Welcome to the Blackpool Advocacy Hub
The statutory service we offer are…
- Independent Mental Health Advocacy (IMHA)
- Independent Mental Capacity Advocacy (IMCA)
- Care Act Advocacy
- Health Complaints
- Relevant Person Representative Advocacy (RPR)
- Children and Young People’s Advocacy (CYP)
Advocacy Referal Forms
Please click on the service below you would like to make a referral to and once completed please email back to email@example.com
Once we have received the referral we aim to be in contact with you within 48 hours.
Our Advocacy Services
What is the Care Act?
The Care Act 2014 is the most significant change in social care law for 60 years. It applies to England and replaces a host of out-of-date and often confusing care laws.
The legislation sets out how people’s care and support needs should be met and introduces the right to an assessment for anyone, including carers and self-funders, in need of support.
Advocacy and the duty to involve
Where the local authority considers that a person has substantial difficulty in engaging with the assessment process, then they must consider whether there is anyone appropriate who can support the person be fully involved. This might for example be a carer (who is not professionally engaged or remunerated), a family member or friend. If there is no one appropriate, then the local authority must arrange for an independent advocate. The advocate must support and represent the person in the assessment, in the care and support planning, and the review. This applies to the following:
- a needs assessment under section 9 of the Care Act
- a carer’s assessment under section 10
- the preparation of a care and support plan or support plan under section 25
- a review of care and support plan or support plan under section 27
- a child’s needs assessment under section 58
- a child’s carer’s assessment under section 60 (therefore some people below 16 years of age)
- a young carer’s assessment under section 63
- safeguarding under section 68
The role of the independent advocate
It is intended that advocates will decide the best way of supporting and representing the person they are advocating for, always with regard to the wellbeing and interest (including their views, beliefs and wishes) of the person concerned. This may involve creative approaches, for example, supporting someone to show film to help explain their needs, wishes or preferences
The Advocate will:
- assist the person to understand the assessment, care and support planning and review and safeguarding processes
- assist the person to communicate their views, wishes and feelings to the staff who are carrying out an assessment or developing a care or support plan or reviewing an existing plan or to communicate their views, wishes and feelings to the staff who are carrying out safeguarding enquiries or reviews
- assist a person to understand how their needs can be met by the local authority or otherwise
- assist the person to make decisions about their care and support arrangements
- assist the person to understand their rights under the Care Act – for an assessment which considers their wishes and feelings and which considers the views of other people
- assist a person to challenge a decision or process made by the local authority; and where a person cannot challenge the decision even with assistance, then to challenge it on their behalf
A Children & Young Person’s Advocate works with you when Children’s Social Care is involved in your life.
Why was the IMHA service introduced?
IMHA services provide an additional safeguard for patients who are subject to the Act. IMHAs are specialist advocates who are trained specifically to work within the framework of the Act and enable patients to participate in decision-making, for example, by encouraging patients to express their views and supporting them to communicate their views. They are commissioned by the relevant local authority as identified under the Act.1 IMHAs should be independent of any person who has been professionally involved in the patient’s medical treatment.
Who is the IMHA Service for?
Patients are eligible for support from an IMHA, irrespective of their age, if they are:
- detained under the Mental Health Act 1983
- liable to be detained under the Act, even if not actually detained, including those who are currently on leave of absence from hospital or absent without leave, or those for whom an application or court order for admission has been completed
- conditionally discharged restricted patients
- subject to guardianship, or
- patients subject to community treatment orders (CTOs).
The following do NOT meet the criteria for an IMHA
- on the basis of an emergency application (section 4) until the second medical recommendation is received
- under the ‘holding powers’ in section 5 or
- in a place of safety under section 135 or 136
The Role of an IMHA
The Act says that the support which IMHAs provide must include helping patients to obtain information about and understand the following:
- their rights under the Act
- the rights which other people (eg the nearest relative has in relation to them under the Act)
- the particular parts of the Act which apply to them (eg the basis on which they are detained) and which therefore make them eligible for advocacy
- any conditions or restrictions to which they are subject (eg as condition of leave of absence from hospital as a condition of a CTO or as a condition of conditional discharge)
- any medical treatment that they are receiving or might be given
- the reasons for that treatment (or proposed treatment), and
- the legal authority for providing that treatment, and the safeguards and other requirements of the Act which would apply to that treatment.
