Disability body faults reaction to its service

A NEW advocacy service for vulnerable people with disabilities is being met with resistance, lack of co-operation and exclusion from such bodies as the Health Service Executive and the Courts Service, an unpublished report claims.

The most recent six-month report of the National Advocacy Service for People with Disabilities (NAS), presented at its September 19th board meeting, cites the “reluctance” of one HSE social work team to recognise that a woman with an intellectual disability and whose baby had been taken into care had any specific needs.

In another case a community nursing home manager withheld a man’s disability allowance from him because his behaviour was “difficult”.

NAS was established last year by the Minister for Social Protection, Joan Burton. It is managed by Citizens’ Information Services in five locations: Dublin, Westmeath, Offaly, Waterford and Leitrim.

Its 35 advocates provide an independent voice and representation to people with intellectual and sensory disabilities, mental health difficulties or an acquired brain injury, when decisions are being made about their lives.

The report, covering January to June 2012, seen by The Irish Times, indicates the service was advocating for 846 vulnerable people at the time, compared to 622 in the same period in 2011, and 772 in the July to December 2011 period.

While all regions reported a “general welcome at the promotional stage” from organisations to new service, “the approach did not always continue when advocates began work on individual cases”.

The report points out the service is new and “there is still a degree of misunderstanding of representative advocacy.

“There appears to be a tendency for services to refer cases with external issues (families, allowances) to NAS but to withdraw when issues relating to the service itself surface. Reports mentioned superficial co-operation but resistance through delay, slow, late or restricted access to background documents and/or absence of the person with disability at appointments because other activities have been scheduled.

“Reports also mentioned lack of response to letters - this happened even with a HSE disability manager. Documents have been withheld from NAS advocates and FOI requests have been needed to get [them].

“In very few cases did the person with whom the advocate was working have access to reports about themselves and in some cases they were formally denied [them].”

The report describes difficulties working with the Legal Aid Board and the Wards of Court office.

“The Legal Aid Board sometimes refer cases [childcare orders involving a parent with a disability] which are due to be heard in a couple of days, allowing very little preparation time for the advocate.

“NAS managers report inconsistent responses from the Wards of Court office, sometimes co-operation, sometimes delay or refusal to release names of a person’s committee.

In one case, information was withheld from the advocate while the organisation worked with the family to make the person a ward of court “without any opportunity for the person to understand the impact this would have on them or to have any choice in the matter”.

ADVOCACY CASES TWO REPORTS

CASE STUDY 1

John (23), who has a history of homelessness and crime, was referred to the National Advocacy Service for People with Disabilities (NAS) by his father. He lived in a community hospital for older people and wanted to live independently.

He also wanted his Disability Allowance reinstated.

John has been involved with disability services since he was released from prison aged 17, having acquired a significant spinal injury. Over a year ago he was offered a “short-term” place in a community hospital.

On entering, his allowance was stopped. The hospital asked that he paid a basic rate of welfare instead and his [higher-rated] allowance was not reinstated. “This was partly done to ensure John would be manageable on the ward.” The advocate negotiated with the hospital and his disability payment was reinstated. He is given half every week and half goes into his account.

John felt he had been “dumped in an old-folks’ home” . With the advocate’s support he called a case conference and was offered a place in a rehabilitation facility in another county.

“The disability service manager of the HSE visits him and tells him if he does not take the rehabilitative placement he will be discharged and will need to fend for himself.” He had an evening to decide and decided to go to the centre.

He and the advocate sought assurance from the HSE that when he had completed the course he would be supported to access independent living. The HSE wants to see the result of the rehab first.

“The advocate did a lot of work with John around his behaviours and their negative effects on service providers. John was supported to challenge prejudice by speaking up, questioning decisions and progressively claiming his rights. Rights restrictions were challenged and John regained control over his own money.

“The lack of suitable services for John made change difficult. The insistence of the disability manager that he take the placement offered caused his trust in disability services to diminish. Because of his difficult behaviour disability services were unwilling to allocate funding to John as they felt that this money would be wasted.”

CASE STUDY 2

Rose (55) approached NAS herself. She lives in a nursing home and is a ward of court. She wanted support liaising with the Wards of Court office about access to her money as she wanted to go to concerts and to visit relatives. The advocate supported Rose to draw up a list of places she wanted to go and things she wanted to do and submitted it, with knowledge of the nursing home, to the Wards of Court office.

“A letter from the Wards of Court office instructed that as Rose is a ward of court and has a court-appointed committee it was inappropriate for an advocate to represent her. This has caused a major barrier for Rose and the Wards of Court office has ultimate and final power over decisions about [her]. The advocate has replied. . . arguing that she has a valid role in supporting Rose at local level to ensure that directions from the office are followed through and processes to support Rose’s wishes and requests are happening on the ground.

“They await a response from the Wards of Court office.”