1. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Independent Advocacy – Supplier Engagement Day Wednesday 2 September, 2015. 1-5pm Grand Jury Room, The Courts Carlisle.

2. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Introduction Background and Scope Overview of Trends. Procurement timetable New legislation Key Issues Questions and Answers.

3. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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

4. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Follow Up A website will display the information from today/ also in tender information. http://www.cumbria.gov.uk/scprocurementhttp://www.cumbria.gov.uk/scprocurement. Main contacts: Donna Story- Adults Advocacy. Paul Dobie- Children’s Advocacy Neil Spence- Children’s Advocacy

5. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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)

6. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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.

7. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Geographical Challenges.

8. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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.

9. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Current Adults Advocacy Provision in Cumbria (Five Separate Contracts ) Type of Advocacy/ServiceStatutory Y/N Relevant LegislationCurrent Provider Care Act Advocacy (evolving from previous non- statutory provision) StatutoryCare Act 2014.People First Best Life Independent Mental Capacity Advocacy (IMCA ) StatutoryMental Capacity Act 2005 & DoLS People First Independent Mental Health Act Advocacy (IMHA) StatutoryMental Health Act 1983 Carlisle & Eden MIND Independent Advocacy Service (IAS) - NHS Complaints StatutoryHealth and Social Care Act 2012. People First Health WatchStatutoryHealth and Social Care Act 2012 People First

10. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Adults Advocacy Procurement Structure in Cumbria from 1/4/16- 1/4/20- Block Contracts Procurement Arrangement Type of Advocacy/ServiceStatutory Y/N Lot 1Care Act Advocacy NHS Complaints Healthwatch IMCA Statutory Lot 2.Independent Mental Health Act Advocacy (IMHA Statutory

11. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Indicative Contract Values - Adults Lot 1Indicative Value p.a. Care Act Advocacy220K IMCA88K Healthwatch251K NHS Complaints134K Lot 2Indicative Value p.a. IMHA81K

12. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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

13. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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.

14. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Referrals per District-IMCA

15. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Healthwatch Functions

16. Serving the people of Cumbria Do not use fonts other than Arial for your presentations NHS Complaints Advocacy. Biggest source of referral is self -referral. Each referral may include multiple issues across different NHS services.

17. Serving the people of Cumbria Do not use fonts other than Arial for your presentations NHS Complaints: Where are Our Customers.

18. Serving the people of Cumbria Do not use fonts other than Arial for your presentations NHS Complaints: Type of Issue (q.2, 2015) Top Issues (April-June 2015)Number Failure to Diagnose31 Treatment in hospital29 Attitude of Staff20 In patient care19 Appointments - Delays/ Cancellations16 Medication related issues16

19. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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.

20. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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)

21. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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.

22. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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

23. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Judging Substantial Difficulty-

24. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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?

25. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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.

26. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Current Referrals

27. Serving the people of Cumbria Do not use fonts other than Arial for your presentations IMHA Trend Information- Numbers of Qualifying Patients in receipt of IMHA...

28. Serving the people of Cumbria Do not use fonts other than Arial for your presentations IMHA Issues Advocated for: Quarterly PeriodNumber April- June 2015429 Jan- March 2015439 October- Dec 2014440 July- September 2014443

29. Serving the people of Cumbria Do not use fonts other than Arial for your presentations IMHA referrals mirror Mental Health Act Trend Information

30. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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 26A 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 24D 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.

31. Serving the people of Cumbria Do not use fonts other than Arial for your presentations 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

32. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Children’s Services Advocacy & IMHA

33. Serving the people of Cumbria Do not use fonts other than Arial for your presentations Questions and Answers