Marvin is in his late 60’s and lives in a low secure hospital ward. Marvin has mental health issues and physical health issues and uses an electric wheelchair.

Marvin has advocacy support at ward rounds and at his 6-monthly Care Programme Approach (CPA) meetings. Natasha is Marvin’s advocate. Marvin requested her support with reading through the reports from his Multidisciplinary Team (MDT) before his CPA meeting and also support him to prepare the concerns he wished to raise at the meeting.

Marvin told Natasha that he feels too embarrassed to tell his MDT that he struggles to read and write. Marvin also told Natasha that he is struggling with his mobility in his room at night especially with access to the bathroom and using the toilet. He told her that his wheelchair does not fit in the bathroom and he has been given a walking stick but he does not feel stable when he uses it. Marvin said that he would like a walking frame. Marvin was on a second floor ward and he did not know what the emergency procedure was for him in case of a fire alarm.

Natasha supported Marvin to make a list of concerns for the CPA meeting. Marvin requested that Natasha raise these concerns on his behalf.

At the CPA meeting the following was discussed and agreed in response to Marvin’s concerns:

• A risk assessment and Personal Emergency Evacuation Plan in case of fire or emergency are in place and are part of Marvin's care plan. Staff will discuss these with Marvin so that he is aware.
• Marvin’s Occupational Therapist agreed to carry out a bathroom assessment and a mobility assessment on the ward. A walking frame and physiotherapy sessions will be looked into to see if these are appropriate for Marvin.
• All future correspondence will be provided in an easy read format and Marvin's primary nurse will provide reading and writing support to him when needed.

Natasha met with Marvin 2 weeks after the CPA meeting. Marvin thanked Natasha for her support at his CPA meeting and for helping him understand his paperwork.

Marvin’s CPA meeting minutes and care plan have now been provided in an accessible format for Marvin so he can read them.

Marvin showed Natasha that he had been provided with a walking frame and that the bathroom had been fitted with a height adjustable toilet seat and a chair for the shower. Marvin told Natasha that he feels much safer using his walking frame than he did with his walking stick and moving around his room and bathroom on his own is now much easier.