Independent Mental Capacity Advocate ( IMCA )

What is IMCA?

The Mental Capacity Act 2005 in 2007 introduces the new statutory role of the
Independent Mental Capacity Advocate ( IMCA ) to support people who lack capacity to make certain decisions.
Independent Mental Capacity Advocates are vetted, trained and comply with the National Code of Practice

An IMCA must be instructed by the NHS and/or Social Services, where there is a decision to be made regarding either serious medical treatment or change of accommodation AND the person has no close family or friends to represent their views and the person has been deemed by the Decision Maker to have capacity not to make that decision in accordance with the Act.

This can include:

• People with dementia or mental ill health
• People with learning disabilities and physical disabilities
• People who have had a stroke
• People with acquired brain injuries, who are unconscious or in a coma

IMCAs may also be instructed in issues of safeguarding Vulnerable Adults
Procedures and Care Reviews.

Definitions

• Serious Medical Treatment applies where an NHS body proposes to provide, or secure the provision of treatment including providing, withdrawing or withholding treatment in circumstances where:
  • In a case where a single treatment is being proposed, there is a fine balance between the benefits to the patient and the burdens and risk it is likely
    to entail for him or her.
  • In a case where there is a choice of treatments, a decision as to
    which one to use is finely blananced, or
  • What is proposed would be likely to involve serious consequences
    for the patient.
• Change of Accommodation applies where the NHS body or Local Authority
  proposes a move for the person to hospital for more than 28 days or to
  alternative accommodation for more than eight weeks.

How Does it work?

An Independent Mental Capacity Advocate can:

• Represent and support the person who lacks the capacity to participate, and ascertain their wishes or feelings.
• Obtain and evaluate information, including relevant client records and
  options
• Discuss options with decision makers and professionals
• Obtain a further medical opinion, if necessary
• Make a complaint on behalf of the person or apply to the Court of
  Protection, if neccessary.

IMCAs submit a report to the decision maker to be used by them in accordance with the statutory best interests checklist, before making the final decision

Assessing Capacity

The Mental Health Act states that a person lacks capacity if they are unable to make decisions because of an impairment of or disturbance in the functioning of the mind or brain.

A person can be deemed to lack capacity to make a decision if:

• He or she is unable to understand the information.
• He or she is unable to retain information
• He or she is unable to use or weigh the information relevant to the
  decision as part of the process of making the decision; or
• He or she is unable to communicate the decision (by talking, sign
  language, or other means)

Assessment of capacity must be decision and time specific and must
optimise the person’s ability to make the decision themselves because of an impairment of, or disturbance in the functioning of the mind or brain.

If you would like any help or advice regarding the “Independent Mental Capacity Advocate” service please contact your local CHC

Brecknock & Radnorshire CHC		Montgomery CHC
	2nd Floor 2 The Struet Brecon Powys LD3 7LH		Ladywell House Newtown Powys SY16 1JB
	01874 624206		01686 627632