Independent Advocacy Services Policy & Procedure Manual
Advocacy Services for People with Mental Health Problems and Intellectual Disabilities: Guidance and Model Policies
Funded by the European Commission
The opinions expressed in this document are the opinions of the authors and may not reflect the opinions of the European Commission; responsibility for the information contained therein lies solely with the authors. The Commission takes no responsibility for the content and for any use that may be made of the information contained therein.
This publication is available in English, and Hungarian. It is available for free download from www.mdac.info.
Copyright © September 2006 held jointly by the Mental Disability Advocacy Centre and Together
Any part of this publication may be distributed, used, adapted, reproduced, translated or copied provided that the parts copied are distributed free of charge and that the source is identified. The Mental Disability Advocacy Centre would appreciate learning about the use or adaptation of this manual as well as receiving a copy of any materials in which information from this manual is used.
Funded by the European Commission, Directorate-General Justice, Freedom and Security, “Actions in support of civil society in the Member States which acceded to the European Union on 1st May 2004”
The opinions expressed in this document are the opinions of the authors and may not reflect the opinions of the Commission of European Union; responsibility for the information contained therein lies solely with the authors. The Commission takes no responsibility for the content and for any use that may be made of the information contained therein.
About the authors
MDAC and Together have worked in partnership to develop this mental health advocacy services guidance and model policies. These documents reflect accepted best practice and guidance which has been developed within the United Kingdom and adopted by MDAC and Together.
This document has been adapted by Nigel Lobley and Sarah Grantham. It is based on Together’s current Advocacy Policy and Procedure Manual, which is used by all of Together’s advocacy services across the UK.
Nigel Lobley is the Advocacy Manager at Rampton Hospital. Rampton Hospital is one of three High Secure Hospitals in England. Nigel is also Together’s’ Lead Role for Advocacy in the UK.
Sarah Grantham is a Patients Advocate for Together. Sarah works in to Arnold Lodge Medium Secure Hospital and Rampton Hospital. She previously worked as an Advocacy Co-ordinator in the community.
The Mental Disability Advocacy Center (MDAC) is a non-governmental organisation based in Budapest, Hungary. MDAC promotes and protects the human rights of people with mental health problems or intellectual disabilities across Central and Eastern Europe and central Asia.
MDAC works with lawyers in several countries to bring human rights cases to court. In order to improve human rights at the local level, MDAC also works with organisations providing advocacy services to people in mental health and social care institutions.
Founded in 1879, Together (Working for Wellbeing), is the oldest community mental health charity in England. Together is one of England’s leading charities and provides a wide range of services for people with mental health needs. These services include specialist advocacy in a diverse range of environments.
Introduction
What is the purpose of this guidance and model policies?
The purpose of this handbook is to assist mental disability advocacy services throughout Europe. We hope that advocacy services will become more effective by reading this guidance, by undergoing training on key topics and by adopting policies similar to the ones presented here. The handbook sets out best practice guidelines for advocacy services and is based on the experience of long-standing advocacy services for people with mental health problems and intellectual disabilities in the United Kingdom, a country in which mental health advocacy has played an important role in protecting human rights for many years.
What is included in this work?
The information in this Manual aims to cover the basic principles and workings of an advocacy service. We have included best practice guidance and model policies.
Best practice guidance is the recommended way of working to achieve the best possible outcome. This guidance is the current standard to which all Together advocacy services work. Best practice guidelines can be used to measure the quality of the service you provide and should always be considered as the minimum standard of working.
The policies can be adapted by an advocacy service, or even immediately applied to the advocacy service as a way of working. The policies are there to protect advocates and service users. The policies are not an exhaustive list but, rather, the minimum standards required by an advocacy service in order to reflect best practice.
Throughout this information, you will see ! This symbol highlights quotes from service users, carers or advocates about their advocacy experiences. It also indicates tips about how to overcome obstacles you may experience working as an advocate.
The PowerPoint presentation which accompanies Advocacy Services for People with Mental Health Problems and Intellectual Disabilities: Guidance and Model Policies has been designed so that it can be easily adapted and used in different contexts. Advocacy services will be able to use the presentation to inform mental health service providers and service users about the role of an advocate, good practice and the benefits to service users and providers.
What words do we use?
We use the word ‘advocate’ to mean someone who advocates on another person’s behalf. We use the word to mean a non-lawyer. We use the word ‘service user’ to mean a patient or resident of a mental health or social care institution.
How can you help us improve our work?
Please tell us how you use these Guidance and Model Policies and what results you have. Please contact us with suggestions about how we can improve these Guidance and Model Policies. Our contact details are on the back cover.
Who funded this work?
This document was drafted by Nigel Lobley and Sarah Grantham. The work was funded by the European Commission (Directorate-General Justice, Freedom and Security, Directorate C: Civil justice, rights and Citizenship) and co-funded by the Open Society Institute Budapest (OSI). Sole responsibility lies with MDAC and Together. Neither the European Commission nor OSI is responsible for any use that may be made of the information contained in this work.
Contents
Page8 / Independent Advocacy Service Principles
v As an advocate, you have six main principles by which you must work. This document outlines what the principles are and contains an explanation of each principle.
9 / Delivering Independent Advocacy Services—Our Philosophy
v Advocacy has a simple philosophy that includes common themes and key elements by which advocacy services should work. This document summarises the key elements, one of which is confidentiality, and the policies supporting those elements.
