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.
