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Advocacy case studies

Case study 1

Kelly (not her real name) lives with severe depression. Advocacy helped her with claiming Personal Independence Payment (PIP) and other benefits. This enabled her to get out and better engage with services and with the help of an Advocate, she was able to put plans into action which has resulted in major life changes and a new secure, housing tenancy.

She now also uses a range of community services such as the library and other leisure facilities, enhancing her quality of life and improving her physical and mental well being. She was able to receive help for physical health problems which needed to be investigated but which her GP was wrongly attributing to her mental health. The advocate went with the person to see her GP and the matter was then looked into thoroughly. The problem was identified and treated improving her physical and mental health. She rarely visits her GP now. She also joined a therapeutic music group at Mind then became a volunteer and is now a sessional music teacher.

Case Study 2

Amy is a qualified child care professional with 2 teenage children. Her son has severe autistic traits and attends a special school.  Her daughter is very academic and studying for her A levels. Both are achieving brilliantly at school.

Amy had been unable to work for several years due to  debilitating and severe depression and anxiety and had become  a virtual recluse in her house. She had got into financial difficulty and had been denied benefits as she had not attended an ATOS medical due to taking her son to a medical appointment.

Her privately rented house was in a terrible state of repairs and an increasing health hazard. The landlord neglected to do any repairs on the property. With the help of an Advocate from Solihull Mind Amy’s benefits were reinstated at a tribunal and her finances put on a steady footing. The advocate also negotiated with the local authority to get the family re-housed.

Amy and her children are now very much looking forward to the future and Amy is currently refreshing her professional skills and will soon be returning to work.

DIAL Case Study

Mrs. A`s husband and companion for forty years, recently passed away. She has been disabled for most of her life however; things took a turn for the worse two years ago following a serious fall which has left her almost immobile.

Since the fall Mrs. A has been confined to one room of her property and since the loss of her husband, her sense of isolation has been overwhelming.  The house was very cluttered with  items belonging to her husband and Mrs. A was clearly struggling to move forward.

Advocacy supported her to talk through her loss and this helped her to identify and prioritise what she needed to do to become a happier person.  Advocacy liaised with a number of professionals to put in place the adaptations and services she needed to make life easier to enjoy.  The advocate spoke to close friends and neighbours and a rota was organised to clear the items that were cluttering the house.

Mrs. A now feels she is moving in the right direction and will become a happier person.

 DIAL Care Act Case Study

Mrs S was initially referred to DIAL by an internal colleague who had been out to complete a financial assessment on behalf of Solihull Council. She is a 47 year old lady who has several chronic health conditions. Mrs S lives with and is supported by her husband who provides her with care and emotional support.

Mrs S was due a review of her services and I advised her that she was entitled to ask for a Care Act Advocate who would support her before, during and after her review. We discussed how I could contact Social Care and request that a referral be made through the brokerage team for an Advocate and that the allocated advocate be contacted prior to any review. The allocated Social Worker sent me a copy of the face assessment and I met with Mrs S to discuss what outcomes she would like to achieve from her review of services.

Mrs S had been receiving services from Social Care in the form of a small personal budget for some time but was dissatisfied with the way her queries to the Social Work Team were handled. She had initially asked if she could employ the services of a mobile hairdresser but was advised several times in the past that this wouldn’t be possible unless it was part of a personal care package. It was suggested to her that a care agency could provide hair washing as part of a package but as she is a very private lady she didn’t wish for paid carers to provide her personal care. However it was suggested to her that she could purchase a laptop with her personal budget as she had discussed in her initial assessment that she was feeling socially isolated.

I supported Mrs S during her social care review & made it clear to the visiting Social Worker what outcomes she would like to achieve.

  • A flexible care package which would include personal care, domestic support & social interaction with another female.

With my support Mrs S has a care agency taking her out once a week. Mrs S has to carry oxygen so this required ringing round several agencies to identify who could provide this.

She is employing a local care agency to provide her personal care. Several agencies were approached but only one could meet Mrs S’s particular needs. She wakes very early in the mornings so needed an agency that could guarantee that she would be there first call of the day.

