Independent Advocacy Supplier Engagement Day Wednesday 2 September

Independent Advocacy – Supplier Engagement Day Wednesday 2 September, 2015. 1 -5 pm Grand Jury Room, The Courts Carlisle. Serving the people of Cumbria

Introduction • • • Background and Scope Overview of Trends. Procurement timetable New legislation Key Issues Questions and Answers. Serving the people of Cumbria

What is Advocacy • “Advocacy is taking action to help people say what they want, secure their rights, represent their interests, and obtain the services they need. Advocates and advocacy providers work in partnership with the people they support and take their side. Advocacy promotes social inclusion, equality and social justice. ” • Definition from the Advocacy Code of Practice 2014 Serving the people of Cumbria

Follow Up • A website will display the information from today/ also in tender information. http: //www. cumbria. gov. uk/scprocurement. • Main contacts: • Donna Story- Adults Advocacy. • Paul Dobie- Children’s Advocacy • Neil Spence- Children’s Advocacy Serving the people of Cumbria

Panel Available today • Peter Woodhouse- Senior Manager, Service Development. (Adults Advocacy) • Donna Story-Service Development Manager. (Adults Advocacy) • Neil Spence- Audit and Practice Development Officer, (Children’s Services advocacy) • Mike Farren, Senior Procurement And Contracts Manager, Cumbria County Council. • Paul O’Donnell, Professional Advisor Mental Health Legislation. (IMCA) • Dave Eldon, Head of Mental Health Legislation and Legal Services Manager, Cumbria Partnership Foundation Trust, (IMHA) Serving the people of Cumbria

Quick Demographics • Older population, and a super –ageing population. • Second largest county in England, population approx. 500, 000. • 48% of the land mass in the North West • More information from the Cumbria Intelligence Observatory. Serving the people of Cumbria

Geographical Challenges. Serving the people of Cumbria

Range of Statutory Advocacy Provision. • We have new statutory advocacy duties under the Care Act from April 2015 • We have statutory advocacy under the Mental Capacity Act for people who lack capacity (IMCA) • We have statutory advocacy under the Mental Health Act for people who are detained in hospitals or on a Community Treatment Order (IMHA) • We have statutory advocacy for NHS complaints. • We have Healthwatch-the health and social care consumer champion. Serving the people of Cumbria

Current Adults Advocacy Provision in Cumbria (Five Separate Contracts) Type of Advocacy/Service Statutory Y/N Relevant Legislation Current Provider Care Act Advocacy (evolving from previous nonstatutory provision) Statutory Care Act 2014. People First Best Life Independent Mental Capacity Advocacy (IMCA ) Statutory Mental Capacity Act 2005 & Do. LS People First Independent Mental Health Act Advocacy (IMHA) Independent Advocacy Service (IAS) - NHS Complaints Statutory Mental Health Act 1983 Health and Social Care Act 2012. Carlisle & Eden MIND People First Health Watch Statutory Health and Social Care Act 2012 People First Statutory Serving the people of Cumbria

Adults Advocacy Procurement Structure in Cumbria from 1/4/16 - 1/4/20 - Block Contracts Procurement Arrangement Type Advocacy/Service of Statutory Y/N Lot 1 Care Act Advocacy NHS Complaints Healthwatch IMCA Lot 2. Independent Mental Health Statutory Act Advocacy (IMHA Statutory Serving the people of Cumbria

Indicative Contract Values - Adults Lot 1 Indicative Value p. a. Care Act Advocacy 220 K IMCA 88 K Healthwatch 251 K NHS Complaints 134 K Lot 2 Indicative Value p. a. IMHA 81 K Serving the people of Cumbria

Procurement Timetable. • • • Key decision- future procurement-. June 2015. Final formal Supplier Engagement Day – 2 September, 2015. Issue tender documents -14 September, 2015. Deadline for receipt of clarifications-26 October 2015. Deadline for receipt of tenders-2 November, 2015. Evaluation of tenders- 3 November- 23 November, 2015. Intention to award contract decision- 24 November , 2015. Standstill period ends- 4 December , 2015 Final award letters- 7 December, 2015. Contract implementation- 7 December- 31 March 2016. N. B. - All timings are indicative and subject to change Serving the people of Cumbria

IMCA Trend Information. October 2014 -June 2015 § 73 referrals- 1 st April- 30 June 2015 § • Council largest source of referrals. § Change of • accomodation largest proportion of decision type. Serving the people of Cumbria