IMHAs can to help patients to exercise their rights, which can include representing them and speaking on their behalf, e.g. by accompanying them to review meetings or hospital managers’ hearings. IMHAs support patients in a range of other ways to ensure they can participate in the decisions that are made about their care and treatment, including by helping them to make applications to the Tribunal.
The involvement of an IMHA does not affect a patient’s right (nor the right of their nearest relative) to seek advice from a lawyer. Nor does it affect any entitlement to legal aid. IMHAs may, if appropriate, help the patient to exercise their rights by assisting patients to access legal advice and supporting patients at Tribunal hearings.
Who can make a referral to the IMHA Service?
- The person who is detained
- Responsible Clinician (RC)
- Approved Mental Health Professional (AMHP)
- Nearest Relative
- Other relevant professionals
Independent Mental Capacity Advocacy (IMCA) and Depravation of Liberty Safeguards (DoLS)
The purpose of the IMCA service is to:
help particularly vulnerable people who lack the capacity to make important decisions about serious medical treatment and changes of accommodation,
and who have no family or friends that it would be appropriate to consult about those decisions.
Who is the IMCA Service for?
If a person who lacks capacity and has nobody to represent them or no-one who it is appropriate to consult, an IMCA must be instructed in prescribed circumstances. These Are:
- providing, withholding or stopping serious medical treatment
- moving a person into long-term care in hospital or a care home (• moving the person to a different hospital or care home. The only exception to this can be in situations where an urgent decision is needed. Further details on the situations where there is a duty to instruct an IMCA
In other circumstances, an IMCA may be appointed for the person
- care reviews or
- adult protection cases.
What will an IMCA do?
- be independent of the person making the decision
- provide support for the person who lacks capacity
- represent the person without capacity in discussions to work out whether the proposed decision is in the person’s best interests
- provide information to help work out what is in the person’s best interests and
- raise questions or challenge decisions which appear not to be in the best interests of the person.
- Write a report for the Decision Maker
The information the IMCA provides must be taken into account by decision-makers whenever they are working out what is in a person’s best interests.
Who can make a referral to the IMCA Service?
Decision Makers (DM) are the people who refer to the IMCA Service
Who can be a decision-maker?
Under the Act, many different people may be required to make decisions or act on behalf of someone who lacks capacity to make decisions for themselves. it is the decision-maker’s responsibility to work out what would be in the best interests of the person who lacks capacity.
- For most day-to-day actions or decisions, the decision-maker will be the carer most directly involved with the person at the time.
- Where the decision involves the provision of medical treatment, the doctor or other member of healthcare staff responsible for carrying out the particular treatment or procedure is the decision-maker.
- Where nursing or paid care is provided, the nurse or paid carer will be the decision maker.
- If a Lasting Power of Attorney (or Enduring Power of Attorney) has been made and registered, or a deputy has been appointed under a court order, the attorney or deputy will be the decision-maker, for decisions within the scope of their authority.
Where possible, decision-makers should make decisions based on a full understanding of a person’s past and present wishes. The IMCA should provide the decision-maker with as much of this information as possible – and anything else they think is relevant. The report they give the decision-maker may include questions about the proposed action or may include suggested alternatives, if they think that these would be better suited to the person’s wishes and feelings.
What are the deprivation of liberty safeguards?
The deprivation of liberty safeguards provides legal protection for those vulnerable people who are, or may become, deprived of their liberty within the meaning of Article 5 of the ECHR in a hospital or care home, whether placed under public or private arrangements. They do not apply to people detained under the Mental Health Act 1983. The safeguards exist to provide a proper legal process and suitable protection in those circumstances where deprivation of liberty appears to be unavoidable, in a people own best interests.
The Role of an IMCA in DoLS
39a IMCA which is an urgent authorisation
If there is nobody appropriate to consult, other than people engaged in providing care or treatment for the relevant person in a professional capacity or for remuneration, the managing authority must notify the supervisory body when it submits the application for the deprivation of liberty authorisation. The supervisory body must then instruct an IMCA straight away to represent the person. It is particularly important that the IMCA is instructed quickly if an urgent authorisation has been given, so that they can make a meaningful input at a very early stage in the process.