Mrs S has a local mobile hairdresser once a week to wash & style her hair. Some hairdressers weren’t willing to visit as Mrs S has a small but very noisy dog!

Mrs S has domestic & laundry services from a local agency whose charges are below the average cost. Some agencies contacted were 50% higher.

At my suggestion Ideal for All are managing her personal budget which up to date has been very successful.

Mrs S is very satisfied with the outcomes that I helped her to achieve and she hasn’t needed to contact Social Care for anything since her review of services. Her husband has also benefitted as he now has a few hours respite from his caring responsibilities when Mrs S is taken out once a week.

Independent Advocacy Case Study 1:

One brother of 3 was referred to the service by the Early Intervention Team based at the Newington Centre. The referral was for support in a DLA appeal for the client’s mother. The client’s mother was too unwell to undertake this appeal herself, so the son was to attend the appeal hearing. The family were of Pakistani origin.

Subsequently (approximately 2 weeks later) the eldest of the 3 sons was referred (again by the Early Intervention Team at the Newington Centre) for assistance with the court case. The case was regarding the second client being taken to court for injuries received to the family of a man involved in a car accident with the client.

In discussion with the first client, it became obvious to the advocate that the Mother, , had no professional supportive evidence for her condition. She had been awarded low level care and mobility in DLA and the appeal was to move her to middle care level. Without the necessary evidence, the advocate advised the client to withdraw the appeal, with a view to obtaining the required evidence by an assessment of the mother’s mental health. The son carried out all the household duties, cooking, cleaning, washing, shopping etc., although the mothers personal care was undertaken by the daughter. The mother was unable to leave the house. This son then made his way to the eldest sons flat, on daily basis, where he carried out similar duties. These duties prevented the son from pursuing his own educational goals.

The second client had no paperwork whatsoever regarding the court case other than the recently received court papers for a hearing at some point after December 8 2014. The advocate, therefore, had to research the insurance company, who were co-defendants in the impending case, in order to gain some knowledge of the case and support for the client. This was achieved and the advocate obtained the community psychiatric nurses statement saying the client was unfit to plead or give evidence at this time.

On discussion with both brothers (privately, each on their own) it became clear to the advocate that the family was in great need.

The mother and the 3 sons (the youngest is detained on Section 3 in long-term rehabilitation) have been subject to 20 years of systematic emotional, physical and sexual abuse by the now absent father. The father took the youngest brother to Pakistan where he was held prisoner and abused. The mother’s family managed to rescue him and return to England. The mother then took divorce proceedings, but was threatened by the father, as were the children. The divorce took place in the father’s absence; he is thought to be in Pakistan. The father has, in the belief of the mother and the children, considerable influence in both Pakistan and the area of Solihull where they now live. All 3 sons have been targeted by ‘gangs’ of youths and the youngest was quite seriously hurt. The eldest has subsequently been threatened by a group of 4 men demanding that he sign a paper admitting ‘fault’ in a car accident. The advocate took the client to the Police Station and the officers are investigating the occurrence and have ‘marked’ the clients flat and will take immediate action if phoned by the client at any time in the future.

The advocate has managed to have the family (mother, daughter and 1 son) re-graded under the housing banding from G to B supplying the requisite medical reports. This was done in conjunction with Solihull Community Housing.

The advocate has managed to have mother fully assessed, by a consultant psychiatrist, and this assessment will be used as evidence in a informative session’ in Disability Living Allowance (DLA) (or what will PIPs under the new arrangements). The assessment clearly shows that the mother is in need of supportive services.

When the mother has been re-graded under PIPs to standard care, she will be able to access a carers allowance as well as a personal budget. This in turn will mean she will have the necessary finance to support her needs with a personal assistant,  freeing the son to pursue his education.

The advocate has been in contact with the London based Solicitors for the Insurance Company involved as co-defendants in the in the eldest sons court case. They have been most supportive and are taking on most of the advocacy client’s defence. The client was detained in hospital shortly (3 weeks) after the alleged accident/incident and cannot remember the incident fully or with any accuracy, but did make a Police Statement at the time. The solicitors acting for the insurance company concerned that the ‘accident’ was staged by the claimant and are looking (since the claimant has refused to answer some court-order questions) to have the claim ‘struck put’.

