IMCA and paid relevant person's representative roles in the Mental Capacity Act Deprivation of Liberty Safeguards
Applications for further authorisations
Authorisation is granted Open
If the authorisation is granted the supervisory body must provide any representative 39A or 39C IMCA with:
- a copy of any current standard authorisation (standard form 12)
- copies of any assessments completed (standard forms 5-10).
These should also be provided to any 39D IMCA involved if requested.
Where a further authorisation is granted the paid representative must be reappointed if they are to continue in their role for the new authorisation (form 25). Similarly it is good practice for a 39C IMCA to be reinstructed in the unlikely situation that it is not possible to appoint a paid representative.
Authorisation not granted Open
If the authorisation is not granted the supervisory body should notify any IMCA or paid representative involved (form 13). The supervisory body should also advise any representative that their role is ending in relation to the original authorisation (form 26).
IMCAs and paid representatives may have the following concerns:
- The person’s treatment or care does not reflect their best interests.
- The person is still being deprived of their liberty.
- The person may have been wrongly assessed as having capacity to make decisions about their treatment or care.
- The assessment process was not followed as required.
There are significant concerns about other aspects of the person’s treatment or care.
The section on 'IMCA role if authorisation not granted' sets out specific formal action which could be taken in these circumstances. Where the original authorisation has not yet ended paid representatives or 39C IMCAs could use their rights to make an application to the Court of Protection to formally raise any significant concerns.
Example of 39D IMCA support Open
Amir had been subject to a standard authorisation in a care home for three months. He had both mental health needs and learning disabilities and the restrictions were in place to address the risk of self-harm both inside the home and outside. This included locked doors and windows as well as the PRN (as needed) use of medication.
Three weeks before the end of the first standard authorisation an application was made for a further standard authorisation. The supervisory body instructed a 39D to support Amir and his sister (who was his relevant person’s representative) during the assessment process.
After a risk assessment the 39D IMCA met Amir and spoke to his sister. Amir’s sister was accepting of the restrictions but was glad of the IMCAs help to explain why a further request had been made and how she could be involved. The IMCA also learnt from Amir’s sister that previously he had enjoyed fishing and gardening. The IMCA also examined the care plan and daily records. This showed that Amir made daily attempts to go outside but he was only supported to do so for about an hour a week.
The IMCA discussed their concerns with the best interests assessor about how rarely Amir’s had the opportunity to go outside, and how his care plan could better reflect his interests. They also put their concerns in a report to this assessor which they copied to the supervisory body and the care home manager.
The authorisation was granted for a further six months. The care home reviewed the care plan to schedule support to be available for Amir to go out at least two hours a day including giving him the opportunity to do activities which he was known to enjoy.
(Example provided by East Lancashire Advocacy Service)