39d IMCA offers support to either the Unpaid Relevant Person’s Representative (RPR) or the Relevant Person themselves to understand the DoLS process
Both the person who is deprived of liberty under a standard authorisation and their representative have a statutory right of access to an IMCA. It is the responsibility of the supervisory body to instruct an IMCA if the relevant person or their representative requests one. The intention is to provide extra support to the relevant person or a family member or friend acting as their representative if they need
it, and to help them make use of the review process or access the Court of Protection safeguards.
39c IMCA covers gaps where no Unpaid RPR can be identified
A person who is being deprived of their liberty will be in a particularly vulnerable position during any gaps in the appointment of the relevant person’s representative, since there may be nobody to represent their interests or to apply for a review on their behalf. In these circumstances, if there is nobody who can support and represent the person (other than a person engaged in providing care and treatment
for the relevant person in a professional capacity or for remuneration), the managing authority (The Care Home) must notify the supervisory body (Blackpool DoLS Team) , who must instruct an IMCA to represent the relevant person until a new representative is appointed.
What are Deprivation of Liberty Safeguards (DoLS)
Sometimes it is necessary to deprive someone of their liberty, but this must be done lawfully in the person’s best interests, and must be the least restrictive option for the person to keep them safe. An example of this is a person in a care home with advanced dementia who is under continuous supervision and control and not free to leave.
What is the Supervisory Body?
Blackpool Depravation of Liberty Safeguarding team which is run by Blackpool Council
What is the Managing Authority?
This is the care or nursing home where the relevant person has been placed
What is the role of a Relevant Person Representative (RPR)?
The role of the relevant person’s representative, once appointed, is:
- to maintain contact with the relevant person, and
- to represent and support the relevant person in all matters relating to the deprivation of liberty safeguards, including, if appropriate, triggering a review, using an organisation’s complaints procedure on the person’s behalf or making an application to the Court of Protection.
This is a crucial role in the deprivation of liberty process, providing the relevant person with representation and support that is independent of the commissioners and providers of the services they are receiving.
Who can be an RPR
When an authorisation is granted by the Blackpool Council DoLS Team, a best interests assessor will be able, in most cases, to recommend somebody to be the relevant person’s representative (i.e. a family member or friend).
If the best interest’s assessor is unable to recommend anyone, the Local Authority (also known as the “supervisory body”) must appoint someone to perform this role in a professional capacity for the duration of the authorisation. This is called a paid Relevant Person’s Representative.
Who makes referrals for Paid RPR’s
The supervisory body must appoint a relevant person’s representative for every person to whom they give a standard authorisation for deprivation of liberty. It is important that the representative is appointed at the time the authorisation is given or as soon as possible and practical thereafter.
What is the role of the Paid RPR?
- Ensure that relevant person, and others involve understand the role of the paid RPR
- Ask questions of all involved in the care of the person
- Read daily notes and Care plans
- Make suggestions to care team for alternative solutions
- Discuss the issues with managing authority Manager
- Follow the Managing authority’s complaints procedure
- Highlight concerns in RPR update to DoL’S team
- Request a Part 8 review if the person is objecting to the placement
- Make a referral to the Court of Protection for a 21a Challenge if the person is objecting to the placement
Blackpool Advocacy Hub advocates who take on the role of Paid RPR will work in line with the Acts best interests check list and will:
- Be Non-discriminatory – that is, your judgments should not be based on age, appearance or condition
- Consider all relevant circumstances– identifying those issues most relevant to the individual who lacks capacity in the context of the decision being mad
- Regaining capacity -if the individual is likely to regain capacity in the future, is it possible to delay the decision until then?
- Permitting and encouraging participation -irrespective of an individual’s disabilities every effort must be made to communicate with the individual concerned
- Special considerations for life-sustaining treatment – ensuring that where life sustaining treatment may be in an individual’s best interests the person making the decision must not be motivated to bring about the individual’s death
- The person’s wishes and feelings, beliefs and values so far as reasonably can be obtained consideration of the individual’s past and present wishes, feelings, beliefs and values should be made
- The views of other people the Act establishes the right for family members, partners, carers and other relevant people to be consulted about the decisions being made.
MOTIVATE 2 is a volunteer advocacy project that is empowering people with personal experience of mental health and/or complex needs and giving them the opportunity to use their knowledge to advocate for other people accessing the advocacy services. The volunteers within MOTIVATE 2 are able to draw from their own experiences to allow them to support the people who need advocacy support.