Independent Advocacy Strategic Plan
North Ayrshire Council · 16 November 2023
Back to Integration Joint Board — 16 November 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Integration Joint Board 16 November 2023 Subject : Independent Advocacy Strategic Plan 2022-2026 Purpose : The IJB to note progress in developing the Advocacy Strategic Plan. Recommendation : The IJB to approve the Advocacy Strategic Plan. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required X 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership IJB Integration Joint Board ASP Adult Support & Protection 1. EXECUTIVE SUMMARY 1.1 North Ayrshire Health and Social Care Partnership (The Partnership) is committed to ensuring people have their voice heard, can express their needs, make informed decisions, and have their rights and interests protected. The Partnership recognises the importance of advocacy in: • Empowering people to express their own needs and make their own decisions. • Enabling people to access information, explore options and make informed decisions. • Providing a voice for people who are unable to speak or who do not use speech as a form of communication. • Ensuring a safeguard for vulnerable people 1.2 This has resulted in advocacy being available to adults with learning disabilities, adults affected by mental ill health, adults with addictions issues, adults with physical disabilities, adults with brain injury, children, and young people.
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1.3 The new North Ayrshire ‘Empowering Inclusion’, Independent Strategic Advocacy Plan 2022-2026 has been collaboratively developed with learning and evaluation of the previous the Advocacy Strategy 2018 – 2021 and associated plans. This new strategy will take us from 2022 to 2026 and has been influenced by a number of national and local policy drivers highlighted within the strategy. Primarily among those is the North Ayrshire Health and Social Care Partnership Strategic Commissioning Plan ‘Caring Together’ 2022-30. Caring Together sets out the partnership’s ambitions to improve the health and wellbeing of all people living in North Ayrshire. It underlines the importance of working with people as they go through their care journey and ensures that people using our services have their voices heard and needs respected. 2. BACKGROUND 2.1 The Mental Health (Care and Treatment) (Scotland) Act 2003 imposed a duty on local authorities and health boards to collaborate to ensure the availability of independent advocacy services in their area. The Act gave everyone with mental illness, learning disability, dementia, and related conditions the right to access independent advocacy support. The Mental Health (Scotland) Act 2015 builds on the right in the 2003 Act to independent advocacy support, by requiring health boards and local authorities to tell the Mental Welfare Commission how they have ensured access to services up to now, and how they plan to do so in the future. Local authorities and health boards have a legal duty to provide independent advocacy for people who have a mental disorder (this includes people who have a mental illness, learning disability or personality disorder, and covers people with dementia and acquired brain injury) under the Mental Health (Care and Treatment) (Scotland) Act 2003. This is not restricted to people subject to compulsory measures; "everyone with a mental disorder is entitled to access independent advocacy, regardless of which piece of legislation is being considered, and indeed, when no legislative intervention is being considered at all" (Patrick &Smith 2009). Under the Adult Support and Protection (Scotland) Act (2007) local authorities are required to "have regard to the importance of the provision of appropriate services (including, in particular, independent advocacy services) to the adult concerned". Therefore, it must be considered whether advocacy is required for any adult subject to ASP procedures, however, as identified above advocacy must be offered to any adult subject to ASP who has a mental disorder. There is a range of legislation in Scotland that requires the local authority to give regard to the views of children, including the Children (Scotland) Act 1995, Children's Hearings (Scotland) Act 2011 and the Children and Young People (Scotland) Act 2014. This may involve the provision of advocacy to ensure children are able to