Referrals per District-IMCA Serving the people of Cumbria

Healthwatch Functions Serving the people of Cumbria

NHS Complaints Advocacy. • Biggest source of referral is self -referral. • Each referral may include multiple issues across different NHS services. Serving the people of Cumbria

NHS Complaints: Where are Our Customers. Serving the people of Cumbria

NHS Complaints: Type of Issue (q. 2, 2015) Top Issues (April-June 2015) Failure to Diagnose Treatment in hospital Attitude of Staff In patient care Appointments - Delays/ Cancellations Medication related issues Number 31 29 20 19 16 16 Serving the people of Cumbria

Care Act Advocacy • The Care Act requires local authorities to involve people in assessments, care and support planning, and reviews. • In order to facilitate the involvement and engagement of people who would otherwise have difficulty, it introduces a new requirement to arrange independent advocacy for people: – who have substantial difficulty in being involved in these processes and, – where there is no appropriate individual (s) available to help facilitate this involvement. Serving the people of Cumbria

• • • Relevant Care Act Processes- a Reminder a needs assessment a carer’s assessment the preparation of a care or care & support plan • a review of care and support plan or support plan • a child’s needs assessment (in transition) • a child’s carer’s assessment • a young carer’s assessment • adults who are subject to a safeguarding enquiry or safeguarding adults review (SAR) • appeals against decisions (from 2016) Serving the people of Cumbria

Additional Exceptions • Advocacy Referral even if there is an appropriate individual if: – Likely to be a placement in NHS provision in either hospital (4 weeks or more ) or a Care Home (8 weeks or more) and local authority believes it is in the best interests of the person to arrange an advocate – Disagreement between the LA and the appropriate individual on who should best represent the person. Serving the people of Cumbria

The Role of the Care Act Advocate • Care Act advocacy referral is practitioner –led. • Role for advocate is to understand Care Act processes; help people weigh up options and make decisions. • Meet privately with the Service User, with SU consent consult with others, as needed challenge the local authority. • Same person can act as the Care Act Advocate as acts as the IMCA Serving the people of Cumbria

Judging Substantial Difficulty- Serving the people of Cumbria

The Link with Information and Advice- a Reminder • Care Act advocacy entitlement starts at first point of contact with the local authority- or even before for those people who need advocacy to access information and advice. • How do contact centre staff identify if someone has substantial difficulty in engaging? Serving the people of Cumbria

Care Act Advocacy. • Fully replacing the generic non-statutory offer in Cumbria from 1 October -contract variation accepted by People First. • Expect rising demand across all catagories of Care Act processes, based on national documentation. • Variable input envisaged for different types of Care Act processes- please refer to SCIE guide for Care Act Advocacy/associated Impact assessment for the Care Act. • Current development activity. Serving the people of Cumbria

Current Referrals Serving the people of Cumbria

IMHA Trend Information- Numbers of Qualifying Patients in receipt of IMHA. . . Serving the people of Cumbria

IMHA Issues Advocated for: Quarterly Period Number April- June 2015 429 Jan- March 2015 439 October- Dec 2014 440 July- September 2014 443 Serving the people of Cumbria

IMHA referrals mirror Mental Health Act Trend Information Serving the people of Cumbria

Children’s Services Advocacy & IMHA/IMCA • Cumbria County Council has a statutory duty to provide looked after children, care leavers and children in need access to advocacy when making, or intending to make a complaint under section 26 A of the Children Act 1989. Statutory guidance introduced by the Adoption and Children Act 2002 and the Advocacy Service and Representations Procedure (children) (Amendment) Regulations 2004 further established a statutory obligation for local authorities to provide advocacy for children making formal complaints under section 24 D and section 26 of the Children Act 1989. • Issue based Advocacy Issue Service. Eligibility is for all children and young people open to Children’s Services. This includes Children Looked After up to the age of 25. • The Tender process for Children’s Services will take place at the same time as IMHA & IMCA. Serving the people of Cumbria

Children’s Services Advocacy & IMHA/IMCA • Over 250 children and young people used the Children’s Services Advocacy Service last year. • Approximately 700 Children Looked After. Research indicates that they have higher levels of mental health issues. They mental health needs are often not met while under the age of 18. • Approximately Children Looked after 180 are placed out of county. • The new tender for Children’s Services Advocacy asks providers to demonstrate how they will ensure transition into Adult Services Serving the people of Cumbria

Children’s Services Advocacy & IMHA Serving the people of Cumbria

Questions and Answers Serving the people of Cumbria