CYP(3)-AS-01

Consultation on a New Service Model for Delivering Advocacy Services for Children and Young People

Key Messages From Bridgend Children and Young People’s Partnership July 2007

Responses were received from Trudy Davies (LHB), Margie Ing (LHB),

Ros Jones (Children’s Services) and comments were received during an Advocacy and Mediation Sub Group meeting.  

General

• Areas delivered by the Draft Consultation are comprehensive and pertinent.

It is important to emphasise (in the opening statement) to give equal measure to ensure children and young people can make positive contributions to service development and effective advocacy support can enable this. The need to prioritise the development of the service is acknowledged, but it is important to ensure that young people’s contribution to service design and development is not lost overall in the midst of more pressing priorities.

Standards should be set to ensure that this aspect of the service does develop, and this includes recruiting and preparing staff to have the necessary knowledge and skills to facilitate this process.

Advocacy services may be working well locally, but could require a wider strategic approach to delivery, rather than a regional approach.  Local voluntary organisations can play a role in delivering advocacy services, and there is a danger this could be lost in adopting a regional approach.

Agree with vision that advocacy services should be available for all children & young people and not just in relation to complaints but also a good opportunity to improve on the raising of awareness of children & young people of their right to complain.  Hope that it will achieve balance and consistency across the country.  

The development of the free phone service and text service is positive but this is an area where young people can be involved to ensure sufficient levels of “user friendliness” and accessibility.  The reference to statutory partners and advocacy partners working together is positive but young people themselves should be acknowledged as key players within the partnership.

Background and Rationale for Change

• Agree with the vision and overall aims for advocacy services for children and young people in Wales

Independent and accessible services are crucial for children and young people, and should be available in places where young people feel comfortable.  Workers should have suitable skills to work in this field.  A greater understanding of advocacy and how it may be accessed is required.  A one-stop shop approach is appropriate.

All participants to share a common understanding and desire to achieve changes beneficial to children.  Funding required for NHS Trust Boards, not competitive bidding for £25k.  Time factor to achieve changes would be reduced if new funding facilitated for at least first year of operation, rather than budget constraints impacting on progress.  

The New Service Model   

• Agree with the proposed staged approach to collaborative commissioning and agree the priority areas within the New Service Model

Advocacy services should be available to schools where a young person is in danger of being excluded, or where other issues affecting their education have been identified.  An impartial adult to speak on their behalf would be beneficial in a variety of situations, for example when a young person is being bullied.

All complaints will feel serious to the children making them, however, there are occasions where advocacy would be critical, the obvious examples being; claims of abuse, complaints about a professional’s conduct e.g. a social worker/teacher compared with a complaint about the food choices available in a residential home. Invariably, a straightforward complaint can sometimes turn out to be far more complex and serious than first envisaged.

All complaints should be taken seriously for investigation.  Advocacy should be available to assist a child to explain or give their perspective.  Children need to be sure that they are taken seriously and listened to / believed.  Feedback should be provided to all children and young people from the advocacy worker.  

It is important that the advocate understands the client and their needs well.  Ultimately, self advocacy and peer advocacy can complement traditional advocacy services.  

Stage 1 definition of children receiving health care should reflect the increasing complexity of children’s health needs and the emphasis on care in the community where possible.  This would include considering children in hospices and those receiving health care in the community.  It is essential to identify a named person / key contact for the young person, as there is a danger of the young people and the issue becoming lost in a web of complicated communications.  

Effective communication and an expert and diverse workforce are required to work effectively with disabled young people.   Stages 1 and 2 differentiate between different groups of children – why should this be? – all should be considered / included equally.  Consider viability of widening Model to accommodate all groups rather than separate stages.   Should be more flexible, move away from labels and should not exclude the vulnerable.  

An additional model 1 should also make reference to:

• children in need seeking asylum and unaccompanied minors from ethnic / culturally diverse backgrounds whose first language is not English / Welsh have additional vulnerability.  They need translators who can explain their rights and assist together with advocates.  
• Schools advocacy for children affected by (unresolved) bullying.
• Advocacy for children whose parents are separating / divorcing and residency / custody has yet to be decided.  Their health and well-being is not considered, in addition to the effect this could have on their education.  