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express their views. Under the Mental Health (Care and Treatment) (Scotland) Act 2003 all children with a mental disorder are entitled to independent advocacy. Under the Equality Act 2010, local authorities and health boards have a statutory duty to ensure services provided are equitable and accessible and that any barriers to this are addressed. For people who are marginalised or face discrimination it is particularly important that they have access to independent advocacy to ensure equitable access to services. People may face discrimination or exclusion of the basis of age, gender, ethnicity, disability, sexual orientation, mental health or substance dependency. This duty requires consideration of the provision of advocacy on a wider basis than that required for people with a mental disorder. In addition to legal requirement, there is a range of policy and guidance that recommends access to advocacy for particular groups, such as Getting It Right for Every Child (2010) and Advocacy for Unpaid Carers, Guidance (2016). In 2023 the MWC published ‘The Right To Advocacy’ which is the outcome of a review undertaken by the MWC to identify how health and social care partnerships, local authorities and NHS boards are discharging their responsibilities under the Mental Health (Care and Treatment) (Scotland) Act 2003. The report identified key recommendations which have been considered in the development of the new North Ayrshire HSCP strategy: Recommendation 1: All health and social care partnerships (HSCPs), health boards and local authorities should work collaboratively to ensure that a strategic advocacy plan has been developed and implemented for a three-year period based on information gathered from a needs assessment, scoping exercises and consultations for the provision of independent advocacy services in their area by 31 March 2024. Recommendation 2: Equality impact assessments (EQIA) must be undertaken when developing and finalising strategic advocacy plans and signed off by senior management from all key partners, e.g. health and social care partnerships, health boards and local authorities. Recommendation 3: All health and social care partnerships (HSCPs), health boards and local authorities should ensure that advocates and advocacy organisations commissioned to provide advocacy services in their area comply with the principles and standards set out in Appendix 1 of the Scottish Government Guidance: Independent advocacy - a guide for commissioners (2013). Recommendation 4: All health and social care partnerships (HSCPs), health boards and local authorities should promote advocacy services among health, social care and social work staff through training/awareness sessions and ensure information is available through a wide range of methods to members of the public.
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Recommendation 5: All children’s integrated service plans should include reference to the provision of independent advocacy services by 31 March 2024. Recommendation 6: All health and social care partnerships (HSCPs), health boards and local authorities to consider the term of funding in response to the feedback from the advocacy organisations about how this can make it challenging regarding long term planning and sustainability of independent advocacy organisations. The new North Ayrshire ‘Empowering Inclusion’, Independent Strategic Advocacy Plan 2022-2026 is in alignment with the MWC recommendations. A short-life working group was established with key stakeholders to ensure application of the strategy to practice could be achieved, identifying and outlining key priorities for delivery. 3. PROPOSALS 3.1 The IJB is asked to approve the new North Ayrshire ‘Empowering Inclusion’, Independent Strategic Advocacy Plan 2022-2026. This approved plan will be provided to the Mental Welfare Commission Scotland. 3.2 Anticipated Outcomes The outcomes of independent advocacy support to individuals as outlined above, are not only of a legal duty but of ethical support to ensure individuals rights are being protected and safeguarded. 3.3 Measuring Impact The progress on implementation of independent advocacy will report using the HSCP Performance & Audit Committee process and form part of the HSCP annual performance report. 4. IMPLICATIONS 4.1 Financial The Advocacy Strategy will be underpinned by the appropriate commissioning of services. Such services are already commissioned separately for children and adults, and have been re-tendered in the past months, with new contract awards due to commence by April 2024. 4.2 Human Resources “None”. 4.3 Legal The HSCP will comply with the legal aspects of independent advocacy.
