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The Mental Capacity Act (MCA) 2005 came into force in early 2007 and introduced the statutory role of the Independent Mental Capacity Advocate (IMCA) to support people who lack capacity to make certain decisions. This can include:

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

From the 1st October 2007, Local Authorities and NHS Trust bodies in Wales had a duty to instruct an IMCA to support an individual if they meet the criteria as laid out in the Act.

 

What is an IMCA?

 

The IMCA role is set out in the Code of Practice, but would include:

 

 

         Meeting in private with the person who lacks capacity and attempting to communicate with them using whatever means are appropriate.

 

 

         Speaking with the decision-maker and any other relevant professionals to understand what is being proposed.

 

 

         Getting the views of anybody else who can give information about the wishes, feelings, beliefs and values of the person who lacks capacity.

 

 

         Consulting any relevant records.

 

 

         Finding out what support the person who lacks capacity has had or needs, to help them make the specific decision.

 

 

         Identifying any alternative options.

 

 

         Reporting their findings to the decision maker.

 

 

 

Who instructs an IMCA?

 

 

The person who instructs an IMCA is the professional who will ultimately have to make the decision concerning serious medical treatment or a change of accommodation, or is responsible for a care review or an adult protection case.

 

 

When should an IMCA become involved?

 

 

An IMCA must be instructed for people lacking capacity who have no-one other than paid staff to support them whenever:

 

 

         A National Health Service (NHS) body is proposing to provide, withhold or stop serious medical treatment (SMT).

 

 

         A NHS body is proposing to arrange a stay in hospital lasting longer than 28 days.

 

 

         A NHS body or local authority is proposing to arrange accommodation (or a change of accommodation) in a care home for a period of longer than eight weeks.

 

 

 

An IMCA may also be instructed on behalf of a person lacking capacity for:

 

 

         Care reviews, where no-one else is available to be consulted.

 

 

         Adult protection cases, whether or not family or friends are involved.

 

Are there any exceptions?

 

The only circumstances where an IMCA need not be involved are situations when an emergency decision is required. For example:

 

 

         To provide emergency life-saving medical treatment.

 

 

         Where the person would be homeless unless they were accommodated in a care home.

 

PLEASE NOTE: Referrals can only be accepted from relevant personnel employed by a Local Authority or NHS Trust.

 

IMCA Wales is part of the Mental Health Matters Wales group, a registered charity (1123842) and a Company limited by guarantee (6468412)

Copyright 2006 MHM Wales. All rights reserved