Advocacy: inclusion, empowerment and human rights
This section is informed by SCIE research and the input of people who use services and carers. We’ve also identified some principles of good practice that can enable commissioners to better understand and specify relevant services. It is intended to give less experienced commissioners a short introduction to advocacy.
I think advocacy is something about rights. I think it’s about people knowing what their rights are and having access to that information and the advocate feeling that they have a role in which they’re being heard and have some strength in the wider discussion. People have a right to have their voices heard to the end of their lives.Co-production workshop participant
Advocacy promotes equality, social justice, social inclusion and human rights. It aims to make things happen in the most direct and empowering ways possible. It recognises that self-advocacy – whereby people, perhaps with encouragement and support, speak out and act on their own behalf – is the ultimate aim. This is the goal which underpins all forms of high quality advocacy, as emphasised in the ‘Advocacy Code of Practice’.
Types of advocacy
It seems that local authorities have advocacy services for people with learning difficulties, people in the mental health system and so on, and one of the things that I think is really worrying is that people are not just experiencing an individual impairment or illness, they’ve often got two or three things that are very important and it’s understanding that holistic approach to what they might need and how they might need supporting.Co-production workshop participant
I have seen in my many years working in self-advocacy that when people with learning difficulties move into self-advocacy they can move away from the family because they start to have more of a voice.Co-production workshop participant
Self-advocacy refers to an individual’s ability to effectively communicate his or her own interests, desires, needs and rights. It recognises that people are experts by experience and involves them in speaking out for themselves about the things that are important to them. It means that people are able to ask for what they want and need and to tell others about their thoughts and feelings.
The goal of self-advocacy is for people to decide what they want and to carry out plans to help them get it. Self-advocacy differs from other forms of advocacy in that the individual self-assesses a situation or problem and then speaks for his or her own needs. The ultimate aim of all forms of advocacy should be to support people to self-advocate as far as they are able to.
Group advocacy Open
Group advocacy involves people with shared experiences, positions or values coming together in groups to talk and listen to each other and speak up collectively about issues that are important to them. These groups aim to influence public opinion, policy and service provision. They vary considerably in size, influence and motive. Representatives of local groups are often included on planning committees and involved in the commissioning and monitoring of health and social care services.
Non-instructed advocacy Open
Non-instructed advocacy is needed when, despite the provision of assistance and support, a person is still unable to give their views and make their own decisions. If this is the case, the independent advocate needs to use the information they have gathered to represent the person. The aim of non-instructed advocacy is to secure the person’s rights, promote their wellbeing and ensure their wishes are fully considered.
There are four recognised approaches and providers should endeavour to integrate them all when providing support:
- rights-based approach – we all have certain fundamental human rights that can be defined and measured
- person-centred approach – based on the development of long-term, trusting and mutually respectful relationships between advocates and people
- watching brief approach – placing the person at the centre of thinking about the best way to support them
- witness/observer approach – in which the advocate observes or witnesses the way in which a person leads his or her life.
It is important to remember that an individual's capacity to be involved in decision-making or to instruct an advocate may fluctuate. This provides a further argument in favour of a whole-systems approach to advocacy, which maximises the chances of continuity of support.
Peer advocacy Open
Peer advocacy refers to one-to-one support provided by advocates with a similar disability or experience to a person using services. Trained and supported volunteers often provide peer advocacy as part of a coordinated project. Peer advocacy schemes argue that they are particularly well placed to empathise with the needs of people, to approach them as their equals and to feel strongly about, and fight hard for, their needs.
Citizen advocacy Open
Citizen advocacy aims to involve people in their local community by enabling them to have a voice and to make decisions about the things that affect their lives. Citizen advocacy partnerships are long term, not time-limited, and last for as long as the citizen advocate and the individual want them to. Citizen advocates are ordinary members of the local community. They are unpaid and usually operate with support from a coordinated scheme.
Professional advocacy Open
Paid independent advocates support and enable people to speak up and represent their views, usually during times of major change or crisis. Such advocacy is issue-based and the advocate may only need to work with the person for a short time.