15 / Advocacy Code of Practice
v The Advocacy Code of Practice is used by all advocates providing Together’s services; the Code also provides good practice guidelines for all UK Advocacy Services. It applies to all environments you are working in to as an advocate and all service users.
19 / Service User-Focused Advocacy
v As an advocate, you are guided by the service user to the outcome. Service users need to be kept informed and involved throughout the advocacy process, without disempowering the service user. This document goes in to more detail and also gives guidelines when working with service users’ carers.
X21 / Delivering Advocacy—Assessment, Records
v Each advocate needs to have a way of assessing and recording his or her work. This document outlines the good practice guidelines when recording information
v This document also provides examples of paperwork which can be used or adapted by an advocacy service. The examples of paperwork are used by all of Together’s advocacy services in the UK.
26 / Confidentiality Policy and Practice
v Confidentiality is essential to advocacy. This document outlines what is required of an advocate, when confidentiality can be broken and to whom.
30 / Minimising Risks and Hazards in Delivering Advocacy
v As an advocate you may work in to a range of different environments. This document outlines how you can keep safe and what is required of an advocate and a service to ensure safety.
34 / Protection of Vulnerable Adults from Abuse
v Often advocates will work with vulnerable adults. This document outlines who is a vulnerable adult and how this may impact on your advocacy role. All social care services and advocacy services in the UK work within this principle.
38 / Child Protection
v Children need to be safeguarded from harm, abuse and neglect. As an advocate there may be times when you have contact with children or are told information about children that may need to be disclosed. This document outlines guidance for advocates on what to do and when.
40 / Autonomy and Independence
v Advocacy services need to have clear working boundaries and guidance when maintaining independence. This document explains the standard to which you work to ensure you work effectively.
42 / Complaints and Compliments
v The advocacy role centres around helping people to speak out, as part of that advocacy services should encourage service users to comment on the service they receive from advocates. This policy gives guidance to advocacy services about how to deal with complaints and compliments.
45 / Equal Opportunities
v Certain groups of people or individuals face discrimination in society. This document applies to all advocates and services with the intention of removing discrimination and ensuring equal opportunities for all.
48 / Recruitment, Selection and Induction
v Advocacy services should ensure that they recruit advocates fairly with service user involvement. It is also important to provide a new advocate with the support and guidance needed when starting the advocacy role. This document outlines what an advocacy service should do to include service users and give a new advocate the best start to his or her role.
50 / Supervision
v Throughout your advocacy role you will often be presented with complex and challenging situations. Supervision gives you a chance to discuss issues or problems you have had within the advocacy service. This document outlines what should be discussed and how often.
54 / Working with Volunteers
v Many advocacy services throughout the UK depend upon volunteer advocates. This document outlines the benefits of volunteers, how to recruit and how to support them in their role.
Independent Advocacy Service Principles
BEST Practice GUIDANCE
The principles of Advocacy are written in the:
Advocacy Philosophy
Advocate Code of Conduct
Code of Practice for Advocates
MDAC recommends that advocacy delivery is in line with current accepted good practice guidance. The points below are the good practice guidance to which experienced advocates in the UK work. These are laid out below:
Independent – The advocacy service should be free from influence from the providers of health or social care. Advocates should have no conflict of interest.
Empowering – An advocate should always do what is necessary to support the views of the service user being heard. This means the first thing you should do is listen. You should either support the service users you represent to speak for themselves, or (if they are unable) represent the service user’s views as if they were your own. Your goal as an advocate should be to enable service users to grow towards advocating for themselves wherever possible.
! ‘Advocates often say that once they have worked with a service user for some time they are no longer needed; because the service user starts to speak up for themselves, this should be the aim of every advocate.’
Inclusive – The advocacy service should recognise the diversity of service users and ensure no one is prevented from accessing the service because of a difference in language, culture, disability or capacity.
Impartial – As an advocate you should not judge a service user. When a service user is mentally unwell, an advocate may be the only person s/he sees who is not responsible for assessing, treating and monitoring his/her illness/condition. This means that advocates should listen to the service users reports and accept their accounts as true and valid.
! ‘Sometimes service users will speak to you about things they say have happened but you may be unsure about parts of their account. As an advocate you must accept it as true and valid, without being judgmental, prejudiced or sceptical’
Confidential – All discussions between a service user and an advocate should be treated confidentially. Confidentiality should be broken only when it meets the guidelines set out in the confidentiality policy.
Free – The service should be free of charge.
Access to Service
All service users should have access to an independent advocate regardless of disability, ethnicity, religion, gender, sexual orientation, personal beliefs, etc. A service user should not be judged by an advocate. Advocates should offer the same quality service to all.
Service Structure
Advocacy services should be structured to include a senior advocate or advocacy manager. This will allow the service to provide the best support to the advocates through supervision and training. It will also give the service ownership and responsibility for complaints and compliments. This will help to ensure the delivery of a quality service.
Delivering Independent Advocacy Services
- our Philosophy
GOOD PRACTICE GUIDANCE
Community-based advocacy is best provided by local advocates who are close to the community that they serve. Some settings, however, are out of the ordinary, such as secure hospitals and prisons. Although many service users have ordinary needs that accompany their extraordinary circumstances, we believe that a specialist advocacy service can help everyone regardless of his or her situation.
As an advocate, the common themes when working with service users are:
· Based on individual need with the intention of maximising service users’ ability to speak and advocate for themselves. No service user will be the same as another, each service user will have different needs and wants and as an advocate you will need to adjust the way you work to reflect the variation of service users.