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The role of the IMCA is to support and represent people aged 16 years or over who lack capacity when decisions regarding serious medical treatment or a long-term change of accommodation need to be made, and to look at how best interest decisions have been made to make sure everything has been done properly and in line with the Mental Capacity Act. IMCA’s as such are an important safeguard for people. They also may be instructed for support and representation of the person for the purpose of care reviews and adult safeguarding cases, but since 2014 this has more usually been undertaken by Care Act Advocates and there is a statutory duty to refer for care act advocacy (though this isn't available for perpetrators and so so such people would still have to be supported by an IMCA). IMCA’s are independent from although approved and instructed by the local authority or NHS. They raise questions about and challenge decisions which don’t seem to have been made in the person’s best interests.
The IMCA must prepare a report for the local council or NHS detailing the support the person needs to partake in the decision-making process and what their wishes, feelings, beliefs and values are. Also what they’d be likely to want if they had capacity and the possible options available. If the decision is about medical treatment then the IMCA also needs to state their opinion as to whether a second opinion should be requested and obtained. Also how the decision should be made in the person’s best interests e.g. could it be delayed if they are expected to regain capacity in order for them to do so; is there anyone else who ought to be consulted etc.
IMCA’s have the responsibility to act according to the 5 principles of the Mental Capacity Act, taking account of guidance from the MCA Code of Practice. They need to have appropriate training and experience, and be of good character and integrity.
When there is a statutory duty to instruct an Independent Mental Capacity Advocate:
If a person lacks capacity and is in need of serious medical treatment (proposed by the NHS) or is undergoing a long-term change of accommodation (being moved by services into a care home for more than 8 weeks or in a hospital for more than 28 days) then the local council or NHS has a statutory duty to instruct an IMCA. This applies as long as there are no appropriate family or friends to be consulted or to represent the person and the person hasn’t previously named someone who could help with such decisions if they lose capacity and made them a Power of Attorney. Also as long as the Court of Protection hasn’t appointed a Deputy.
When there is a power to instruct an Independent Mental Capacity Advocate:
If a person is undergoing a care review and has no appropriate family or friends who can be consulted, or is a vulnerable person subject to or the perpetrator in adult safeguarding procedures then the local authority has the power (rather than duty) to instruct an IMCA if they assess that it would be of particular benefit to the person. In the case of safe-guarding cases, the person would be eligible for an IMCA regardless of whether they have appropriate family or friends who could represent them or someone with Power of Attorney.
2. Section 39C IMCA’s are appointed as RPR’s when there is no other appropriate person available for that role.
3.Section 39D IMCA’s can be consulted by friend or family RPR's, or requested to represent the client under standard DoLS authorisations when necessary.
Spot purchase IMCA referrals can be made by professional employees of any council or NHS for any eligible client currently placed anywhere across Yorkshire & The Humber. All referrals must be accompanied by a completed spot purchase authorisation form. Please use the forms below. Completed forms can be sent to us at firstname.lastname@example.org using your preferred secure email system or in password protected files.