The case study demonstrates that a single ‘issue’ referral can, and should, lead, when necessary, to other needs from the referred client. In this case a referral for support for a very unwell woman, a route back into education for a young person, an informative session in PIPs and a realistic prospect of re-housing. This has come about through working with the police, Solihull Community Housing, Psychiatric Services at the Newington Centre and the family as a whole.

Independent Advocacy  Case Study 2

The client was referred to the services by the Patient Advice and Liaison Service (PALS), initially for a complaint about the services received.

The client was in recovery from 17 years of cocaine abuse and was showing considerable signs of mental distress. The client has also become ‘homeless’ (staying on a couch at mothers) and although this lack of housing was not on the original referral, was impacting on their mental health well-being and their substance abuse recovery.

After initial conversations with the client it became obvious that the need was for a ‘holistic’ approach to the various issues. The complaint has arisen because of the client’s overriding need for occupation. Occupying time is an important part of addiction recovery, as in change.

This immediate issue of housing was tackled by a supported visit to Solihull Community Housing, who settled the client in a temporary accommodation with a view to permanent placing when appropriate accommodation was sourced.

The client was encouraged to access the various group activities at Lyndon Clinic, although these were of a time limited nature. The client was signposted, with support, to the activities happening at Mind Solihull and has joined 2 groups there which are on-going. At the same time the client was encouraged to join the groups facilitated by SIAS, as these are specifically designed to maintain and sustain recovery; these have proved a success with the client.

These various activities (the client is now at some form of group support 5 days/week) have given the client a focus in their life as opposed to spending too much time analysing their recovery, although the groups do, of course, use the analysis as part of the individuals recovery journey but is, significantly, part of a peer group rather than a solitary exercise. The client has maintained their recovery now for 9 months. The client is still in contact with the service and will remain ‘open’ to us until adequately housed.

Independent Advocacy Case Study 3

Gentleman aged 53 was referred to the advocacy service following a diagnosis of depression he was having difficulties with finances and employment. His wife was not convinced about the diagnosis and required further support in aiding the client to gain further support.

The client, a previous mental health professional and current IBM engineer was also having difficulties gaining the support for his current diagnosis. During the initial visit with the client advised that he was nearing the end of his sick leave and could not envisage being able to return to work at the present time, he also advised that his symptoms appeared to be worsening and that he was not seeing any improvement. We discussed about making an application for PIPs he stated that he had been declined for ESA due to his current employment status although would like to make a claim for disability benefit and were not entirely convinced with his diagnosis. I arranged contact with GP regarding some psychological support.

Benefits – PIPs application

Employment – Company vehicle, pension and expectation

Support – Cognitive function assessment, psychological support

Second visit – completed a DLA application and returned. Arranged to contact employer to advice of my support with any meetings he may have to attend at work with regards to his return. I also wrote to his GP and consultant with regards to a full cognitive assessment and psychological support.

The GP made a referral to psychological therapists and a full cognitive assessment was carried out, it found that the client had early onset of dementia and subsequently the outlook was not positive. We discussed a befriending service and looked at other support services. We requested on behalf of the client for a direct payment application to help fund a befriending service and transport service to and from someday services sourced by his wife.  Initially the social worker advised that he would not be entitled to this. However this was soon challenged and the application was made.

The DLA was initially refused and an appeal was made on the client’s behalf. The appeal was heard and the judge deemed my client met the criteria for DLA. A backdated payment was subsequently made.

The client had made arrangements to have his company car returned with the support of his wife. During the months that followed the employer continued to take direct debit from the clients account. I was requested by the client to contact the employer and rectify this issue. Initial telephone call to employer and directed to human resources. They advised that they would look into the matter and contact me. The client’s wife informed me that they had stopped the DD although he owed them some money. This is still and outstanding issue and I am awaiting a meeting with the client and his wife.