VoiceAbility, 2012


This evidence is provided to assist the Department of Health's review, following the events at Winterbourne View Hospital. The Department of Health aims to:

  • identify any systemic issues which need to be addressed;
  • identify real examples of best practice, their key components and how they can be replicated;


The role of advocacy in preventing, detecting, responding to abuse and ensuring instances of abuse are brought to an end has been highlighted over many years, including extensively by SCIE. Evidence from the 67 CQC learning disability review reports thus far indicate that where there were concerns raised about safeguarding:

  • Patients often had to request advocacy, as opposed to mechanisms that allowed regular contact and trust building with advocates
  • Patients (and their carers) lacked appropriate and accessible information, including easy read, on for example safeguarding vulnerable adults, how to raise a concern or make a complaint and how to access independent advocacy
  • Involvement of patients in developing their care plan was limited. Advocacy was rarely used to help people make decisions. Care plans were not person centred and unable to inform their delivery of care in a way that met individual needs and ensured patient welfare and safety
  • There were inconsistencies in both the understanding, and practice, of the use of restraint.


The evidence presented here indicates the nature of advocacy support required and the conditions that need to be in place to support it to operate successfully. Engaging with advocacy in this way is essential to safeguarding vulnerable adults, particularly in institutional health and social care settings such those inspected following the broadcasting of abuse and crimes committed against people at Winterbourne View.