Advocacy In Practice
Real cases; real people
What do real cases look like?
Advocacy is not an abstract concept. It is a practical tool used every day in Cardiff to support people through some of their most difficult moments. Below are six real categories of need, with examples drawn from cases the Cardiff & Vale Advocacy Gateway has supported in recent months.
🤱 Personal Relationships & Capacity A woman who wanted a relationship and a baby ▼
A woman living in supported accommodation with a diagnosis of Obsessive-Compulsive Disorder, psychosis, and a learning disability was referred to CVAG by her Deputy Home Manager. She had openly expressed a strong desire for a relationship and a baby, potentially with another resident. Her parents strongly opposed both the idea of her having a relationship and discussing these topics, which created tension around her wishes and her support plan.
- What do you need to find out before deciding whether someone has capacity to make decisions about relationships and pregnancy?
- How should professionals respond when a person's wishes are in conflict with what their family believes is best?
- Why might an advocate be particularly important when these very personal topics are being assessed or discussed?
The most urgent step was a formal capacity assessment around relationships and pregnancy. Several routes were considered before CVAG referred her to a specialist professional advocacy provider, given her learning disability and the need for a female advocate to be present during the assessment. The advocate enabled her views about relationships, capacity, and future parenting to be heard safely and clearly.
🙅♂️ Adult Safeguarding A man under duress in a cuckooing situation ▼
An adult safeguarding consultant from Cardiff Council contacted CVAG about a man who had been identified by South Wales Police as a possible victim of "cuckooing" – where exploiters use his home as a base. He was open to the Community Mental Health Team, was described as "under duress," and his property was considered unsafe for lone working. The goal was to secure an Independent Professional Advocate (IPA) under the Social Services and Well-being (Wales) Act 2014 to support him in expressing his views, wishes, and feelings about a necessary move from his current address.
- What makes someone like this particularly vulnerable when they are being asked to leave their home suddenly?
- Why might a person open to mental health services be referred to a specific advocacy provider, and how does that affect timing?
- What does it mean when a person ultimately declines the advocacy that has been arranged for them?
The Service User met the eligibility criteria for IPA under the Social Services and Well-being (Wales) Act 2014 due to the safeguarding concerns. The referral was treated as a priority. An advocate was allocated and contacted him; however, he told the advocate that the issue was resolved and that he did not want any further support, so the case was closed. The referrer was kept informed at each stage, and the man's right to decline the advocacy was respected.
🏥 Mental Health Act Discharged from hospital, homeless and highly vulnerable ▼
The mother of a young man detained in hospital under the Mental Health Act contacted CVAG, worried he would be discharged into homelessness after destroying his flat and being held by police for over 36 hours. He had a diagnosis of psychosis, was known to community mental health services, and had no allocated social worker. His mother feared he was too confused and vulnerable to manage his own discharge or engagement with staff, and wanted him formally recognised as an adult with significant needs, and supported in making complaints about the police and hospital. She was not in a position to support him herself.
- What are the risks when someone with serious mental health needs leaves hospital without a clear, supported plan?
- When someone is detained under the Mental Health Act, what type of advocacy are they legally entitled to, and why does this take precedence over other routes?
- How important is it for a family member to be able to raise a complaint when they feel a person's rights and safety have not been properly protected?
CVAG explained that because the young man was detained under the Mental Health Act 1983, his statutory right was to an Independent Mental Health Advocate (IMHA). The helpline completed a referral to the IMHA service. An advocate was allocated, made contact with the young man, and began supporting him through discharge planning and his broader care and support needs. His mother was kept informed and signposted to Llais for information and advocacy support on making complaints.
🏠 Housing A housing crisis that led to an IPA‑supported care review ▼
A 79‑year‑old man living alone in an adapted housing association flat contacted CVAG because his home had become "unbearable." He was being verbally abused by an upstairs neighbour, suffered constant noise, had no working cooker, and felt unsafe. He avoided being at home for most of the day and had no close family or friends. He also reported poor mental health, anxiety, and coping difficulties. At the time there was no Social Worker involved, and he had never had a formal care and needs assessment.
- When someone feels unsafe in their home but is reluctant to contact their housing provider, what can be done to prevent that situation from escalating?
- How might a person's physical and mental health needs be overlooked if they are only seen as a "housing case"?
- What difference does an IPA make when someone is going through a first care and needs assessment?
CVAG helped the man shift from seeing his situation as purely a housing problem to recognising that his wider care and support needs also needed to be addressed. He agreed to request a care and needs assessment from Social Services himself and to accept advocacy through that process. The helpline made a referral for an Independent Professional Advocate (IPA) under the Social Services and Well‑being (Wales) Act 2014 to Mental Health Matters. An advocate was allocated and contacted him, though their first meeting was postponed when he became unwell. The original housing issue was not fully resolved, but the process to formally assess his needs and secure appropriate support had begun, with an IPA in place to support him through that assessment.
👩👧👦 Parents & Children's Services A mother struggling to be heard in social services meetings ▼
A mother with significant mental health challenges, including diagnosed anxiety and depression and concerns about possible PTSD and Borderline Personality Disorder, contacted CVAG because she felt her voice was not being heard in social services meetings about her children. She found professional language difficult to understand, felt meetings were frequently cancelled or rearranged, and was unsure what stage of the process she was at, all of which increased her anxiety and sense of helplessness.
- What barriers might prevent a parent like this from fully participating in social services meetings?
- What does it tell us if someone feels their voice is not being heard by the very services meant to be supporting them?
- When statutory advocacy is not available, what alternatives exist to ensure people can still access independent support?
CVAG explained that she did not currently meet the statutory criteria for an Independent Professional Advocate under the Social Services and Well-being (Wales) Act 2014, but discussed non-statutory options with her. She was advised about the possibility of a spot-purchase of professional advocacy arranged by her Social Worker and was supported to request this directly. CVAG also signposted her to Llais to raise a complaint about the lack of advocacy support at earlier stages, and encouraged her to re-engage with mental health services if needed. She left the conversation with clear next steps and agreed to update CVAG on the outcome.
🤕 Self-Neglect A situation that escalated from self-neglect to best interests decisions ▼
A Social Worker contacted CVAG about an adult living alone without family or close friends, who was experiencing serious self-neglect. The person was refusing most support, including from their GP, and was not accepting offers of respite or alternative accommodation. Concerns grew as their situation deteriorated, and a Best Interests meeting was being planned with Court of Protection options under consideration. The Social Worker wanted an advocate to support the person to understand and express their views about their care and about remaining at their accommodation placement.
- What happens to advocacy when someone refuses almost all kinds of help but may lack capacity to make decisions about their own safety?
- How does the role of an advocate change when the focus moves from community support to hospital discharge and best interests meetings?
- Why might two different types of statutory advocate be needed as a case moves from social care to mental capacity planning?
CVAG initially arranged a referral for Independent Professional Advocacy (IPA) under the Social Services and Well-being (Wales) Act 2014, so the person could discuss their options and be supported if they agreed. After the person was admitted to hospital following a fall, the situation changed: they were assessed as lacking capacity to make an informed decision about their long-term care, and the focus shifted to a Best Interests meeting and discharge planning. CVAG then advised the Social Worker to refer directly for an Independent Mental Capacity Advocate (IMCA) to support those decisions, ensuring the right type of statutory advocacy was in place at each stage.