What Happens If a Care Home Resident Has No Family to Advocate for Them?

Posted 3rd June 2026

If a family member is living in a care home and you are concerned that their voice is not being heard, or that decisions are being made without proper regard for their wishes, independent advocacy services exist specifically to help.

Advocacy is not the same as legal advice, and it is not the same as complaining to the care home. An advocate is an independent person whose sole purpose is to represent the interests and wishes of the person they are supporting, without any allegiance to the care provider, the NHS, or the local authority.

This guide sets out what advocacy is, who is entitled to it, and where to access it in Nottinghamshire.

What Does an Advocate Do?

An advocate speaks up on behalf of someone who is struggling to do so themselves, or who needs support to understand and exercise their rights. In a care home context, this might mean:

Helping a resident understand their care plan and what it means in practice
Attending care reviews or best interests meetings to ensure the person’s views are represented
Raising concerns about the quality of care on the resident’s behalf
Supporting someone to make a complaint through the care home’s formal process
Ensuring a resident’s rights under the Mental Capacity Act are properly respected
Helping someone understand their rights around discharge, transfer, or a change in care

An advocate does not make decisions for the person. They support the person to make their own decisions wherever possible, or ensure their known wishes and values are represented when they cannot.

Types of Advocacy Available in Care Settings

Different types of advocacy apply in different circumstances. It is worth understanding which applies to your situation.

Type of Advocacy	Who It Is For	Who Provides It
Independent Mental Capacity Advocate (IMCA)	Adults who lack capacity and have no appropriate family or friends	Local authority or NHS must instruct one
Independent Care Act Advocate (ICAA)	People going through a care needs assessment, care planning, or review who have substantial difficulty engaging	Local authority must instruct one
NHS Complaints Advocate	Anyone making a complaint about NHS treatment or services	Independent, locally commissioned
Care Home Residents Advocate	Residents who want independent support to raise concerns or participate in decisions	Voluntary or commissioned advocacy organisations
Relevant Person’s Representative (RPR)	Someone subject to a Deprivation of Liberty Safeguards (DoLS) authorisation	Appointed as part of the DoLS process

Who Has a Legal Right to an Advocate?

Under the Care Act 2014 and the Mental Capacity Act 2005, certain people have a statutory right to independent advocacy, meaning the relevant body is legally required to provide it. This is not discretionary.

Independent Mental Capacity Advocate (IMCA) An IMCA must be instructed by the local authority or NHS body when:

A person lacks mental capacity for a specific decision, and
The decision involves serious medical treatment or a long-term move to a care home or hospital, and
There is no one appropriate to consult other than paid staff

An IMCA can also be instructed where there is concern that a person’s interests are not being adequately represented, even where family is present.

Independent Care Act Advocate (ICAA) Under the Care Act 2014, a local authority must arrange an independent advocate for someone who has substantial difficulty in:

Understanding relevant information
Retaining that information
Using or weighing that information as part of the process
Communicating their views, wishes, or feelings

This applies during care needs assessments, care and support planning, care reviews, and safeguarding enquiries. If your family member has cognitive difficulties, communication barriers, or severe anxiety that makes it hard for them to engage meaningfully, they may be entitled to an ICAA regardless of whether family is available.

Relevant Person’s Representative (RPR) Where a Deprivation of Liberty Safeguards authorisation is in place, the person must be appointed a Relevant Person’s Representative. This is often a family member, but where no one suitable is available, an independent RPR must be appointed. The RPR has the right to request a review of the DoLS authorisation at any time.

Advocacy Services in Nottinghamshire

Several organisations provide independent advocacy services across Nottinghamshire, covering Mansfield, Kirkby-in-Ashfield, and the wider county.

POhWER

POhWER is one of the largest advocacy providers in England and operates across Nottinghamshire. They provide IMCA, ICAA, NHS Complaints Advocacy, and general community advocacy services.

Website: pohwer.net Helpline: 0300 456 2370

Advocacy Experience

Advocacy Experience provides a range of advocacy services in Nottinghamshire including Care Act advocacy, mental health advocacy, and independent advocacy for people in care settings.

Website: advocacyexperience.com

Age UK Nottinghamshire

Age UK Nottinghamshire offers advocacy and support services for older people, including help with care home concerns, benefits, and navigating care decisions. Particularly useful for families looking for informal support before engaging a formal advocacy service.

Website: ageuknotts.org.uk Tel: 0115 844 0011

Healthwatch Nottinghamshire

Healthwatch Nottinghamshire is the independent consumer champion for health and social care in the county. They are not advocacy providers in the formal legal sense, but they can direct you to the right services and take feedback about care quality that may inform local oversight.

