Independent advocacy is crucial to make sure a person’s voice is heard and their human rights are protected. This is especially important when a person is subject to compulsory and restrictive powers. Consistent and effective advocacy must be provided to people who most require it, whenever they require it, including to people with learning disabilities, autism or both, who are subject to long term segregation. Improvement to the delivery and commissioning of advocacy is required to achieve this. This briefing highlights the key features of advocacy for people with learning disabilities, autism or both who are in long term segregation, which must be accessible, highly competent, holistic, independent and perceived to be so, connecting, supporting and joined up. The paper also sets out two commissioning options: national commissioning – the model could be specified clearly, activated promptly, its delivery easily monitored, and there would be a clear line of sight on the resources; and local commission – this would allow locally commissioned services to align with most existing statutory provision. Irrespective of the commissioning arrangements, the service must be able to undertake the full range of statutory advocacy duties, rather than referring the person on and requiring that they relate to several advocates. The paper conclude with eight recommendations, including ensuring that advocacy for people in long term segregation is provided on an opt-out basis, to ensure a greater number of people in long term segregation receive the timely advocacy support and representation they need for their voice to be heard and their rights upheld.

Advocacy helps to ensure that individuals are in control of their own lives and are supported to make their own decisions. This good practice guide has been developed to help professionals and advocates to decide on the most appropriate route to take to challenge decisions about an individual’s care. It will help advocates to develop a ‘tool-kit’ of different approaches to get the best possible outcome for people depending on their views and the situation. The guide discusses when it is most appropriate to use informal approaches to challenge decisions; the skills required to be effective when taking this approach, including negotiating and influencing; and using Best Interests meetings. It also looks at using formal routes to challenge decisions through the Mental Capacity Act 2005, Mental Health Act 1983, the Care Act 2014, and through formal complaints processes and judicial review. The guide provides useful case examples and makes reference to relevant sections within Acts and Statutory Guidance to illustrate key points. The guide is relevant for professionals across the health and social care sectors, as well as for friends and family members who are supporting a friend or relative.

A guide for health and social care staff on how, and in which situations, a person can be referred to the Independent Mental Capacity Advocacy service.