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What is Independent Mental Capacity Advocacy?
Providing Independent Mental Capacity Advocacy is a key aspect of the Mental Capacity Act 2005.
The Act places a statutory duty on local authorities to ensure that people who are considered to lack capacity and have no appropriate family or friends to consult, have access to an Independent Mental Capacity Advocate (an IMCA) when a decision is being made about:
- Providing, withdrawing or stopping serious medical treatment.
- A change in the person’s accommodation where the NHS or local authority are proposing a stay of more than eight weeks in a care home.
- A hospital stay of more than 28 days.
- Adult protection proceedings.
- Care reviews.
An IMCA is :
- Independent of the person or people making the decisions.
- Able to meet the person who lacks capacity in private.
- Has the right to see all relevant health, social services and care home records.
An IMCA will not tell anyone information about you without your consent, unless breach of law or danger to life is involved. Find out more about our confidentiality policy
Who is eligible for IMCA?
Patients are eligible for the support of an IMCA if they have been assessed as lacking capacity in relation to a specific decision at the time that decision needs to be made, and if they have no family or friends who are willing and able to represent their likely views.
What does ‘a person who lacks capacity’ mean?
The term ‘a person who lacks capacity’ means a person who is assessed as not capable of making a particular decision or taking a particular action for themselves at the time the decision or action needs to be taken. A person may lack capacity because of an impairment of the functioning of the mind or brain. This might be because of dementia, a learning disability, or an acquired brain injury.
How is capacity assessed?
Capacity must be assessed at the time the decision needs to be made and only in relation to the decision that needs to be made.
Typically a doctor or social worker will carry out an assessment. It is not the role of the IMCA advocate to carry out this assessment.
What does an IMCA do?
An IMCA can:
- Work with and support the person who lacks capacity to find out their views, wishes and feelings, as far as is possible, and involve them in the decision-making process as much as possible.
- Represent the person’s likely views to those responsible for making decisions about their care and treatment.
- Check that those working with the person adhere to the main principles of the Mental Capacity Act and act as a safeguard for the persons rights.
- Obtain and evaluate information on behalf of the person.
- Provide the Decision-Maker with a written report (the Pre-Decision report) which outlines what the likely views of the person are and makes recommendations for alternative courses of action and includes details of how they arrived at their recommendations. Decision-makers have a responsibility to give full consideration to the contents of the IMCA's Pre-Decision report.
- Visit the person again after the decision has been made and provide the Decision-Maker with a further written report (the Post-Decision report).
- Challenge decisions and actions that have been taken. An IMCA can appeal on behalf of the person if they believe a decision has been made without due consideration being given to their report.
When is it not appropriate to refer to an IMCA?
- When serious medical intervention is required immediately, for example, in life threatening circumstances. A referral may still be made once the emergency has passed.
- When the treatment is regulated by Part 4 of the Mental Health Act 1983.
- Where it is necessary to provide accommodation urgently.
- Where restrictions are placed on an individual’s accommodation under the Mental Health Act 1983.