In-between the person and the process: the liminal role of independent advocates under England’s Care Act 2014

Alcock, Robert (2025) In-between the person and the process: the liminal role of independent advocates under England’s Care Act 2014. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

The Care Act 2014 extended rights to independent advocacy for some users of adult social care in England. The Care Act Advocate (CAA) role supports and represents people regarding involvement in processes conducted by the local authority, including needs assessment, care and support planning, and safeguarding. CAAs’ responsibilities include making necessary challenges to the local authority, with or on behalf of the person. This thesis addresses knowledge gaps about the nature and operation of the CAA role. Key questions concern how legal and policy requirements for CAA services are being implemented, how effective CAAs are in fulfilling their defined role, and what factors influence effectiveness. The CAA role’s identity is explored, including its relationship to other types of advocacy. Links between advocacy’s form and its effectiveness in achieving various outcomes are examined. The analysis is novel in viewing independent advocacy through the conceptual lens of liminality, doing so across two dimensions. Acting in-between describes CAAs’ interactions with service users and local authority practitioners, as they seek to bridge gaps in involvement. Being in-between refers to the CAA role’s indeterminate qualities. Significant technical knowledge is required of CAAs, given they must uphold rights within complex legal and procedural contexts. This creates professionalising impetus, which is shown to be in tension with other aspects of advocate identity that are linked to pursuing egalitarian partnerships with service users. Case studies of CAA services in two local authorities were conducted, via interviews with CAAs, CAA managers, service users, social workers and a local authority commissioner. Four individuals with national-level expertise were also interviewed. Braun and Clarke’s method of reflexive thematic analysis of data was applied. Five main themes were discerned: ‘barriers to access’; ‘defining advocacy relationships’, concerning person-centred advocacy practices and limits to these; ‘partnership, negotiation and challenge’, about CAAs’ interactions with practitioners; ‘constructing occupational identity’; and ‘developing organisational effectiveness’, regarding service structure and funding. A critical realist approach was taken, involving exploration of the underlying causal mechanisms that help shape people’s experiences of CAA services. Blom and Morén’s CAIMeR model, which applies critical realism to social care studies in order to understand causation within complex systems, influenced the analysis. Recommendations for policy, practice and future research are presented.