I wonder if providers of entirely non-statutory advocacy are able to maintain a richer and more holistic advocacy relationship than their colleagues who provide only statutory advocacy. While providers of statutory advocacy might do similar things, those who offer non-statutory advocacy but not statutory advocacy have held on to the following distinctive qualities.
Open to everyone
They may be able to work with people who would not be eligible for statutory advocacy. Are organisations that provide non-statutory advocacy more likely to offer groups as well as individual work and engage with people who want to campaign for system change as well as changes in the circumstances of individuals? Such arrangements can provide access to those who prefer an ongoing relationship with the advocacy organisation rather than the ‘task and finish’ approach required of many providers of statutory advocacy. Is this diverting valuable resources away from those who need them most, or does it have a preventative function, that reduces or delays reliance on publicly funded services, as suggested by the OPAAL evaluation here?
Tackle any topic
They may have broadened the range of topics on which they support people to express their view. As a result, they might work in: finance and debt; consumer rights and fuel poverty; health, housing and social care; immigration; divorce and family conflicts; neighbourhood disputes and mediation; legal matters and the courts.
But we might wonder if, as the skills and knowledge of advocates broadens, do they lose their detailed knowledge of statutory advocacy and its careful analysis of the right way to work? Do they learn about and use caselaw affecting consumer rights as well as care rights? Do they get better at face-to-face work beyond the health and social care sector but lose their skills in report writing?
Do they find it harder to identify the endpoint of a piece of work, as new areas for support can come up and lengthen the duration of the advocacy relationship? Do they find that the risk of creating dependency is increased? This way of working could weaken the person’s skills in shopping around for help and risk the person being in trouble if the advocacy organisation were to close or the staff member were to leave, since all the support has come through the same relationship. As it takes skill and knowledge to navigate each field and uncover and then manage one’s own assumptions so that they do not influence the person, broadening the range of fields increases the risk of making mistakes. Does it slow down the work, as new areas need researching and the advocate cannot work with established relationships? If the advocate stays long enough to develop a broad working knowledge across all fields then do they become invaluable, but also irreplaceable?
They may sometimes advocate for people who find themselves surrounded by professionals who are not listening. In an environment that listened carefully and responded to people, such a person may be perfectly capable of self-advocating, but in a ‘deaf environment’ we find that special skills are needed for their voice to be heard.
For example, one self-funding care home resident was assertive, articulate, enunciated well and was perfectly able to express his wish to return to his own home, but it appeared that neither care home staff, social workers nor health professionals would take him seriously. They did not listen until the advocate stepped in with his specific skills in representing others, overcoming delays and inactivity, and persistently pressing for a meaningful response.
This surely happens from time to time in statutory advocacy too, but the problem may be more severe in non-statutory advocacy because the law does not oblige anyone to listen, while in statutory advocacy, the Decision Maker, Social Worker or Mental Health Professional is expected to pay attention to the person and the advocate. As the non-statutory advocate has less formal power, they develop greater skills in influence and persuasion.
Able to serve
Advocates working in non-statutory services may occasionally step over from a strict advocacy role into a support role in a very deliberate, circumscribed and disciplined action, underpinned by good reasons which all enhance the person-centred advocacy relationship. So for example, they may fetch a single bag of shopping for someone discharged from hospital into an empty house, as well as supporting them to challenge the hospital’s discharge decision. The advocate will then refer on to support workers if an enduring need is identified.
Is there a potential conflict of interest between offering this kind of brief practical help, and working as an advocate? Would it be different if it was personal care rather than shopping that was needed?
The statutory advocate would never do these things, but would instead refer the person to another service. In the same way, the advocate who works in a non-statutory service would refer people on to their statutory counterparts when a specific need arose. The upside of such referral is that it releases the referrer to focus on their core work, but the downside is that it reduces their competence in their colleagues’ area of expertise. Do advocates working in non-statutory provision miss out on the skills that are developed by statutory advocates simply because they can refer people on? One older person’s service asserted that they did not need skills in non-instructed advocacy, as they did not have the contract, as if declining mental capacity was not a feature of the lives of some of the families amongst whom they worked.
If the advocacy partner is to remain in control, the advocate needs to be brilliant at explaining things so that the person genuinely understands and can make an informed decision. Anyone who has tried to buy a mobile phone, select the best energy provider or amend their pension scheme knows that sometimes it is terribly difficult to remain in control and make your own informed decision. Advocates become highly skilled in presenting choices in creative ways; spotting and eliminating jargon, metaphor and colloquialism; detecting when the person has given up following the explanation; and trying alternative ways.
These skills are even more important when the issue to be explained is complex and the person has cognitive impairments. So, for example, an Independent Mental Capacity Advocate (IMCA), working with people living in a care home will develop a repertoire of approaches to explaining how the finances work that helps the resident know what is happening to their income, bank account, previous home and estate. If these skills in explanation are absent, the advocate becomes a financial adviser or broker, navigating this incomprehensible world on behalf of the person and magically producing their professional recommendation for approval.
Advocates working in statutory roles have a challenging task as they try to make complex decisions clear to people with limited mental capacity. Their work is made easier by the fact that they have a limited number of fields of work – accommodation, serious medical treatment decisions and so on. In contrast, the advocate who works in an entirely non-statutory service must stretch these abilities to cover a much wider range of circumstances. They may negotiate with mortgage companies regarding repossession, quote the law to utility companies regarding customer rights in respect of fuel disconnection or challenge public transport providers to meet their obligations towards disabled passengers. Each time, they need a clear understanding of a complex environment and creative ways to communicate it that genuinely empowers the individual to remain in control of their own life.
All this means that advocates working in non-statutory services have the opportunity to develop highly sophisticated skills in making complex decisions clear to people with limited ability to understand them. But do they miss out on this challenge by choosing not to work with anyone who has limited mental capacity? Do they abandon their commitment to upholding the person’s right to choice and control and drift into the role of information and advice worker?
Finally, we might also expect providers of non-statutory advocacy to be experts at finding alternative sources of funding, since many of those who commission statutory services have left the field.
Some non-statutory advocates believe that expansion in these dimensions is innovative and holds tightly to the principles of the Advocacy Charter, creating a more person-centred approach than is often demanded from hard-pressed statutory providers. They claim that this work is simply returning advocacy to its roots.
Is this a true and fair representation of the focus of those organisations that restrict their advocacy offer to non-statutory work? Do these things enrich the advocacy world, or does it represent a risky blurring of the distinctive role of the advocate?