE 26 March

Our offices at the Royal Edinburgh Hospital and 332 Leith Walk are now closed and all our staff are working from home. Please call 0131 537 6004 if you want advocacy in the Royal Edinburgh Hospital. For all other community issues call 0131 554 5307 (Leith Walk). Your call will either be diverted to one of our workers or we’ll pick up your voicemail message as soon as we can.

We’re doing our best to keep up to date with the rapidly evolving guidance and practice around the Mental Health Act, Guardianship and Adult Protection.

For those of you who need support to complete a benefit form or to draft a reconsideration, Arlene can offer a telephone appointment with you on 07920207569 or can offer support by email at [email protected]

For our Problematic Substance Use service please call Scott on 07918127366 or email: [email protected] to find out more or to make a phone appointment.

Collective advocacy meetings will not be taking place until further notice.  We’ll keep you updated about online opportunities to take part in collective advocacy in our newsletter which goes out once a month.  If you’re not on the email list for your newsletter and would like to be added to it, please contact [email protected]

Thank you for your patience during these challenging times.

AdvoCard

CORONAVIRUS UPDATE

We understand that this is a difficult time for many of you who use our service. We are trying to find ways to provide as much support as we can to those who need it.

From today, we will not be offering face to face appointments at our Leith Walk office. This will continue until further notice.

However, we will still be around if you need to call us and we will try to work with as many people over the phone as we can.

For those of you who need support to complete a benefit form or to draft a reconsideration, Arlene can offer a telephone appointment with you on 07920207569 or can offer support by email at [email protected]

Collective advocacy meetings will not be taking place until further notice.  We’ll keep you updated about online opportunities to take part in collective advocacy in our newsletter which goes out once a month.  If you’re not on the email list for your newsletter and would like to be added to it, please contact [email protected]

We can also still attend appointments if you have been detained in hospital or if you have an upcoming tribunal.

If you are worried and need our help we can still be contacted on 0131 554 5307

Coronavirus

We’re doing everything we can to minimise the risk of infection to everyone involved with our services.

You can help us by:

– letting us know if you’re unwell with cold or flu-like symptoms (continuous cough and/or high temperature);

– you’ve had an appointment with us recently or;

– you’ve got one coming up


This will help us keep all our visitors, employees, trainees and volunteers as safe and well-informed as we can.


We may offer alternatives to face-to-face appointments in the coming days, such as email, text and telephone appointments.


We appreciate your cooperation.


AdvoCard

Charities call for an independent inquiry into benefit related deaths

Leading charities and mental health organisations, including AdvoCard, Mind, Liberty and the Trussell Trust are backing a campaign by Rethink Mental Illness calling for an independent inquiry into the deaths of vulnerable people who rely on support from the welfare system.

The charity has also written to the Secretary of State for Work and Pensions expressing deep concern about the welfare of vulnerable benefits claimants, following the emergence of evidence that people are being pushed to breaking point from their experience in the welfare system.

In many of the cases which have emerged mental health appears to be a significant factor. A recent report by the National Audit Office showed that the Department for Work and Pensions investigated 69 instances where people receiving benefits have taken their own lives since 2014-15, but suggested it is very likely that there are more cases that could have been investigated.

The statement, co-signed by a wide range of charities and mental health organisations, is accompanied by the launch of a public petition which will be launched online on Wednesday 11th March.

The joint statement reads:

“As organisations that work with people who need support from the benefit system, we are deeply concerned that some of the policies and processes of the Department for Work and Pensions appear linked to avoidable deaths. 

“The National Audit Office reports that the Department has internally investigated 69 cases where people claiming benefits have taken their own lives since 2014-15. It was also clear that is ‘highly unlikely’ that these represent the total number of cases that could have investigated in the past six years, and that there is ‘no tracking or monitoring’ of the status of the recommendations that have been made following the investigations that have taken place.

