A day in the life of a Cloverleaf Advocate
Cloverleaf volunteer, Claire talks to Rowena - a Cloverleaf Advocate about her role as an advocate and the impact that the pandemic has had on her ability to support those most in need of a voice.
What type of Advocacy do you specialise in within the team?
I started off doing RPR (Relevant Persons Representative) work when I joined Cloverleaf. No formal training is required for this role, anyone can be an RPR such as family members, although all paid RPR’s do receive training through their employer. I then did some Care Act training and became a Care Act Advocate, which I would say is the most diverse type of statutory Advocacy. I then did the IMCA (Independent Mental Capacity Advocate) training so I could provide maternity cover in the team. This was a baptism of fire and involved a lot of work! It is one of the most specialist areas of Advocacy, which you need to be qualified for because of the legislation and legal framework of the Mental Capacity Act.
How did you get into Advocacy work and what drew you to it?
I worked as a holistic aromatherapist for 16 years before I got into Advocacy. I worked in Nursing Homes with people with profound and complex learning difficulties and physical needs. I also worked with people with HIV and Aids and their families, as well as with private clients. I learnt so much during this time and felt very safe and comfortable in this role. However, when I encountered a safeguarding issue, I felt a sense of injustice within the care system because it is not a level playing field.
There are different environments and standards of care and a lot of inequality in the system. This was a big catalyst for me, a life-changing moment. I decided I wanted to work in a different way in order to improve people’s quality of life. I started to look into this, and I discovered Cloverleaf and realised I wanted to work for them and become an Advocate.
When an IMHA (Independent Mental Health Advocate) job came up in Calderdale I applied. I didn’t get it, but I was offered an RPR job instead.
No one mentions Advocacy at school careers advice. People come to Advocacy from different roles. You need some life experience first and you need to have the right attitude and values. The more I work, the more I recognise this!
Good Advocates listen a lot in order to get a good grasp of the situation because Advocates are often brought in late. As an Advocate, you need to be strong in order to ensure all the options are looked at properly and that everyone involved in a decision understands the situation fully, as well as making sure the person the decision is being made for is fully involved in the process and that all steps are taken to gain their views and opinions.
Best Practice process kicks in when someone lacks capacity, but Advocates need to remind family and professionals that the person still needs to be involved in making decisions, otherwise this can be overlooked.
The best kind of Advocacy is self-advocacy when the person speaks for themselves. Sometimes just the physical presence of an Advocate is enough for someone to feel empowered enough to speak up for themselves. Sometimes other professionals want you to give advice or your opinion and don’t really understand what an Advocate is.
Could you tell me what you did yesterday or on an average day at work?
The job is just so diverse. You can have a day planned but it can often turn into something different. For example, any IMCA serious medical decision takes priority over other work. IMCAs are attached to hospitals. You could be writing an RPR report for a Best Interest Assessor in the morning but an urgent serious medical treatment referral might come through and so you have to re-prioritise your workload and travel to CRH (Calderdale Royal Hospital) and so writing the report must be postponed. When you arrive at the hospital there is often limited information in the referral so the situation can prove to be quite different from what you initially thought, for example rather than a DNA CPR, the decision could be about withdrawing all medical treatment.
Once, during a best interest meeting at CRH, it became clear that the meeting needed to stop and I had to travel to see the client, along with the social worker and mental health professionals, at their home in Todmorden. This was unplanned but was necessary to determine what the client wanted to happen next.
Sometimes instant decisions need making and these take precedent over more routine visits. However, I feel that helping with smaller things and checking people are ok and raising their concerns is so important, such as contact with family. Small things which people lose in care, such as sending Christmas cards can be really important to someone but they don’t necessarily get the support to do it in care - even though they have always sent out Christmas cards and it’s a way of keeping them in touch with family and friends.
What do you like most about your job?
The people we support! All advocates have an inquisitive mind. Being an Advocate is a fantastic opportunity to get to know amazing people. In our role, we land on a page of someone’s book. Our role is to work out who that person is and what their story is and how we can best support them at that moment. Often, we meet people at a difficult time in their lives and it can be very profound if you can support them and put the power back into their hands and give them a voice. Hospitals can be very disempowering especially if you are very poorly and have no family. Professionals can often go down the track most trodden for people, but it might not be the right track for them.
Why do you think Advocacy is important?
Questioning! Giving people their power back and their voice. People can become very disempowered and can be very compliant. Advocates are there to let people know they are individuals and that their voice is strong, important and valued because the decisions being made are about them!
How have you adjusted to working more remotely?
We have all had to adjust because of the situation we are in. The way I see it is that some form of Advocacy for our clients is better than nothing at all, but remote working does not replace a face to face visit! Video is not a suitable platform for everyone. However, some clients have become more used to the virtual world, as we all have! With different age groups, there are different challenges of working remotely. We can use WhatsApp with some of our younger clients but in care homes, with older people, video calls usually must be facilitated by someone else.
What did you find most challenging about the COVID restrictions to carrying out your role as an Advocate effectively?
None of my clients in care homes had working mobile phones or tablets. Care homes often had only 1 tablet for up to 70 residents and were only able to facilitate 1 video call per day! Poor WIFI in care homes is a common problem and WIFI will not reach to people’s bedrooms, care homes need to invest in boosting their WIFI and improving their technology.
Supporting residents to keep in touch with family and friends in the outside world is often not prioritized in care homes, people’s address books with all their contacts are often lost and this makes people in care feel more isolated. The world suddenly went ‘online’, and care homes had to close their doors and if residents can’t get online, they have no means of contact with the outside world. Going into care takes away people’s social skills and more so now when everyone is losing their social skills!
You miss out on so much when you cannot physically be in someone’s environment. During a phone call or video call you can’t tell if someone has got their heating/ lights on, bread and milk in the fridge or if they are getting dressed. It is much harder to assess if they need more support. Impromptu visits aren’t possible if there are safeguarding concerns. How can you deal with these issues without actually visiting someone?
How do you see the future of Advocacy work given the nature of the ongoing pandemic?
Well, I think video calls will remain part of the way we work in the future. We need to ask care homes to think creatively about facilitating family contact. Advocacy also needs to be more creative e.g., we can go for walks with clients and join clients on walks with their Social Workers. We can send letters. What is clear to me is that we cannot just stop doing our jobs! The reporting of safeguarding has fallen during the lockdown, but cases of domestic violence and deaths caused by domestic violence have increased.
"The role of Advocacy is more important than ever right now. People are more deprived and have less access to Advocacy than ever. As Advocates, we must find a way of breaking down the barriers."
Advocates are often seen as having a similar role to family members. Therefore, when Health Care Professionals and Social Workers have been allowed into care homes and hospitals to see people – whereas Advocates have not. This is a challenge for the profession. How can we continue to support our clients in the most restrictive times? When Advocates feel disempowered how do we do our job of empowering others?
What advice would you give to someone who is interested in becoming an Advocate?
Just do it! It is the best life experience, being part of people’s lives and going on journeys with them and being able to really help people. There really isn’t another more ‘person centred’ role. If that appeals to you then just do it, dive in! You will learn so much about yourself as a person as well, through your work. You can find yourself in incredibly challenging situations with people who are in challenging circumstances in their lives. If you can support that person through the most challenging time in their life and give them a voice, then that is a real privilege. With each new person you work with you learn something new. The role of Advocacy gives as much back as you put in.