Advocacy's role in ensuring choice, control & safeguarding of service users

1. Advocacy's role in ensuring choice, control & safeguarding of service users Dr Shereen Hussein Principal Research Fellow (Chair) King’s College London Shereen.hussein@kcl.ac.uk Melbourne, Australia, August 2017

2. Workshop Structure • Overview of the role of advocacy, in the context of social service delivery • Key features of advocacy work • Models of Advocacy work • Advocacy strategy • The interplay between advocacy and social policy • Group discussions reflecting on the Australian context Future of Social Service Institute

3. What is Advocacy Advocacy in all its forms seeks to ensure that people, particularly those who are most vulnerable in society, are able to: have their voice heard on issues that are important to them; defend and safeguard their rights; and have their views and wishes genuinely considered when decisions are being made about their lives. There is a clear role for advocacy in social policy development and implementation Future of Social Service Institute

4. Advocacy in context • Mixed-economies of care (cost contained strategies) • De-institutionalisation of care • Increased focus on choice and control • Increasingly personalised, person-centred and flexible approaches to service delivery • The means through which social and liberal democratic ideals are articulated and pursued • Collective and shared concerns Future of Social Service Institute

5. Key Features of Advocacy • Independent from services • Empowering: • providing people who access support with a voice • supporting people who access support to achieve active citizenship • Challenges inequality • Promotes social justice • Supports people to challenge inequity and unfairness Future of Social Service Institute

6. Advocacy benefits • Individuals benefit from the process of advocacy regardless of the exact outcome • A collective voice: raising awareness, whistleblowing • Limited evidence on the effectiveness of advocacy • Usually measured in outcomes which are hard to define and monitor • Action for Advocacy has developed outcome measures, which have been effectively used in research Future of Social Service Institute

7. Models of Individual Advocacy • Self-advocacy: Individuals represent and speak up for themselves, with support, either individually or collectively. • Peer advocacy: The advocate and the person have a common background, for example, they may have shared experience of service provision, “experts by experience” • Citizen advocacy: volunteers (unpaid) are recruited, trained and matched with an individual. The volunteer represents the individual independently from the advocacy organisation. • Independent/professional advocacy: apartnership between a paid advocate and a person. The advocate provides support, information and representation, with the aim of empowering the individual and enabling them to express their needs and choices. Future of Social Service Institute

8. Collective Advocacy • Involves a peer group of people, as well as a wider community with shared interests • Aims to represent their views and experiences • A collective voice can be stronger particularly for • Campaigning • Strategic planning • A collective advocacy group can help reduce an individual’s sense of isolation when raising a difficult issue • Groups can benefit from the support of resources and skilled help from an advocacy organisation and from each others’ experience Future of Social Service Institute

9. Advocacy Strategy Problem Tree Method Demonstrate performance, ensure learning The political context; stakeholders etc. Policies, behaviour, procedure, discourse Indicators, timing, responsibilities Core messages; then tailored Future of Social Service Institute

10. Setting Objectives Future of Social Service Institute

11. The RAPID Framework: Context, Evidence and Links Future of Social Service Institute

12. Example of an Evaluation Framework For Advocacy Work • Developed by the Scottish Independent Advocacy Alliance (2010) • Focuses on: • The differences that have been made • Whether these were intended differences • If there have been any unexpected differences • The methods that were used and which were most effective • What works well • Develop an annual comparative picture of achievements Future of Social Service Institute

13. Advocacy and policy change • Individualised consumers and personalised services • First promoted by a disability movement heavily critical of traditional services • Systems of direct payments and personal budgets • Lobbying for ‘consumer-directed’, ‘self-directed’ and ‘self-managed’ care • Carers’ support • The carers’ movement in England gained some recognition since the start of the millennium • The Care Act 2014 formally stipulate carers’ assessment and access to information Future of Social Service Institute

14. Facilitators of Advocacy • The policy context: • Scottish Mental Health Act 2003 stipulates that local authority in Scotland has a statutory duty to provide advocacy services for those subject to compulsory measures under the Mental Health Act • However, There is no statutory duty under the Adults with Incapacity (Scotland) Act, 2000, or the Adult Support and Protection (Scotland) Act, 2007 – it is however recommended as good practice • The English Care Act 2014 made access to advocacy mandatory for people eligible to receive state social care service (means tested)- • ‘The advocacy duty’ in the Finnish Vouchers in Social and Health Care Act 2004 Future of Social Service Institute

15. Challenges to Advocacy Work • Funding and resources • Availability and recruitment • Particularly in remote areas or in certain services e.g. aged care or mental health • Gaps in provision for certain groups of society e.g. cultural and heritage background • Some models of advocacy are more difficult to implement with certain groups of users • Especially for peer-advocacy – fear of stigma etc. • Knowledge and skills Future of Social Service Institute

16. Advocacy and Safeguarding • Balance between choice/ control and safeguarding • Accountability • Registration • Background checks/ references etc. • Sensitivity when formal carer is a family member (in case of personal budgets for example) • The role of advocacy in raising concerns, communicating with other professionals and lobbying for positive change Future of Social Service Institute

17. Discussion points • The place of advocacy within the Australian agenda for social change • Access and entitlements (rights and choice) • Service structure, variety and quality • From your own experience, what works and what are the challenges • Potential future directions and strategies • Key messages from research of advocacy working Future of Social Service Institute

18. Shereen.hussein@kcl.ac.uk @DrShereeHussein 00 44 2078481669 This presentation draws on a number of studies funded by the Department of Health, Policy Research Programme. Future of Social Service Institute