IMCA involvement in accommodation decisions and care reviews
Visiting accommodation options
The IMCA may wish to visit accommodation options that are being seriously considered. The purpose of these visits is to explore how well the service could meet the person's needs and wishes.
Visits to potential services can provide information in addition to that contained in CQC reports and the information brochures care homes are required to provide. The IMCA may need to establish:
- The accessibility of the room which the person may move into. For example, how difficult would it be for the person to independently access other parts of the home?
- Whether there will be restrictions on the person's movement. For example, is the kitchen locked, will they be able to go out of the front door or into the garden without support from staff to release a lock?
- The physical state and size of parts of the home which may be important for the person. For example, is a proposed bedroom of a similar standard to others, and how well is the garden maintained? Are there concerns about hygiene standards?
- Any restrictions on what the person could bring to or keep at the service. For example, furniture or pets.
- Features relating to the physical location of the service which may be significant for the person. For example, the view, whether there is a lot of traffic noise, access to public transport, accessibility of shops and other facilities. While a desired facility may be close by, there may be particular challenges to get there for the person, including no, or uneven, pavements, lack of street lighting, difficulties crossing the road, or evidence of crime which may inhibit the person from going out.
- Information about compatibility with other people living in the service. For example, having similar interests, or whether the person may be at risk from other service users.
- How the person's ethnicity, gender, religion or sexuality may impact on their experience in the service. For example, are there staff who speak their language?
- Local opportunities.
Although a lot of the above information could be gained without visiting the service – for example, by talking to the manager - going there gives the IMCA an opportunity to further evidence the information. It also allows for factors to emerge which may not otherwise have been identified – for example, observing good or poor practice in the service with regard to the dignity of the people currently living there.
For practical reasons the IMCA may request a colleague or an IMCA from another service to visit a service and/or to provide feedback on how it might meet the person's specific needs and wishes. An example of this is if it is proposed for the person to move to a service in another part of the country.
Visiting with the person
Consideration should be given to the person themselves having the opportunity to visit a proposed service before the final decision is made. This may be required under the MCA because the MCA Code of Practice states that decision-makers should 'make sure that all practical means are used to enable and encourage the person to participate as fully as possible in the decision-making process' (5.23). The IMCA may wish to make representations for this to happen.
Attention should be given to the best time for the person to visit the service and who may be best to support them during the visit. This is likely to be a member of staff who knows them well, who may not necessarily be a senior member of staff or their key worker. It should not be assumed that the person will have just one visit prior to a decision being made, and/or moving. It may be the case that they will benefit from transition visits to help prepare both themselves and the receiving service for the move.
Ideally the IMCA will be able to arrange visiting a proposed service at the same time as the person does. This allows the IMCA to capture the person's responses to the service, as well as responses from other service users and staff, which could raise important issues with regard to what would be in the person's best interests. Examples include:
- interaction with other service users and staff
- observation of the person's ability to access different parts of the service (e.g. the size of their wheelchair in relation to doorways and corridors, or their ability to use any lift independently)
- their response to the physical environment
- if there are pets, and their interaction with them
- their familiarity with the locality.
IMCAs should be very careful about taking on any responsibility for the person's support if they are visiting a service together. This includes giving the person a lift in their car, accompanying them on public transport, or being available to provide support with supervision, personal care, or eating and drinking.
Generally it is not appropriate for IMCAs to take on these roles: they are the responsibility of any current care provider and the responsible body proposing the arrangements. In exceptional cases it may be acceptable for an IMCA to offer this type of support, but this should only happen with prior written agreement from either the responsible body or the current care provider and a risk assessment should be undertaken by the IMCA provider (who would also need to check that their insurance covers such roles).
Where a person is unable to visit the service, or to support further discussions where they have been able to, the IMCA may wish to take photographs of the proposed service (or other video/audio recordings as appropriate to the needs of the person). Care must be taken not to photograph other service users unless the IMCA is confident of their informed consent.