The Independent Mental Capacity Advocate (IMCA) Service

 

The Mental Capacity Act 2005 required the introduction of a new Independent Mental Capacity Advocate Service. This service is applicable from the 1st April 2007.   

The IMCA Service is available to persons aged 16 years or older who have been formally assessed to be lacking mental capacity and have no appropriate friends or family* to consult in certain situations.

 An Independent Mental Capacity Advocate must be instructed when…

  1.      A decision must be made on their behalf regarding either, the provision, or withdrawal, or
           withholding, of serious medical treatment.

2.      A decision must be made on their behalf regarding long term accommodation in a hospital,
          residential nursing or other supported care environment.

An Independent Mental Capacity Advocate may be instructed when…

3.      A review is proposed or is in progress of the qualifying arrangements which have been made by
          a responsible body as to their accommodation, or;

4.      *Irrespective of whether they have appropriate family or close friends, it is proposed to take
          protective measures under adult protection procedures.

    Making a Referral

The IMCA service across Stoke and Staffordshire is provided by Asist. You can download the referral form from this website.  Referrals can only be made by an authorised person – known as the Authorised Officer - and should be made in writing by completing the attached pro forma and sending it by e-mail, post or fax. Where a verbal referral is made, the referral form should be completed and returned within 24 hours. The contact details for Asist are…  

Asist will confirm acceptance of the referral within one working day of receipt.

    Contacts

For further information please see our list of frequently asked questions (FAQs). You can contact Asist using the details above, or the IMCA project leads at Staffordshire or Stoke on Trent . They are…

Steve Dale, Adult Protection Co-ordinator, Staffordshire County Council on 01785 278531 or stephen.dale@staffordshire.gov.uk

Peter Ball, Project Development Officer (Adults), Stoke on Trent City Council on 01782 235940 or peter.ball@stoke.gov.uk

 
    FAQs

Why do I have to fill in the referral form when I have already given you the details by telephone?
The form represents a formal instruction under the terms of the Mental Capacity Act 2005 and Asist is obliged to receive and retain a completed form for each case. We regret any inconvenience this may cause and trust that persons making referrals will understand that we must request the form in order to comply with the terms of our contract to supply the service.

What are Authorised Officers. Client Contacts and Decision Makers?
An Authorised Officer is a person who has been given approval to instruct an IMCA by the body responsible for the decision. This is at the discretion of the responsible body, however, examples of Authorised Officers might include Consultants, Doctors, Psychiatrists, Social Workers, Team Managers and Nurses or, indeed, anyone who is acting with the Decision Maker’s approval.

A Client Contact is the person most appropriate for the IMCA to contact in order to make arrangements to visit the person who is the subject of the decision. They need not be involved in the decision process but should be able to make arrangements for access.


The Decision Maker is the person who has the ultimate responsibility for making the decision, and is the person to whom the IMCA will present their findings and report.

It is important to recognise that the Authorised Officer, Client Contact and Decision Maker may all be the same person, however, the referral form has to allow for the fact that they may be different.

Which IMCA Service is instructed when a person lives in one geographical area and is subject to a decision being made in another?
In respect of persons requiring Serious Medical Treatment it is envisaged that the responsible body will instruct the IMCA Service covering the location where the person is being treated. In respect of long term care, section 10.12 of the Code of Practice states that “The organisation that must instruct the IMCA is the one that is ultimately responsible for the decision to move the person. The IMCA to be instructed is the one who works wherever the person is at the time that the person needs support and representation.” The Department of Health lead on the IMCA Service, Paul Gantley, recently put this quite succinctly when he stated that the service is instructed where the person is, not where they live.

Is the IMCA a Decision Maker?
No. The IMCA does not make decisions and, for the avoidance of doubt, does not propose solutions or choose from a range of options. The Act makes it clear that the role of the IMCA is solely to provide information which the Decision Maker may take into consideration in reaching a decision.

Is the IMCA Service an emergency response service?
No. The service is commissioned on a 9-5 Monday to Friday basis, and Asist will confirm acceptance of a referral within one working day of receipt. Asist will make every effort to be flexible and to provide a quick response where necessary, however, we trust our referrers will appreciate that, at this stage, the demand for the service is not known, and there will undoubtedly be a steep learning curve for all involved in instructing and providing the service.

What constitutes Serious Medical Treatment?
The definition of Serious Medical Treatment is contained within the Mental Capacity Act Code of Practice sections 10.43 through 10.45. The Code of Practice is available on the Department for Constitutional Affairs website at www.dca.gov.uk/menincap/legis.htm#codeofpractice

When are friends or family inappropriate to consult?
In general terms, the IMCA Service is only available to persons who lack capacity and have no friends or family to support them, however, there can be exceptions. The most obvious exception is where the IMCA is being instructed in relation to procedures for the protection of vulnerable adults and friends or family are involved in the situation.

It is not possible to give definitive guidance on other situations where friends or family may be available yet considered inappropriate as each case must be judged on its merits, however, the following is offered as general guidance on situations where an exception might be considered reasonable.

Friends or family could be considered inappropriate to consult if…

Please note that where friends or family are involved, an exception cannot be made solely on the grounds that they disagree with the proposed course of action - one or more of the above criteria would also have to apply.

If it is decided that friends or family are inappropriate to consult, it is the responsibility of the Decision Maker to record the reason why they have made this decision.

 

Where can I find out more about the IMCA Service?
Most authorities are providing local training on the Mental Capacity Act, including the IMCA Service, and you should check for availability on notice boards and with Team Managers.

The Mental Capacity Act Code of Practice chapter 10 explains the IMCA Service. It is available on the Department for Constitutional Affairs website at www.dca.gov.uk/menincap/legis.htm#codeofpractice

The Department of Health website also provides a useful information bulletin on the IMCA Service from April 2007 which is available at www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_066049

The IMCA Service leads for Stoke on Trent City Council and Staffordshire County Councils are given below. These persons represent the Councils on an IMCA Steering Group which will monitor the performance of the Service and provide a forum for any issues to be addressed. These are:-

Steve Dale, Adult Protection Co-ordinator, Staffordshire County Council on 01785 278531 or stephen.dale@staffordshire.gov.uk

Peter Ball, Project Development Officer (Adults), Stoke on Trent City Council on 01782 235940 or peter.ball@stoke.gov.uk