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4.4 Equality/Socio-Economic Ensuring parity of access for those in need. 4.5 Risk To not provide this service would be in breach of legal duty. 4.6 Community Wealth Building This is not a requirement of the service. 4.7 Key Priorities Advocacy Strategy will ensure equitable access to services and ensure any barriers to equitable provision are addressed meeting the objectives of the Strategic Plan. 5. CONSULTATION 5.1 The new strategy has been developed in collaboration and consultation with key partners within commissioned and statutory services. The views of the people who may require to access advocacy services were presented via their advocacy supports. Caroline Cameron, Director, NAHSCP Thelma Bowers, Head of Service, Mental Health, thelmabowers@north-ayrshire.gov.uk /01294 317763 Appendices • Appendix No 1, Independent Advocacy Strategic Plan 2022-2026
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North Ayrshire Health and Social Care Partnership Empowering Inclusion Independent Advocacy Strategic Plan 2022-2026 In partnership with
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Independent Advocacy Strategic Plan 2022-2026 v7 2 3rd October 2023 Document Control Control Aspect Information Document Name: Independent Advocacy Strategic Plan Directorate: Health & Social Care Partnership Prepared by: Julie Barrett Authorised by: Thelma Bowers Source Location: Published Location: Other documents referenced: Empowering Inclusion: Independent Advocacy Strategic Plan 2019-2021 Related documents: Scottish Independent Advocacy Alliance (2019) Independent Advocacy: Principles, Standards & Code of Best Practice. Acknowledgements: With thanks to the authors and contributors of the previous North Ayrshire Independent Advocacy Strategic Plan that provided the foundation for this review and refresh. Also many thanks for the authors that produced and contributed towards this updated plan Version Control Version Number Date Issued Author Update Information V1 01/03/2022 J. Barrett Review and refresh from previous Strategic Plan 2019-2021 V2 21/06/2022 J. Barrett Draft distributed following working group V2 21/06/2022 J. Barrett Issued to Child and Family Services V2.1 22/06/2022 P. McArthur Updated following return from Addiction Services V2.2 27/07/2022 M. McClurg Updated following return from AIMS Advocacy V2.3 03/08/2022 M. McLennan Updated following return from Partnership Engagement V2.4 08/08/2022 P. McArthur Updated following return from Addiction Services V2.5 08/08/2022 S. Bryan Updated following return from Strategic Planning V3 26/08/2022 J. Barrett Draft distributed following working group
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Independent Advocacy Strategic Plan 2022-2026 v7 3 3rd October 2023 Version Number Date Issued Author Update Information V3.1 26/08/2022 W. Lauder Updated following return from Inpatient Services V3.1 29/08/2022 J. Barrett Request for update from Child and Family Services V3.2 13/09/2022 P. McArthur Updated following return from Addiction Services V3.4 30/09/2022 J. Thomson D. Jarrett Updated following return from LDS V4 03/10/2022 J. Barrett Updated following return from working group V4 30/11/2022 J. Barrett Draft Paper tabled at PSMT V4 12/12/2022 J. Barrett Draft Paper tabled at SMT V4.1 13/01/2023 V. McInulty Updated following return from CAMHS V4.1 31/01/2023 J. Barrett Updates from Health & Community Care Services requested V4.1 31/01/2023 J. Barrett Updates from Child and Family Services requested V4.2 31/01/2023 D. Thomson Updates from Health & Community Care Services provided V4.3 06/02/2023 A. Sutherland Updates from Child and Family Services provided V5 29/03/2023 J. Barrett UPDATED REPORT V5 04/05/2023 J. Barrett Updated report tabled at PSMT V5 11/05/2023 J. Barrett Updated Report shared with HoS for Child & Families and Chief Social Work Officer (in follow up to PSMT) V5 07/06/2023 J. Barrett Updated reported shared with HoS for Mental Health and Director of H&SCP to try and finalise outstanding tweaks V5.1 08/06/2023 E. Stewart Update from Child and Family Services provided V6 08/06/2023 J. Barrett UPDATED REPORT V6 15/06/2023 J. Barrett Requested update from CSWO V6 28/07/2023 J. Barrett Updated reported shared with HoS for Mental Health to try and finalise V6 08/09/2023 J. Barrett Request to consider life span of Advocacy Plan made. ? Reducing plan to 3/4/5 year plan to coincide with tender process. V7 03/10/2023 J. Barrett Update to life span of advocacy strategy; 2022-2026.