Advocacy principles and standards
Guidance on market shaping and the commissioning of care and support in relation to the Care Act 2014 states that local authorities should take a co-production approach to market shaping and commissioning.
Quality advocacy services are person-centred and developed using a co-production approach that aims to maximise the participation of people who use services and their carers. Co-production means delivering services based on an equal and reciprocal relationship between people who use services, carers and professionals, and results in the provision of support that meets individual goals as well as needs. SCIE has a collection of co-production resources if additional support is required.
Co-production means that what you have to say as a service user is just as important as what other people have to say about the service you receive.Co-production workshop participant
Equality and diversity
Advocacy projects should be able to meet the needs of diverse local populations.
Publicly funded advocacy providers must comply with the public sector equality duty (PSED) (Equality Act 2010) by paying due regard, when carrying out their functions, to the need to eliminate discrimination, advance equality of opportunity and foster good relations between people who share a ‘protected characteristic’.
The protected characteristics are:
- gender reassignment
- marriage and civil partnership
- pregnancy and maternity
- religion or belief
- sex and sexual orientation.
For further information on complying with the public sector equality duty please see the Equality and Human Rights Commission (EHRC) guidance.
The eight quality areas
The advocacy Quality Performance Mark (QPM) is a robust, quality assessment and assurance system for providers of independent advocacy. It is a tool used to benchmark independent advocacy services against a framework. The eight key quality areas that form the Mark are as follows.
The QPM framework is designed for use by providers of independent advocacy. It is the independence of advocacy that allows services to be led by and responsible to the client. Research shows that independence is one of the key attributes that people coming to advocacy services are looking for.
Clarity of purpose Open
It is essential that everyone knows what they can expect from an advocacy service. Providing clarity helps in the following ways:
- people can evaluate the support they receive
- advocates are clear about their role and its boundaries
- it is easier for appropriate referrals to be made, and to ensure that funding intended for independent advocacy is used in precisely that way.
Confidentiality is a cornerstone of independent advocacy. It establishes a relationship of trust that enables people to tell their stories and explore the options available to them. However, confidentiality should not be a barrier to the supervision and support of advocates.
It is essential that services have a clear confidentiality policy which is regularly reviewed. It is equally important that people who come to the advocacy service are given clear information about what confidentiality means and the circumstances under which it will not be possible to maintain confidentiality.
An additional set of indicators relating to safeguarding has been added to the latest edition of the Quality Performance Mark. This was necessary following the abuse and neglect at the Winterbourne View and Mid-Staffordshire hospitals, to ensure that advocacy providers and advocates are suitably knowledgeable and experienced in identifying safeguarding issues.
Empowerment and putting people first Open
Advocacy services need to be focused on the person they are working with. One way of achieving this is to ensure that people who do, or may, use the advocacy service have meaningful influence over the direction of that service.
As advocacy is about increasing the amount of control that people have over their own lives, advocacy services need to ensure they are working in a way that fosters independence. It is important to create a culture that promotes individual empowerment and to develop methods to determine outcomes with clients and measure the effectiveness of the advocacy relationship.
Equality, accessibility and diversity Open
As well as complying with equality legislation (Equality Act 2010 in particular), it is expected that advocacy services take proactive steps to ensure equitable and easy access to them. Having equal opportunities policies is only part of the process. Proactive efforts must be made to implement such policies, remove barriers and deliver accessible and equitable services.
Accountability and complaints Open
Advocacy services must be held accountable for the work they do and the way they use the funding they receive. Different stakeholders can hold advocacy services to account in different ways. Funders should be able to see that money is being spent wisely by assessing the effectiveness of the advocacy service. The service should be accountable for meeting the needs of its local community, its legal responsibilities and adhering to agreed advocacy principles. Just as importantly, individuals should be able to expect a high quality service and should have a clear and accessible route for complaints if they are unhappy with the service provided. This must include independent support for complainants.
Supporting advocates Open
Policies, procedures and organisational structure count for nothing if the people delivering advocacy are not adequately trained or supported. Providing training for advocates and ensuring adequate and appropriate supervision are essential if services are to retain skilled advocates and ensure high quality advocacy for people who need it.