It is important that service users in a care setting are aware of their rights and can realise them.
Many service users in a care setting, especially those that are older or vulnerable, will require the assistance of an advocate to make their voice heard and to ensure they can access the care and support services they require. Care providers should ensure that service users have appropriate access to advocacy services. This is not only to ensure people’s rights are respected, it will also assist a Provider to demonstrate their compliance with Regulation 9 (person centred care) to the Care Quality Commission (CQC). The use of Advocacy services can also strengthen adult safeguarding procedures within a service and promotes the independence and dignity of service users.
Regulation 9 requires the provision of person- centred care. This includes the provision of care which meets an individual’s needs and reflects their preferences.
Provider obligations under regulation 9 include:
· To carry out, collaboratively with the relevant person, an assessment of the needs and preferences for care and treatment of the service user;
· Designing care or treatment with a view to achieving service users’ preferences and ensuring their needs are met;
· Enabling and supporting relevant persons to understand the care or treatment choices available to the service user and to discuss, with a competent health care professional or other competent person, the balance of risks and benefits involved in any particular course of treatment;
· Enabling and supporting relevant persons to make, or participate in making, decisions relating to the service user’s care or treatment to the maximum extent possible;
· Involving relevant persons in decisions relating to the way in which the regulated activity is carried on in so far as it relates to the service user’s care or treatment; and
· Providing relevant persons with the information they would reasonably need for the above purposes.
It can easily be seen how advocacy services would help to facilitate compliance with the obligations above. An advocate should be someone who can speak up for service users and support them to express their views and where possible to help them make decisions about their care and treatment.
In some circumstances, family members and care staff will perform an advocacy role. However, this will not always be appropriate and a service must recognise the need for independent advocacy services and promote a care environment where independent advocacy services are involved appropriately. There should be clear procedures for the involvement of independent advocates which should be documented and clearly displayed and all care staff should be familiar with them.
Services should have up to date records of local independent advocacy services. All service users should be made aware of the arrangements for accessing advocacy support and be supported to do so where necessary. Advocacy services should be well advertised throughout the home for example with posters and leaflets. Consideration of whether advocacy support is required should form part of regular care plan reviews.
Good practice around advocacy and strong links with independent advocacy services will help to evidence to the Care Quality Commission a service that is effective, responsive and well-led.