IMCA Quality Service

IMCA

IMCA (Independent Mental Capacity Advocacy) is a statutory form of advocacy that came into being in April 2007 as part of the Mental Capacity Act 2005.
It provides safeguards for people who lack capacity to make certain serious decisions for themselves and have no one to represent them.

ATGlos is the Gloucestershire provider for the IMCA service.

It is not normally available to people who have family or friends who can be consulted about the decision.

The advocate’s role is to give an independent report on the person’s current or past wishes, culture, beliefs and known needs to help the professionals making the decision to ensure that they are working in the person’s best interests.

People who need IMCA are likely to be facing a crisis. IMCA advocates will therefore work as quickly as possible to establish the wishes and needs of the person, and the views of those who care for them.

IMCA's can:
• Ask to see the person they are representing in private
• Ask for access to the person’s medical and health records, and to take copies from these
• Request further medical opinions

1. Who is IMCA for?

IMCA is for people who lack capacity to make decisions about
• serious medical treatment or
• moving into, or between, care settings (including hospital) other than for the short-term. If the person will be in hospital for more than 28 days, or in a care home for more than 8 weeks.

In order to get support from IMCA, a person lacking capacity must also:
• Lack family or friends with whom the decision maker may consult.

The IMCA does not make the decision they will gather information about the person’s wishes, values and circumstances as well as identifying possible alternative courses of action, in order to inform the final decision.

2. Capacity?

Before a referral is made to IMCA, the decision maker or another competent person must determine whether or not the individual has capacity to make the decision in question. Only if they lack capacity should IMCA be contacted. The Code to the Mental Capacity Act gives guidance on the test for capacity.

If, in working with an individual who has been assessed as lacking capacity, the advocate believes that the person in fact has capacity for the decision in question, they may request a re-assessment.

3. What is ‘serious medical treatment’?

Serious Medical Treatment

The regulations for the Mental Capacity Act give the following definition of ‘serious medical treatment’:

Serious medical treatment is treatment which, involves providing, withdrawing or withholding treatment in circumstances where—

(a) In a case where a single treatment is being proposed, there is a fine balance between its benefits to the patient and the burdens and risks it is likely to entail for him,

(b) In a case where there is a choice of treatments, a decision as to which one to use is finely balanced, or

(c) What is proposed would be likely to involve serious consequences for the patient.

Family or friends?

People can only get support from IMCA if family or friends with whom the decision maker can realistically consult are unavailable or not appropriate.

This may mean that the person has no living family, but it could also mean that they have little or no contact with their family, or that any known family or friends are too far away to play a meaningful part in consultation.

IMCA should not be involved simply because family or friends disagree with the decision maker.

However, if Protection of Vulnerable Adult procedures have been activated in relation to family or friends, the individual may be referred to IMCA.

Moving home

Moving to a care home or hospital

IMCA should be contacted whether the person is going into a care home or hospital for the first time, or moving from care home or hospital to another.

‘Care home’ may include warden-assisted accommodation, supported living, and other arrangements made by the local authority.

Self-funding

Self Funding

People who are paying for their own medical treatment are not eligible for IMCA for serious medical treatment decisions.

People who fund, or will fund their own residential care are eligible for IMCA if they have been assessed by the local authority, and the authority decides it has a duty to them under Section 21 or Section 29 of the National Assistance Act 1947, or Section 117 of the Mental Health Act 1983.

Response time

We aim to respond to all appropriate referrals to IMCA as soon as possible. We would expect to begin working on a referral, usually by visiting the person concerned, within 3 working days.

Response Time Aims