“We are therefore calling on the Government to establish an independent inquiry into those deaths where it appears that the welfare benefits system may have been a significant factor, with a remit to recommend changes to policy as well as internal DWP processes where needed.

“The clock is ticking. In November, the Government plans to begin a ‘managed migration’ of people from the current sickness benefit—Employment and Support Allowance—to Universal Credit.  It is vital that we properly understand the circumstances of these deaths before embarking on this change.” 

Signatories:

AdviceUK

AdvoCard

Centre for Mental Health

Child Poverty Action Group

Disability Rights UK
Hafal

INQUEST

Liberty

Mental Health Foundation

Mind

MS Society

National Axial Spondyloarthritis Society

New Savoy Partnership
Rethink Mental Illness

Royal College of Psychiatrists

Support in Mind Scotland

The Trussell Trust

UCKP

Z2K (Zacchaeus 2000 Trust) 

Read our consultation response to the Scottish Government Consultation on Advocacy Standards

AdvoCard is a user led independent advocacy service for individuals who identify as having a mental health condition. We are based in Edinburgh and provide advocacy support in 3 specific areas – hospital-based advocacy for those who are currently inpatients of the Royal Edinburgh hospital or have been detained on wards in other Edinburgh based hospitals, prison-based advocacy for inmates of HMP Edinburgh and community-based advocacy for those out-with these institutions. As part of our community team we provide a dedicated service for welfare reform and social security advocacy. This service has been in place for 6 years now and in the last year dealt with 725 referrals, a 577% increase in referrals from year one.

In order to prepare our response, we held several focus groups where individuals who have used the current Welfare Reform advocacy service at AdvoCard were asked to provide feedback on the draft advocacy standards.

In order to reach as many people as possible we held focus group meetings at our offices and at three different mental health services in Edinburgh.

In total we spoke to 65 people over the four groups. At each meeting, we discussed the proposed changes to the new benefits that are being devolved to Scotland and the type of support that people felt that they would need to help them through those changes. We then discussed the proposed standards in relation to the type of support that people felt that they would need. This response reflects the issues and concerns raised during these meetings along with observations that we have made as an organisation currently providing independent advocacy in social security.

Do you agree with the definition of advocacy?

AdvoCard agree with the definition of advocacy in these standards. When people refer to our social security service their main priority is to engage support to make sure that they are heard, that they are listened to and that they are given the chance to say exactly how their conditions affect them. In our focus groups there were no issues raised with the definition, with many of the people agreeing that this is an accurate reflection of what an advocacy worker should do.

It was also agreed that the distinction between advice and advocacy was an important factor. Many services often confuse advocacy with advice, particularly when it comes to support with social security and it is important that this distinction is made here to avoid confusion not only for those who may refer to the service but also for services that may seek to provide advocacy in the future.  

However, whilst we support the overarching definition of advocacy as laid out here, we do share the concerns of the SIAA that the definition refers to “advocacy” and “advocacy worker” rather than “independent advocacy” and “independent advocacy worker”. We feel that as the standards apply to the provision of “independent advocacy services” that the term should be used consistency throughout the standards to avoid confusion.     

Is anything missing from this definition and, if so, what?

We are concerned with the statement – You are entitled to the support of an advocacy worker if you have a disability and, because of your disability, you need help with the Scottish social security system.

Whilst it is appreciated that the Scottish Government do not intend to limit the definition of what the term disability means, many of the people who use our service and those who attended the focus groups do not identify their mental health conditions as a disability. This may result in them not being aware that they are entitled to use advocacy support. More clarity is need to address this.  

 Do you agree with the principle of “independence”?

Whilst we appreciate that the definition in the standards meets the definition as described in the Social Security Scotland Act, neither AdvoCard nor the people who have used our service, agree that adhering to this definition in the standards will provide the best possible service for those who will have cause to engage with Independent Advocacy.