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Independent Advocacy Strategic Plan 2022-2026 v7 4 3rd October 2023
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Independent Advocacy Strategic Plan 2022-2026 v7 5 3rd October 2023 Contents 1. Who are we and what do we do? ................................................................................................................................... 6 2. Our advocacy strategic plan ............................................................................................................................................ 9 3. What is independent advocacy and why do we need it? .............................................................................................. 13 4. Types of Advocacy ........................................................................................................................................................ 15 5. Advocacy services in North Ayrshire ............................................................................................................................. 17 6. Enhancing our advocacy approach ................................................................................................................................ 19 7. Evaluation and review .................................................................................................................................................. 20 Appendix........................................................................................................................................................................... 21
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Independent Advocacy Strategic Plan 2022-2026 v7 6 3rd October 2023 1. Who are we and what do we do? North Ayrshire Health and Social Care Partnership (the Partnership) provides community-based health and social care services for people throughout their life: from birth through childhood, teenage years and adulthood. Our service delivery areas include: Adult Health and Community Care Services Children, Families and Justice Services Mental Health, Learning Disability, Drug And Alcohol Services The majority of our services are delivered in collaboration between North Ayrshire Council and NHS Ayrshire and Arran. Our service delivery teams include, but are not limited to; Allied Health Professionals (dieticians, physiotherapists, occupational therapists, speech and language therapists), addictions workers, care at home and care home staff, child immunisation, community alarm and digital health staff, community link workers, welfare rights officers, nurses (including specialist and advanced nurses), paid carers, psychologists and psychiatrists, social workers (across all age groups) and social work assistants, residential adult and childcare staff and volunteers in a range of teams. In many services, we also have peer support workers, who are staff members employed due to their lived experience of services. We also work closely with our partnering Health & Social Care Partnerships, Primary Care colleagues; Dentists, GPs, Optometrists and Pharmacists, wider members of North Ayrshire Council; particularly Housing and Education, and wider members of NHS Ayrshire & Arran. In delivering effective Health and Social Care services, we also appreciate many things are out with the scope of either NHS or North Ayrshire Council partners to achieve. That is why our partnership actively includes representation from the Third Sector Interface and from the local independent sector. We want to ensure people in North Ayrshire have access to the right care at the right time, in the right place with the right professional. We work together to provide high quality, safe and sustainable care, as seamlessly as possible. This is perhaps summarised best in our Partnership Vision:
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Independent Advocacy Strategic Plan 2022-2026 v7 7 3rd October 2023 Our vision is that all people who live in North Ayrshire are able to have a safe, healthy and active lifestyle. Our intentions for achieving this vision are set out within the North Ayrshire Health and Social Care Partnership Strategic Commissioning Plan, ‘Caring Together (2022/30). The plan identifies our five strategic priorities to help us reach our vision. We will seek to: o Enable Communities o Develop and Support our Workforce o Provide Early and Effective Support o Improve Mental and Physical Health and Wellbeing o Tackle Inequalities We see these priorities as interlinked, and we expect that where we see success against one priority, its effect will positively impact against others. You can find out further information about our priorities, and how we intend to address them, in our strategic commissioning plan, ‘Caring Together’, and how we are working towards achieving them in our annual performance reports at Caring Together: NAHSCP Strategic Commissioning Plan 2022-2030. Caring Together (2022/30) also identifies our values as a Health and Social Care organisation. Our values were informed by engagement with local people, who told us that they expect us to embody: Care, Empathy, and Respect o By being a Caring Partnership, we look after and support the health and wellbeing needs of those who require it. o By showing Empathy, we understand the needs, wishes and concerns of people accessing our services as we support them on their care journey. o By showing Respect, we see people accessing services as unique individuals and actively involve them, and their family, in the planning and delivery of their care.
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Independent Advocacy Strategic Plan 2022-2026 v7 8 3rd October 2023 The role of advocacy is an essential component of meeting the Health and Social Care requirements for our community and is also an opportunity to provide a critical voice for our communities in meeting their health and wellbeing ambitions. There is great opportunity through our diverse workforce in promoting the use of advocacy in its many guises as per section 4 of the document. The Health and Social Care services within the Partnership are committed to raising awareness of the types of advocacy available and to promote and assist access to such supports with the goal of empowering individuals and their families to make informed decisions in relation to their care and support needs.
