Hello, I am responsible for our secure and complex services covering England and a little part of Scotland. Advocates in secure settings work in high, medium and low mental health hospitals, step down units and rehabilitation services. They also work in prisons.

This blog and future blogs will be about working with people in these settings, challenges that we face, observations and raising some difficult questions. I hope to blog bi-monthly and as and when topics arise.

For those of you not familiar with POhWER we are a human rights advocacy charity, delivering advocacy services across the country.

Managing the delivery of advocacy in secure settings is a constant conundrum; one that constantly finds me deliberating with myself and others. I have come to see this as a way of checking myself and perhaps an assurance against complacency. There’s that word ‘complacency.’ Those that work with me will have heard me use this word over and over again as a warning ‘don’t be complacent, it is the biggest risk’. Biggest risk to who? Ultimately and most importantly to our beneficiaries.

I often check and reflect on our independence. I often get asked about our independence too. If we are contracted by a hospital or a provider for example, how could we possibly be independent? I am resolute in my response. POhWER is a charity, we have our own governance, we have our own chair and board of trustees and beneficiaries all of whom we answer to. Our independence is at the heart of all we do, we report to our commissioners but we are not nor will we be prevented from speaking up on any matter no matter how uncomfortable or difficult.

But, still, I do question it each time we raise concerns or issues. Check – did we raise it early enough, check - have we made the point clearly and assertively, check - have we compromised our position in any way, check – have we let those that commission us or are in a position of some power sway our view or water down our concerns, check – are we being listened to. Have the voices of our beneficiaries been heard loud and clear.

Everyone says we are all here for the same reason but are we? Well, the answer is sadly No. Most people working in these settings, in whatever capacity are, yes! But not everyone. We don’t really need Panorama, media and historical abuse scandals to inform us of the fact there are bad people doing bad things to vulnerable people do we. However it shines a light and reminds us all, it’s still there, it’s still happening. It is a truth in all services be that NHS, prisons, care homes etc. Let’s not fool ourselves and therefore stop the conversation.

So I ask myself how does an advocacy charity fit into this world, with all the sad, terrible stories of what is happening to people, what is our part when things go wrong, are we seen as failing? Can we risk this as a charity? Should we deliver advocacy in these settings?

My answer to my last question always comes first and it is always a yes. We are advocates, that’s what we do. We pride ourselves on working with those who are hardest to reach, those who have no voice at all whether through disability or illness or vulnerability. There is no question we should be there, right in the mix of it. What would happen if we weren’t there at all? I reprimand myself for even asking the question. Of course we should be there.

I wish our advocacy services could stop the terrible things that happen. All good people working in these settings wish the same too, support workers, carers, professional’s et al. Dare I say this, there is a great deal of excellent work happening in these services, really good people, doing really good work, helping, supporting and caring for people at the worst times of their lives. We must not lose sight of this or it will all be lost, be devalued further. But equally we must consider what occurred at Whorlton Hall and the abuse vulnerable adults were subjected to and perhaps the more recent CQC report regarding Yew Trees.

It is hard to be an advocacy provider in such settings when things have gone wrong. You shine a light on yourself and you ask even more questions of yourself and your service and you know people are going to shine their light on you also and ask their questions. Is it fair? In all truth it probably is even though it doesn’t always feel it. You have to be open to questions and truthful with yourself and others.