Website: healthwatchnottinghamshire.co.uk Tel: 0115 963 6435

Nottinghamshire County Council Adult Social Care

The local authority itself has a duty to commission and arrange statutory advocacy. If you believe your family member is entitled to an IMCA or ICAA and one has not been arranged, contact Nottinghamshire County Council’s Adult Social Care team directly.

Tel: 0300 500 80 80 Website: nottinghamshire.gov.uk/care/adult-social-care

When Should You Consider Requesting an Advocate?

You do not need to wait for a crisis. Advocacy is most useful when introduced early, particularly at key decision points. Consider requesting advocacy support when:

A care review is coming up and your family member struggles to communicate their views
A significant decision about care, treatment, or living arrangements is being made
A best interests meeting has been called and you are concerned about the process
Your family member has made a complaint and is finding it hard to navigate the process
You feel the care home is not listening to your family member’s wishes
A Deprivation of Liberty Safeguards authorisation is being sought or reviewed
Your family member is being moved to a different home or unit without their full agreement

You can request advocacy on someone else’s behalf, but an advocate’s primary duty is to the person they represent, not to family members. In some cases, a family member’s interests and the resident’s interests may not be identical, and the advocate will always act in the resident’s corner.

Advocacy Is Not the Same as Making a Complaint

Many families conflate the two. An advocate helps the person engage with the system and ensures their voice is heard. A formal complaint is a separate process that challenges specific actions or failures.

If you want to make a complaint about care quality at a Nottinghamshire care home, the routes are:

The care home’s own complaints procedure is the first step. All registered care homes are required to have one. Ask for it in writing.
The Local Government and Social Care Ombudsman (LGSCO) handles complaints about local authority funded care that cannot be resolved locally. lgo.org.uk | 0300 061 0614
The Care Quality Commission (CQC) does not investigate individual complaints but takes concerns into account in its regulatory oversight. Concerns can be submitted at cqc.org.uk.
NHS England handles complaints about NHS-funded care, including NHS Continuing Healthcare placements.

Deprivation of Liberty Safeguards: A Note for Families

If your family member is living in a care home and is unable to leave freely due to their care needs or cognitive impairment, they may be subject to a Deprivation of Liberty Safeguards (DoLS) authorisation. This is a legal protection, not a punishment. It ensures that any restriction on someone’s liberty is lawful, proportionate, and in their best interests.

As a family member, you have the right to:

Be informed if a DoLS authorisation has been applied for or granted
Be consulted during the best interests assessment that forms part of the process
Request a review of the authorisation at any time if circumstances change
Be appointed as, or identify someone to act as, the Relevant Person’s Representative

If you are unsure whether a DoLS is in place for your family member, ask the care home manager directly. They are required to tell you.

Our guide to what is a best interests meeting in a care home covers the decision-making process that sits alongside DoLS in more detail.

Frequently Asked Questions

Is advocacy free of charge? Statutory advocacy (IMCA, ICAA, RPR) is free because it is provided under a legal duty by the local authority or NHS. Community advocacy from voluntary organisations is usually also free for the individual, funded through grants or local authority commissioning. Always confirm with the provider.

Can I be my family member’s advocate? Informally, yes: you can support and speak up for them. But formal independent advocacy specifically means independent of family as well as professionals. A family member cannot act as a statutory IMCA or ICAA.

What if my family member does not want an advocate? If they have capacity, their choice must be respected. An advocate cannot be imposed on someone who does not want one. If they lack capacity for this specific decision, the decision about whether to instruct an advocate is itself made in their best interests.

Can an advocate attend a care review with my family member? Yes, and this is one of the most common and valuable uses of advocacy support. The advocate can help the person prepare, understand what is being discussed, and ensure their views are communicated clearly.

What if the care home refuses to involve an advocate? If your family member has a statutory right to an advocate (IMCA, ICAA), the relevant body is legally required to arrange this. A care home cannot refuse. If you believe a statutory right is being ignored, contact Nottinghamshire County Council’s Adult Social Care team or POhWER directly.

Supporting Residents’ Rights at Lidder Care

At Newgate Lodge Care Home and Lowmoor Nursing Home, we support residents’ rights to independent advocacy and involve advocates in care planning and best interests meetings where appropriate. Families are always kept informed, and we work to ensure residents can participate meaningfully in decisions about their care.

If you have concerns about a family member’s care or want to understand more about their rights, our team is happy to talk it through. Call us on 01623 622 322 or visit our contact page.

You may also find our guides on understanding care needs assessments, the fundamental standards of care, and how to choose the right care home useful at this stage.