At our focus groups we discussed what it means to be an Independent Advocacy Service working to SIAA standards and principles and what it would also mean as defined by the Social Security (Scotland) Act 2018. We explained to people that the definition of advocacy used here means that agencies that provide employment support, benefit advice, social support etc can all provide “independent” advocacy for the purposes of social security.

Most people were alarmed at this. Although it was explained that the terms of the Act did not require any service to be completely independent it was felt that the standards and principles should be used to tighten the definition of what it means to be independent. Many of the people present were involved in the campaign to have the right to access independent advocacy included in the Act and commented that this is not what they were campaigning for.  Some commented that they were concerned about conflict of interest and the likelihood of impartiality from advocacy workers.

 “It’s important that the person helping you is on your side and not just doing what their service decides is right for you.”

Currently, independent advocacy organisations work to SIAA’s ‘Principles, Standards and Code of Practice’, which defines an independent advocacy organisation as one that, “…. only provides independent advocacy. All the activities it undertakes are about providing, promoting, supporting and defending independent advocacy. Its independence means that it does not provide any other services and so it is structurally, financially and psychologically separate from other organisations and interests”.

For those who use our service the issue of being financially and psychologically separate is an important one. At our focus groups, concern was raised that organisations that provide other services will not be able to maintain independence no matter what guidelines and safety features are put in place. It was felt that the members of staff providing advocacy within that organisation would be affected by organisational culture, service requirements and maintaining relationships with other team members who provide other areas of support such as advice or employment support. Therefore, they may struggle to maintain their level of psychological independence from the organisation and may try to steer the direction of work with the person seeking advocacy towards one that fits with their organisational culture and benefits their organisational outcomes. There is also a danger that a person may have used the organisation for another purpose, such as advice, and been unhappy with the service so therefore feels that they cannot access the service for advocacy as they are too closely related.

Is anything missing from the standards and if so, what?

We support the SIAA call for a definition of independence that will ensure meaningful independence, rather than independence in name only. This requires a far more nuanced assessment of what makes a person or organisation independent than the current definition of, ‘a person other than the Scottish Ministers’.

Do you agree with the principle of “person centred”?

Yes, AdvoCard, and those who use our service, strongly support the principle of a person-centred approach to advocacy. The addition of a standard for a person-centred approach is seen as a welcome addition and an important factor in ensuring that any work carried out is always done at the express wishes of the person, regardless of organisational opinion. This was seen as particularly important in the area of benefit uptake and income maximisation. It has been suggested that by engaging with advocacy that the person may be supported to engage with the social security system and which will in turn aid benefit uptake and income maximisation. In many cases this may prove true, however, a person centred approach as described here must allow for circumstances where the person no longer wishes to engage with the social security system for their own personal reasons, regardless of their entitlement to claim a benefit, they may wish to withdraw a claim or chose simply not pursue their entitlement. A truly person-centred approach to advocacy will ensure that the persons wishes are respected and that the person is supported to do what is best for them.

Do you agree with the standards?

Yes, we agree with the standards as they are written.

Is anything missing from the standards and if so, what?

AdvoCard support SIAA’s concern that multiple sets of standards for independent advocacy, the SIAA standards, the Social Security standards and the Child Hearing standards, runs counter to a person-centred approach. Those who use our advocacy service also use our service for other reasons such as housing issues, children and family issues, problems with treatment and diagnosis etc. Having different organisations providing different types of advocacy working to different standards will be confusing for the individual and does little to place them at the heart of the process as claimed in the principles.

Do you agree with the principle of “accessible”?

We agree with principle of accessibility and, as an independent advocacy organisation already work to ensure that our service is accessible to all that need to use our service. We provide face to face advocacy through office-based appointments, home visits and external appointments at other agencies such as support groups etc. We also provide telephone-based appointments if necessary. With regards to additional services required, we have access to interpreters in sign language and foreign language interpreters, however these come with additional costs that are met through our own limited budget. In order to ensure continued accessibility, it is vital that the Scottish government commit to the provision of adequate funding to cover the additional costs of ensuring absolute accessibility.