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Independent Advocacy Strategic Plan 2022-2026 v7 9 3rd October 2023 2. Our advocacy strategic plan North Ayrshire Health and Social Care Partnership (The Partnership) is committed to ensuring people have their voice heard, are able to express their needs, make informed decisions and have their rights and interests protected. The Partnership recognises the importance of advocacy in: Empowering people to express their own needs and make their own decisions Enabling people to access information, explore options and make informed decisions Providing a voice for people who are unable to speak or who do not use speech as a form of communication Ensuring a safeguard for vulnerable people This has resulted in advocacy being available to adults with learning disabilities, adults affected by mental ill health, adults with addictions issues, adults with physical disabilities, adults with brain injury, children and young people. This new strategy will take us from 2022 to 2029 and has been influenced by a number of policy drivers. Primarily among those is the North Ayrshire Health and Social Care Partnership Strategic Commissioning Plan ‘Caring Together’ 2022-30. Described in the previous section, Caring Together sets out the partnership’s ambitions to improve the health and wellbeing of all people living in North Ayrshire. It underlines the importance of working with people as they go through their care journey and ensures that people using our services have their voices heard and needs respected. In turn, the NAHSCP Commissioning Strategy is underpinned by several other policy drivers: National Drivers The Promise The Partnership will work closely with our national and local partners as we help to deliver ‘The Promise’ for Children, Young People and Families. The promise is responsible for driving the work of change demanded by the findings of the Independent Care Review. Made on 5th February 2020, the Promise seeks to improve the experience of all children, young people and their families if they require additional support. The Promise aims to create a more compassionate care service for families and young people. The Promise has five key foundations that all change must be delivered against. Among these is the foundation of ‘Voice’, in which all children must be listened to and respected and appropriately involved in decisions about their care. Specifically referencing advocacy, 'All care experienced children and their families will have access to independent advocacy at all stages of their experience
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Independent Advocacy Strategic Plan 2022-2026 v7 10 3rd October 2023 of care.’ 'Care experienced children and young people will be able to easily access child centred legal advice and representation.' Advocacy provision will follow the principles set out in the promise. Mental Health Strategy (2017-27) In a strategic response to the National Mental Health Strategy, we undertook the Ayrshire Mental Health Conversation in 2019. This Ayrshire wide engagement and consultation identified a number of key priorities to support people affected by poor mental health or complex mental health conditions. Highlighted in the key priorities was: o The need to promote community-based support, including self-management and peer support o Improving access to services for people with mental health problems and distress, and o Bringing the voice of those with lived experience into the heart of care planning Advocacy service must play a strong part in supporting local people with mental health concerns have their voices heard. Learning Disability Strategy The work of North Ayrshire Learning Disability Services is informed by a variety of national strategies, including the aforementioned Mental Health Strategy. In addition ‘The Keys to Life: Implementation Framework and Priorities’ highlighted ‘Choice and Control’ as one of its themes for action, and highlighted the need for access to advocacy organisations to support people with learning disabilities to gain greater choice and control over their lives. This theme was carried forward into the ‘Towards Transformation’ plan; a bridging strategy published by Scottish Government as a part response to the pandemic experience of people with autism and /or learning disabilities. Supporting self-advocacy organisations, and ensuring parents have access to advocacy to enable them to be equal participants in their child’s education, were 2 aspects of advocacy related action highlighted within the latter document. Medication Assisted Treatment (MAT) Standards: access, choice, support Services have processes in place to inform and support individuals to access Advocacy services: 1. All services will inform people of independent advocacy services that are available and feel able to use them to discuss the issues that matter to them.
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Independent Advocacy Strategic Plan 2022-2026 v7 11 3rd October 2023 2. All service users will have support if they choose from advocacy or a family member or nominated person(s) and are encouraged to do so. 3. All services will have clear pathways that enable family members or nominated person(s) to use independent advocacy to raise concerns and receive support 4. Service staff are clear on their responsibility to provide accessible, accurate information on and proactively promote independent advocacy. 5. Services will have policies and procedures to ensure people are informed of independent advocacy services that empower them to access their rights and enable informed decision making; 6. Services will have a documented system in place that ensures people are informed of independent advocacy and that their family member or nominated person(s) can be included from the start in care planning 7. All people should be informed of independent advocacy services should they wish support in their journey throughout services. 8. Staff should have training to understand the role of independent rights-based advocacy and have access to rights-based and health inequalities training. North Ayrshire Local Policy Drivers North Ayrshire Local Outcome Improvement Plan 2022-30 Published by the North Ayrshire Community Planning Partnership (CPP) in April 2022, the North Ayrshire Local Outcome Improvement Plan (LOIP) sets out the strategic vision and direction for improving the lives of the local people. The LOIP has identified three areas for focus: o WELLBEING – providing a focus on the health and wellbeing of local people, with an aim of reducing local health inequalities through targeted support to improve individual, family and community health and wellbeing. o WORK – focussing on the local economy and improving the local skills base to help address the root causes of poverty and deprivation. o WORLD – focussing on efforts to address climate change, reduce carbon emissions and improve the local natural environment. With a key focus on health and wellbeing and on addressing social, economic and health inequalities, the LOIP 2022-30 is in close alignment with our own strategic objectives. Its delivery will help develop a local environment that provides greater opportunities to local people, and supports them to achieve their identified ambitions.
