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Independent Mental Capacity Advocate IMCA

The Mental Capacity Act 2005 (MCA) creates the Independent Mental Capacity Advocate (IMCA).

Advocacy Partners currently provides the IMCA service in;

Camden, Croydon, Islington, Merton, Sussex, Sutton, Tower Hamlets and Wandsworth.

You can download an IMCA referral form (Word document) here

You can download guidance to filling out the form here

Central Referrel Tel: 0845 0175 198 

(calls cost 2p per minute during daytimes (from 6am to 6pm), and a half pence per minute at all other times.)

Fax: 0208 330 6622

email: imca@advocacypartners.org

Download this page in word here

Read more about IMCA at www.dh.gov.uk/imca

Read the MCA and its Code of Practice www.dca.gov.uk/legal-policymental-capacity/index.htm

Who should be referred to the IMCA service?

The LA/NHS decision-maker must refer any person who meets all the following criteria:

· A decision is being made about either
1) serious medical treatment or
2) long term moves (more than 28 days in hospital/8 weeks in care home)
· and the person does not have the capacity to make that decision
· and they have no 'appropriate' family or friends to consult with.

You may also be able to make a referral where a person does not have the capacity to agree to the arrangements for;

3) accommodation reviews, where there are no family or friends able to support and represent the person.
4) adult protection proceedings, where the person is victim or alleged perpetrator, regardless of family and friend involvement.

You will need to check your Local Authority guidelines about when you can refer for reviews and adult protection proceedings.

Who can refer people to the IMCA service?

It is the decision-maker's legal responsibility to decide if the person meets the criteria and to make the referral. The decision maker is the NHS or the Local Authority. E.g. Dr/ care manager. In Camden, Islington, Tower Hamlets and Wandsworth only 'authorised' referers can refer. Please check your intranet or ak your manager who these are in your area.

We may accept an initial referral from someone other than a decision-maker where the referrer has been unsuccessful in persuading the decision-maker to refer and it seems likely that the person meets the criteria for an IMCA. In this situation however, we will need to contact the decision-maker to authorise the instruction of an IMCA before we provide an IMCA.

What will the IMCA do?

The IMCA's role is set out in the MCA and further in IMCA Regulations and the Code of Practice;
· support and represent the person in the decision making process
· can meet the person in private,
· find out the person's past and present wishes, feelings, values
· evaluate information including accessing and copying relevant social and medical records
· evaluate alternative courses of action
· consult with others involved in the person's life
· establish the support given to the person in the decision making process
· seek a further medical opinion if necessary
· check the Mental Capacity Act principles and best interest check list are being followed
· prepare a report, which the decision maker has a legal duty to consider
· challenge the decision (including capacity) if necessary, informally first and through Court of protection as a last resort


The Mental Capacity Act 2005 (MCA)

This is a new piece of legislation to empower and protect people who may be unable to make some decisions for themselves. There are five principles on the face of the MCA that you must follow;

· Assume a person has capacity unless proved otherwise
· Do not treat people as incapable of making a decision unless you have tried all practicable steps to help them
· A person is not incapable of making a decision because their decision may seem unwise
· All acts done/decisions must be in the best interest of the person concerned
· Use the action least restrictive of the person's rights and freedoms

The person who is deciding to do an act on behalf of someone has the responsibility to follow the Capacity test, which is set out in the Mental Capacity Act.

Capacity test

Does the person have an impairment that could affect their capacity?
If yes, then a person is unable to make a specific decision for themselves, if they are unable to -
· understand the information about the decision
· retain that information
· use that information to make the decision
· communicate their decision

The MCA also says that people must be given as much help as possible to make their own decision, for example having time to understand the information and access to interpreters.

Best Interests

If after using the capacity test you have a reasonable belief that the person lacks capacity to make that decision, then you must take a Best interest decision.

The MCA provides a Best Interest check list that you must follow;
· Consider if the person may have capacity at some other time
· Involve the person who lacks capacity
· Have regard for their past and present wishes, feelings, beliefs, values and other factors they would consider if they were able
· Consider all relevant circumstances
· Consult with others who are involved in the care of the person
· Do not discriminate because of age, condition etc.

You can contact us for more information about the IMCA service and if we provide IMCA in your area we may be able to come and talk to your team.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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