I’ve been thinking a lot about the Care and Support bill and
the fact that it defines advocacy as a social care service for which there may
be a need. Identifying needs is important.
Many years ago I did some research about needs evaluation in
care planning. It turned out that there was a big difference between what was written
in care plans and what was understood and known by ward staff. In general,
staff were aware of and acted on a range of information that was rich, complex
and arose from an ongoing relationship with the people on the unit. The care
plan on the other hand was a bare essentials plan of must do actions. It often
missed out some of the most important facts about a person’s needs and
abilities because it was assumed that “everyone knows that”. The problem was
that when the use of agency staff increased, not everybody did know that. Lesson; sometimes we assume and imply too
much when we really need to spell it out.
On that note, a recent meeting relating to the draft social
care bill and white paper is worth exploring. The Department of Health’s
interim report on Winterbourne View explicitly stated that the care white paper would explore the role of
information, advice and advocacy. In that regard (and many others) it was
surprising to see that so little actually appeared in the white paper about
advocacy. However, it appears from the meeting at DH that advocacy is implied within
the need for information and advice within the bill. We can argue that it needs
to be further developed, that the advocacy “bit” needs to be clarified as
somewhat different to the information and advice roles, but we were told that
advocacy hadn’t been entirely forgotten. The lessons from Winterbourne are too
important for that.
In fact, looking through the principles of the white paper
and the aim of the bill, it is hard to imagine the step change in services
being delivered without advocacy. You could say that advocacy runs through the white
paper like the words in a stick of rock, but I’m concerned that it doesn’t
stand out clearly enough. If you haven't been told it's there, if you aren't plugged into the need for advocacy, then you won't notice the word advocacy.
And that means that at the moment with have a stick of rock with no “Blackpool”
in it. If the need for advocacy isn’t explicitly spelled out it may get missed
when guidance goes from national to local level, something which would reduce
the chance of ensuring dignity, choice and control for all. We need the writing
to be clearer. If you think so too, please get involved in the consultation on the
Care and Support Bill website – or sign up to Action for Advocacy’s
100 Words on Advocacy.