With the proposed changes heading our way with the Liberty Protection Safeguards, I’ve been thinking about the implications on qualifications and the likely impact on people’s training needs.
10 years ago I worked with a fabulous group of people to create the first ever suite of National Advocacy Qualifications. When I look back, I must admit I am proud of what we did. It was an important development in raising standards, securing respect and in setting benchmarks in what was expected of an Independent Advocate.
Anyone around at the time will know that the cost of raising standards and professionalising the sector has undoubtedly been the erosion of an active and vibrant grass roots movement. The criticism then was advocacy was too unpredictable, too maverick, too inconsistent. The criticism now is that we are too safe, too complicit, too rigid.
But I will leave that for another day. Instead I want to talk about the qualifications now and what employers and advocates need in 2019. 10 years after writing the qualifications, I ask myself, if we were to write the qualifications now, would we develop something similar? If I am being honest, I don’t think we would.
The problem, as I see it, is that advocacy in any guise is still advocacy. If you think about the skills required to be an IMCA or an IMHA or a NHS complaints advocate – it’s the same skillset. But at the moment we have different routes in becoming an IMCA and an IMHA – and there isn’t even a unit which supports complaints advocacy. (For those who are interested in why, this was at the time ICAS was commissioned by central government from 3 national providers who, to be blunt took a protectionist approach and so didn’t support a specialist unit that could be delivered or accessed independently by others).
To continue with the history lesson, this was at a time when IMHA was introduced with mental health advocacy organisations already in place to simply take on the role of the IMHA. IMCA was a brand new development that many services were terrified of because it did this thing called ‘non instructed advocacy’. Care Act Advocacy and DoLS were mere twinkles in City and Guild’s eye.
At the time we felt developing a suite of qualifications which provided a ‘core’ grounding in basic advocacy essentials supplemented by ‘specialist’ units would be a sensible way of training people in their respective roles. I remember when we asked people what specialist units we should develop a total of 29 ‘specialisms’ were identified! These extended to deaf advocacy, BME advocacy, older people’s advocacy, advocacy with learning disabled people… and just about every other interest you can think of. We had to look at the volume of likely future uptake and also the coverage needed to train the current workforce. From the multitude of specialisms we eventually agreed upon the 10 units that make up 301-310.
In 2013, the Welsh Government funded a further review and we saw the introduction of two new knowledge-based units designed to help advocates understand mental health and mental capacity legislation: the idea being that an IMHA needs to know about the Mental Capacity Act and vice versa. I thought they were a great idea at the time.
Finally in 2014 we added another unit in preparation for the shiny new Care Act Advocacy role.
Today a total number of 13 units are available – with a diverse choice of 6 ‘specialisms’.
Whilst choice is always good, this is also now giving us a problem. Advocacy is increasingly being commissioned across the statutory spectrum. No more is the sector an advocacy smorgasbord of different specialist advocacy services delivery different contracts. Instead, commissioners are being more savvy with funding arrangements bringing together IMCA, IMHA, DoLS, IHCA, Care Act etc under single delivery contracts.
Advocacy services are responding by offering ‘multi skilled’ or ‘multi trained’ advocates who can seamlessly move between roles, working with people in different settings. This also reduces the need for some people to require more than one advocacy because their situation bridges roles. This makes sense for commissioning, the professionals or public who want one point of entry – and ultimately for the person receiving advocacy.
So let’s assume it’s beneficial for one advocate to stay with a person through a multitude of decisions, which in real terms means one advocate helping with care plans (Care Act) AND helping with a long term change of accommodation (IMCA) AND helping through a DoLS authorisation (IMCA DoLS).
The problem is we then require a super-one-stop advocate to complete those 3 different specialisms. For the qualification this has two significant consequences:
Cost. Its expensive paying out to train someone in three + qualification units
Time. It’s a significant commitment completing three + qualification units (especially when the advocacy skill set underpinning them is essentially the same). Currently there is much duplication across the units, because they need to fully support a learner’s knowledge in isolation from the other units – all specialist units require advocates to evidence their supervision, record keeping, report writing, their skills in promoting choice and self advocacy. This means the learner has to show the same competency – just in different settings – over and over and over again. Genuinely this could be considered an administrative time wasting exercise.
So should we be thinking about revamping the qualification? Could we have just one course which supports all advocates regardless of which statutory role they provide?
I think yes.
Advocates should be competent in all settings. People’s lives don’t come in neatly packaged boxes. If you are an IMCA – you need to know about the Care Act because the people you support will be affected by broader planning processes which must follow Care Act rules. What’s the point in representing a person through a placement move if you don’t know anything about what makes an eligible need an eligible need?
Similarly, if you are working as an IMHA you need to know about the Mental Capacity Act and how this interacts with the Mental Health Act. If you’re a Children’s advocate you’ll need to know about the Care Act (as this overlaps with the Children and Families Act). And everyone needs to know about DoLS – or the LPS when they come in. Yes, even children’s advocates need to know this as the LPS are going to affect 16 and 17 yr olds.
So if we need super advocates, with a working knowledge of key pieces of legislation, I think it makes sense to make it easy (and as cheap as possible) to offer this broad syllabus – rather than the complicated route we currently have.