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Independent Advocacy Strategic Plan 2022-2026 v7 12 3rd October 2023 North Ayrshire Council Plan (2019-24) Aligning closely to the LOIP, The North Ayrshire Council Plan (2019-24) sets out the Council’s priority areas to achieve the vision of a “North Ayrshire that is ‘Fair For All”. The Community Wealth Building strategy is a key driver behind the Council’s three priorities which are: o Aspiring Communities – A society where everyone has the same life chances to grow, prosper and have fulfilling and healthy lives. o Inspiring Place – An enterprising, vibrant and sustainable environment that is appealing to investors, attractive for visitors and a place where our residents are proud to live and work. o A Council for the Future – Ensuring the Council is forward thinking and motivated to improve the services we provide for our communities through innovation. Being ‘fair for all’, actions taken by North Ayrshire Council will seek to reduce the economic and social inequalities in North Ayrshire, support all residents to have equal access to services and have the opportunity to be involved in local decision making processes.
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Independent Advocacy Strategic Plan 2022-2026 v7 13 3rd October 2023 3. What is independent advocacy and why do we need it? There are three parts to this question. The first is to define what we mean by ‘advocacy’ the second is about what makes advocacy independent and the third is why we need it. There are many different ways to describe advocacy. Most definitions include statements regarding ensuring people have their voice heard, are able to express their needs, make informed decisions and have their rights and interests protected. Wherever possible, advocacy supports people to gain increased skills and confidence so that, over time, they will feel able to advocate for themselves when the need arises. Advocacy enables people to be involved in decisions which affect their lives. It helps them to express their views and wishes, to access information, to make informed choices and to have control over as many aspects of their lives as possible. Independent Advocacy - Guide for Commissioners Scottish Government (2013) We believe that everyone who needs independent advocacy should have access to it. Independent advocacy must be of the highest possible standard. The Scottish Independent Advocacy Alliance (2019) Vision Statement The Partnership recognises the benefits of advocacy in: Empowering people to express their own needs and make their own decisions Enabling people to access information, explore options and make informed decisions Providing a voice for people who are unable to speak up for themselves Ensuring a safeguard for vulnerable people Advocacy can be carried out by the person themselves (self-advocacy) or with support from a third party. An advocate supports a person to get the information they need to make real choices and if needed, ensure these choices are communicated to others. In summary, advocacy helps amplify people’s views, concerns, rights and aspirations.
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Independent Advocacy Strategic Plan 2022-2026 v7 14 3rd October 2023 Family members, carers and friends, as well as health and social care staff often act as advocates for people. However, it is sometimes difficult for them to put forward the person’s views due to their own opinions of what is in the person’s best interests or their responsibilities to the organisation they work for. There are also situations where a person needs advocacy support and has no-one else in their life who can act as an advocate for them. Having an advocate is particularly important for people who may lack capacity, face prejudice or who may be more vulnerable than other members of our communities. It is in those situations that Independent Advocacy is appropriate to ensure that the person’s views are taken into account in decision making processes, free from conflicts of interests with the views of others. Advocacy can take place in a group setting as well as on a one-to-one basis. This can be where an advocate supports a group of people with the same issue or to provide a setting where people can develop their self-advocacy skills. There is no one way of describing when advocacy is independent. The legislation and guidance listed in Section 2 define ‘independent’ in a range of different ways. The Scottish Independent Advocacy Alliance, who publish good practice guidance for independent advocacy in Scotland, for example, expects its members to demonstrate structural, financial and psychological independence. This implies that advocacy and advocacy related activities are the only function of an independent advocacy organisation (structural independence), that the organisation will strive to generate funds from a range of sources (financial independence) and that their first accountability will be to the people they advocate for (psychological independence). Each piece of legislation has its own definition of independence, some of which use a wider level of compliance, along with differing responsibilities being delegated to local health and social care partnerships in regard to the availability of independent advocacy services that meet the need within their area. The purpose of this plan is to take account of the responsibilities delegated to NAHSCP within the legislation and guidance documents listed in Section 2 in order to assure the provision of Independent Advocacy for people in North Ayrshire who need it.