Stage 3 could highlight adults who have ‘been through the system’ themselves, and can highlight improvements.  

A Framework to Implement the New Service Model

Question if this is the appropriate time for collaborative commissioning across local areas.  

At a local level, the Advocacy sub group of the Children and Young People’s Partnership could be further developed.  A range of advocacy services (mainly stage 2) are available for children and young people via providers locally.  Development is required on all 3 stages.    

It would be difficult to pass the lead to one Partnership, and it is unclear on a regional basis how this would be facilitated.  A collaborative approach would a) achieve a consistency across Wales, whereby children and young people should expect the same standards and quality of service regardless of where they are in Wales and b) be more cost effective.  

This could be an opportunity to improve working relationships between local authorities, advocacy providers, carers etc.  This should be seen as benefiting not only the child but all concerned e.g. children can raise both positive/negative issues. Information can assist in identifying where things going well/badly and be used in informing service improvements.

Independence – difficult to achieve total independence of advocacy provision due to fact that local authorities and other organisations commission and pay providers.  Children may not see this as being a totally independent service

Will children be offered a choice of provider for children – how will this work?

Support proposal for partnership working/joint commissioning but what is deemed to be a partnership i.e. does it have to be social services, Education Health  &, Police or would say 3 social services departments (say Bridgend, Neath Port Talbot, Swansea) suffice? Clarification required.  There is also scope in the voluntary sector for provision of advocacy services.  

How will proposal be funded as partners may be at different stages in terms of advocacy provision, have larger/smaller client base etc?  How can each partner ensure they receive fair share of service provision?  How will budgets be managed?

Also difficulties may be encountered as partners may work in different ways e.g. may not have a complaints officer, different structures, cultures etc.

Appointment of “Lead Commissioning Officer” – who will fund this??

The selection of a lead on these proposals should be based on an understanding of children and their concerns; empathy with the problems associated with growing up, and a desire to ensure their concerns are dealt with equitably, comprehensively and effectively, as soon as possible.  To provide clear leadership, to have knowledge and understanding of the problems encountered with achieving collaborative working and to ensure that a holistic approach is understood and adopted by all.  Barriers to establishing lead CYPP Commissioners relate to lack of expertise and knowledge in specific areas.  Time is required to acquire these, with a possible secondment of experts on contracts until training locally is acquired.  

Practical application – there are implications for service delivery, how will this work?

With regard to the lead body approach, there could be a danger of lead being dominant – how do you balance this to ensure balanced approach and accountability?

Number of complaints received direct from children is considerably low both in BCBC and across Wales – agree with need to continue to raise awareness/ understanding of child’s right to complain and also their right to receive advocacy support.

Regional partnerships (proposed by 2011) – possible danger that things will get “too big.

Who will inspect?  Requires performance monitoring to ensure that national standards are maintained – more tick boxes??  The skill base required of the Lead Commissioner is very broad.  Expertise should be available from others when necessary.  

Concern about submitting Expression of Interest by closing date for consultation when partners not identified and commitments made.

The Role of a Children’s Advocacy Unit

The support and development needs to ensure the delivery of the service model proposed have been identified.  We agree an Advocacy Unit would provide additional support in commissioning advocacy services.  

It would be useful to have representation from the Unitary and Health Board areas, and at least one from each of the Independent Advocacy Services.  

The timescales for implementation of commissioning service under the New Integrated Service Model (by 2008 for Stage One and Two) are challenging.  There may be some constraints locally.  There is an assumption that expertise is available across Wales.  For example, there is a lack of independent advocacy services in North Wales.  Cost implications could strain existing budgets.  

Cymorth funding beyond 2008 will be used to commission services, which could include advocacy services.  

Workforce

Advocacy services should be regulated, and advocacy should be a recognised profession.  Registration and regulation of advocacy providers would be reflected in service level agreements with service providers.  Recognised qualifications are essential in safeguarding young people and ensuring quality of advocacy support provided.  

Having said this, it is important to build on existing expertise, e.g within the voluntary sector, or ‘buddy schemes’ via young people themselves.