Do you agree with the standards?

We do not believe that the last four standards under this principle relate to accessibility and feel that they would be much better situated elsewhere in the document, perhaps within the definition of advocacy, within the section on the principle of independence and within the section on the principle of quality assurance.

We also have concern about the principle that states, ‘If you tell your advocacy worker that you may be at risk of harm or that you want to harm yourself or someone else they will discuss this with you but may need to share this information with others without your consent’.  There is not enough information here to highlight under what circumstances an advocacy worker would decide to share information without consent. Deciding what constitutes risk of harm cannot be left to the advocacy worker alone and must be in line with current safeguarding guidelines.

This standard could be improved by a) the addition of a sentence stating that the advocacy worker will always speak with you before breaching your confidentiality and b) explicit use of the word safeguarding to describe these situations. It is critical that both independent advocates and people using independent advocacy know and understand that confidentiality will only ever be breached within the context of safeguarding.

Do you agree with having a principle of “trained”?

We agree that it is important that advocacy workers are trained in both advocacy and in social security legislation and guidance

Feedback from our focus groups showed agreement that advocacy workers should be trained and experienced in providing advocacy. They should also have a good working knowledge of the Social Security System and a good understanding of individual rights under the social security act. In addition to this, many also suggested that the advocacy worker should be trained and experienced in working with the specific group that they are providing advocacy for. For example, training in mental health conditions, autism, learning difficulties etc. There was also a suggestion that all workers should receive Applied Suicide Intervention Skills Training as there is a need to discuss suicide and self-harm at face to face benefit assessments. 

Some of the comments that we received were

“I need someone who knows the right questions to ask me. I don’t like talking about my illness so if you don’t ask I won’t tell you.”

“The (…advocacy worker…) needs to know what’s going on with the benefits or what help will they be?”

 “If they don’t know what my rights are how will I know?”

“They need to have mental health training, or learning disabilities if they are working with people with learning disabilities or how will they know how to work with us?”

Do you agree with the standards?

Whilst we do agree with the standards, we do not feel that principles 1 and 4 are specific enough

Whilst we agree with the intention, we feel that these principles do very little to detail the level of training and knowledge required and leave this to the interpretation of the service provider. This can result in disparities across services. These principles would be strengthened by including the level of training required.

Do you agree with having a principle of “quality assured”?

AdvoCard agree with quality assured as a principle. In order to ensure high quality services, it is important to have robust, transparent systems in place for monitoring and evaluating the service.

Do you agree with the standards?

Of all the standards we felt that the principles of quality assurance were the most problematic. Whilst we agree with the standards, we feel that the wording could be strengthened in several places to ensure consistency across services.

1 – Advocacy workers will keep accurate and up to date written records of action taken, progress made and outcomes achieved. – reference should be made to what is considered an outcome and what the written records will be used for.

2. Advocacy services will have systems for receiving, addressing and monitoring feedback and complaints and you will be told about these. – to ensure consistency there needs to be an agreed system for feedback and complaints that will be used

throughout all advocacy services involved in the provision of advocacy in the social security and reference must be made to this in the principle.

3. Feedback and complaints forms will be available in accessible formats, without having to be requested. – this does not go far enough. To ensure a high level of service advocacy services must proactively seek feedback through various forums.

4. Advocacy services will take all feedback and complaints seriously and will respond promptly. – “promptly” is open to interpretation, to ensure a high-quality service as standard, specific timescales must be given.

Consultation on advocacy standards in social security

The Scottish Government have posted a consultation on the proposed standards that advocacy services will have to work to to provide advocacy in the new Social Security Scotland system. You can have your say here. https://consult.gov.scot/social-security/social-security-advocacy-service-standards/

AdvoCard will be holding focus groups to provide a response to this. If you would like to be involved please get in touch with Arlene on [email protected] / 01315545307