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Independent Advocacy Strategic Plan 2022-2026 v7 15 3rd October 2023 4. Types of Advocacy There are many types of advocacy, both voluntary and paid, to support people in a range of situations. Other than self and citizen advocacy, which are, by their nature, always independent, each type may be independent or non-independent. Some or all types may be needed to address the advocacy need within an area. The main types of advocacy are: Self-advocacy Self-advocacy is the ability of a person to express their own views and concerns about the things that are important to them. Self- advocacy means people are able to ask for what they need and want, and they are able to tell people about their thoughts and how they feel. Self-advocacy means people are able to communicate their choices and decisions about their life. Citizen advocacy Citizen advocacy is one to one, medium to long term support for people who cannot speak up for themselves. Citizen advocacy is based on a relationship of trust and understanding between two people – the advocate and the person seeking support. Citizen advocates are often supported by independent advocacy organisations. These organisations ensure people who are advocates use clear principles and standards and receive on-going training and support. Citizen advocates are unpaid. Collective advocacy Collective advocacy happens when a group of people with similar experiences or challenges support each other about an issue that affects them all. The group has a unified voice that is often difficult to ignore. This group support can often increase an individual’s self-confidence and self-worth and can help to reduce social isolation and stigma. Group advocacy Advocacy can occur in group settings to support participants to gain or develop their ability to advocate for themselves. This type of advocacy can be carried out in a range of ways such as a series of workshops or using expressive arts based activities to provide opportunities for people to share their views and opinions with others.
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Independent Advocacy Strategic Plan 2022-2026 v7 16 3rd October 2023 Peer advocacy Peer advocates share their own significant lived experience, e.g. age, gender, ethnicity, diagnosis, service experience or issues, with an individual or a group. They offer understanding, empathy as well as information and assistance to the people they support. Peer advocacy helps to increase people’s self-awareness, confidence and assertiveness so that they can begin to speak out for themselves. Professional advocacy Professional advocacy is also known as one-to-one or individual advocacy. It is provided by paid and unpaid advocates, mainly through an independent advocacy organisation. The advocate supports the person to express their views and make choices and decisions on issues that affect them. This support (providing information, not advice) can be short or longer term, depending on the complexity of the issues. Non-instructed advocacy Non-instructed advocacy happens when a person who needs an independent advocate cannot express their wishes to the advocate. This can happen where the person has complex communication issues or has a long term illness or disability that prevents them from being able to state their needs and wishes. The advocate will take time to get to know the person and explore the use of alternative methods of communication, e.g. people’s behaviour and actions, to enable the person to express their views. The advocate will also get to know the person’s family, carer and friends. This will help to build a picture of what is important to the person to support decision making and ensure the person’s rights are upheld.
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Independent Advocacy Strategic Plan 2022-2026 v7 17 3rd October 2023 5. Advocacy services in North Ayrshire AIMS Advocacy AIMS Advocacy provide independent advocacy in North Ayrshire for people over 16 years who require independent advocacy and who are eligible to receive a community care service. This includes people who experience mental ill health or disabilities. AIMS Advocacy provides professional advocacy services to individuals and also supports group advocacy when appropriate. Advocacy support is provided in the community as well as hospital settings. Barnardo’s Hear 4 U Barnardo’s Hear 4 U is an independent advocacy service based in Kilwinning, although operational across North Ayrshire. The service provides community-based advocacy to children and young people ensuring that they are aware of their rights as defined within the United Nations Convention on the Rights of the Child (UNCRC). Hear 4u is funded by North Ayrshire Health & Social Care Partnership. Priority is given to children and young people who: • Are involved in the child protection process and/or children’s hearing system. • Are Care Experienced in Foster Care, Residential Care and/or Kinship Care. • Are on the periphery of Secure Care • Were previously looked after and accommodated • Have additional support needs Woodland View Woodland View provides our main inpatient facility within the Ayrshire Central Hospital Site. As lead partnership for mental health services, Woodland View sits within the North Ayrshire Health & Social Care Partnership. Should independent advocacy be required for inpatients within woodland view the commissioned service from the individuals respective Health & Social Care Partnership should be approached. For anyone out of area (i.e. out with Ayrshire & Arran), the commissioned services for North Ayrshire may provide support on an interim basis, until appropriate transfer is completed.
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Independent Advocacy Strategic Plan 2022-2026 v7 18 3rd October 2023 Foxgrove The new National Secure Adolescent Inpatient Service for Scotland (NSAIS) will sit within the Ayrshire Central Hospital campus in Irvine, North Ayrshire. Foxgrove will provide secure adolescent inpatient service for young people from across Scotland. As it is known that young people will likely be from out of area, separate specialist independent advocacy support will be commissioned.
