Terms of Reference

Review of advocacy arrangements for older people resident in care homes in Wales


See section 5(4) of COP(W)A for definition of advocacy[1].

This review will focus on advocacy within the meaning of the Action for Advocacy definition: ‘Advocacy is taking action to help people to say what they want, secure their rights, represent their interests and obtain services they need. Advocates and advocacy schemes work in partnership with the people they support and take their side. Advocacy promotes social inclusion, equality and justice’ [2].

Care homes are facilities that provide care, including nursing care, to adults, and are registered under the Care Standards Act 2000.   

Rationale for review

Advocacy Counts 3 highlighted the inconsistent provision of advocacy for older people across Wales, in particular the geographical gaps in provision[3].

Many older people bring to our Information and Enquiries team cases concerning their experiences of care homes[4]. Many of these cases relate to situations where access to an independent advocate would be beneficial and may have led to different outcomes.

Interviews and discussions with advocacy organisations, care homes and commissioners highlighted the particular vulnerability[5] of older people within care homes and that advocacy can be viewed as an important safeguard and that, whilst the value and need for advocacy is widely recognised, it is not universally available[6].

Preliminary research undertaken asserts that advocacy can be of crucial importance at all stages of decision making in terms of care homes: from deciding to enter, whilst living in the home, or when leaving[7].

Powers of the Older People’s Commissioner for Wales

The Commissioner has the power to review arrangements for advocacy, or the failure to make arrangements, through powers and functions derived from section 5 of the Commissioner for Older People (Wales) Act 2006.

The review must be to assess whether and to what extent the arrangements are effective in safeguarding and promoting the interests of older people.

Obtaining information

Under Regulation 4 of the Commissioner for Older People in Wales Regulations 2007 the Commissioner can require certain people[8] to provide information which she considers is necessary or expedient to have for the purposes of the review.

Power of entry and interviewing

Under section 13 of the Commissioner for Older People (Wales) Act 2006 the Commissioner or a person authorised by her may, for the purposes of a review, enter any premises, other than a private dwelling, for the purpose of interviewing an older person accommodated or cared for there, and may interview the older person with their consent.

Principal aim

The review will cover the advocacy arrangements of the following:

 -     Welsh Government (Minister for Health and Social Services and Deputy Minister for Social Services and Children),
 - Local authorities in Wales,
 - Local Health Boards in Wales where there are joint commissioning arrangements in place, and
 - Local authority and independent care and nursing homes.


To establish whether and to what extent the arrangements in place are effective in safeguarding and promoting the interests of older people. In determining the interests of older people, OPCW will have due regard to the United Nations Principles for Older Persons[9] and the Human Rights Act 1998.

OPCW will listen to older people living in care homes so that their views and experiences help to shape the development of advocacy in Wales.

Terms of Reference

Review advocacy provision for older people who are resident in care homes. This will cover both statutory advocacy and generic independent advocacy.

Obtain and present the views and experiences of older people who are resident in care homes.


Build upon preliminary research already undertaken, updating the legal and policy framework relevant to advocacy provision, the regulatory framework and stakeholder interviews.

Obtain information from the organisations whose advocacy arrangements or failure to make arrangements, are being reviewed.

Visit a selection of care homes to meet with and obtain the views and experiences of older people residing in them.

Obtain the views of staff, advocates, relatives and carers.

Obtain examples of both good and poor practice.

Prepare a report setting out the findings, conclusions, and recommendations of the Commissioner and send to the First Minister, the Assembly and the Houses of Parliament, and the organisations whose arrangements or failure to make arrangements have been reviewed.


Announcement     September 2011
Require information     October - December 2011
Visit care homes to
interview residents
    November 2011- January 2012
Report writing        January - May 2012
Report launch          Summer 2012



[1] Arrangements made by a person for making persons available – (a) to represent the views and wishes of relevant older people in Wales; (b) to provide relevant older people in Wales with advice and support of a prescribed kind. The kind of advice and support prescribed is – 1. The provision of advice and support to relevant older people in Wales which is intended to enable and assist them to express their views and wishes orally or using any other means of communication, and 2. The provision of advice (including information) to relevant older people about their rights and welfare.

[2] www.actionforadvocacy.org.uk

[3] Advocacy Counts 3 Age Cymru/OPCW March 2011

[4] 196 enquiries What Older People are Telling Us May 2011

[5] Based upon a situational definition of vulnerability

[6] Advocacy and Care Homes OPCW Elsmore & Griffiths June 2011

[7] Advocacy and Older People In Wales – An Initial Scoping Study OPCW Dunning June 2010

[8] See definition of ‘prescribed person’ Regulation 4

[9] United Nations 1991 In particular, Principle 3: Care, states that older people should have ‘access to social care and legal services to enhance their autonomy, protection and care’, be able to use institutional care that provides protection, rehabilitation, stimulation within a ‘humane and secure environment’, and, be able to enjoy human rights, including the right to make their own decisions ‘about their care and the quality of their lives’.

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