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.