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Independent Advocacy Strategic Plan 2022-2026 v7 19 3rd October 2023 6. Enhancing our advocacy approach North Ayrshire Health and Social Care Partnership is committed to ensuring that advocacy continues to be developed across North Ayrshire in a planned, and collaborative way. This includes providing services for vulnerable people to have their voice heard, express their needs, make informed decisions and have their rights and interests protected where there is no one else and/or it is not appropriate for others to do this on their behalf. There are a number of key pieces of legislation that outline a requirement for independent advocacy and therefore the Partnership prioritises the following groups: Older People (including people living with dementia) People with a mental illness People with learning disabilities People with drug and/or alcohol problems Disabled Children and young people Children and young people (under the age of 16) who have a mental disorder Young people with forensic level mental health problems (as part of the National Secure Adolescent Inpatient Service) Adult Support and Protection Adults with Incapacity Child Protection There are also a number of other groups that would benefit further development of independent advocacy. We will continue to consider the best ways to support these groups by working with individuals and organisations already supporting them, including: Carers, including young carers People with a brain injury/physical disability (and have communication support needs) While we acknowledge that we have made good progress with advocacy over the last few years, we recognise that our approach to advocacy will continue to evolve as the Partnership develops. People can input into the direction of services via the Care
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Independent Advocacy Strategic Plan 2022-2026 v7 20 3rd October 2023 Improvement Network. Full details of our ambitions for Community Engagement are outlined in our Participation and Engagement Strategy. 7. Evaluation and review The Pan-Ayrshire Mental Health Programme Board will be responsible for the direction, implementation and review of our Advocacy Strategy. This group provides a basis for stakeholder representation within the Partnership and makes recommendations to North Ayrshire Integration Joint Board (responsible for the direction, effectiveness and efficiency of North Ayrshire Health and Social Care Partnership) for implementation We believe that robust monitoring and evaluation will improve the quality of the services provided and drive-up standards in promoting greater accountability. To embed effective monitoring and evaluation into practice we will: o Establish an effective advocacy monitoring framework, built around the Principles and Standards of Independent Advocacy, within the first year of this plan. o Undertake an annual internal evaluation of local advocacy services, using the monitoring framework as a basis for evaluation work The strategy and monitoring framework will be reviewed annually. This evaluation will help us ensure the on-going effectiveness of advocacy across North Ayrshire and highlight any gaps or identify future needs. An annual advocacy report will be produced and distributed across key governance groups, including the Partnership’s Strategic Planning Group (SPG). Any future commissioning needs, based on identified gaps will be considered by the SPG and recommendations made to Integration Joint Board. Key highlights from the annual report will be published in the Partnership’s Annual Performance Report.
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Independent Advocacy Strategic Plan 2022-2026 v7 21 3rd October 2023 Appendix Appendix A: Principles and Underpinning Standards for Independent Advocacy (Scottish Independent Advocacy Alliance, 2019) Principles: 1) Independent advocacy is loyal to the people it supports and stands by their views and wishes. 2) Independent advocacy ensures people’s voices are listened to and their views taken into account. 3) Independent advocacy stands up to injustice, discrimination and disempowerment. Standards: 1) Independent advocacy is loyal to the people it supports and stands by their views and wishes. a) Independent advocacy follows the agenda of the people supported regardless of the views, interests and agendas of others. b) Independent advocacy must be able to evidence and demonstrate its structural, financial and psychological independence from others. c) Independent advocacy provides no other services, has no other interests, ties or links other than the delivery, promotion, support and defence of independent advocacy. 2) Independent advocacy ensures people’s voices are listened to and their views taken into account. a) Independent advocacy recognises and safeguards everyone’s right to be heard. b) Independent advocacy reduces the barriers people face in having their voice heard because of communication, or capacity, or the political, social, economic and personal interests of others. 3) Independent advocacy stands up to injustice, discrimination and disempowerment. a) Independent advocacy recognises power imbalances or barriers people face and takes steps to address these. b) Independent advocacy enables people to have more agency, greater control and influence.
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Independent Advocacy Strategic Plan 2022-2026 v7 22 3rd October 2023 c) Independent advocacy challenges discrimination and promotes equality and human rights.