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IMCA information for health and social care staff

What should I do if I think someone should have an IMCA?

Independent mental capacity advocates (IMCAs) are available for particularly vulnerable people who lack the capacity to make specific important decisions. They are mainly intended as a safeguard for people who do not have family or friends who can represent them. See What do IMCAs do and who should get an IMCA?

IMCAs can only start work with an individual if instructed to do so by specific people:

  • for decisions about where someone lives and care reviews this is likely to be the care manager or social worker
  • for serious medical treatment decisions this is likely to be the doctor acting in the best interests of the person
  • for decisions about potential abuse this is likely to be the chair of the adult protection proceedings
  • for the Deprivation of Liberty Safeguards contact the Supervisory Body.

If you think someone should have an IMCA the first step you make should be to talk to the person who should instruct the IMCA. You could also speak to your local IMCA provider directly. They may be able to make sure that an IMCA is instructed where required.

If a person is not eligible for the IMCA service but you feel they could benefit from the support of an advocate, you could find out what other advocacy services are available in your area. You can find out more about advocacy services in England and Wales from the Action for Advocacy database.

How do I check that the IMCA is who they say they are?

Good practice is for health and social care staff to check the identity of everyone before they give them access to clients or share personal information about them. This applies to IMCAs.

The IMCA should carry photographic identification as proof of which organisation they work for.

If there are any concerns about the identity of an IMCA the following are options:

  • contact a manager at the IMCA organisation
  • ask to see a signed copy of the IMCA referral form
  • contact the decision maker
  • contact the local authority that commissions the IMCA service.

What do I need to do if the IMCA wants to meet the person?

IMCAs have a legal right to meet the person. Where possible this should be in private so that the person feels able to talk freely.

You may feel that the IMCA would gain little by meeting the person, for example if the person doesn’t appear to understand or use words. The IMCA is still likely to want to meet the person as it would be difficult for them to represent them without doing this.

If the IMCA asks you to meet the person the following information would be helpful to them:

  • how best to help the person to communicate?
  • whether there are times of the day when the person might find this easier?
  • whether there are any risks the IMCA should be aware of. For example, the person might be physically violent or have a history of making false allegations.

The IMCA must not be expected to take on any supervision or support roles that are normally undertaken by staff. For example, if the person needs to be supervised continuously it would not be acceptable for the IMCA to meet the person without other staff present. Similarly, if the person has particular support needs as regards eating or drinking, the IMCA should not provide this support.

Can I talk to the IMCA about the person?

Health and social care staff are a very important source of information for the IMCA and the decision maker. Their knowledge of the person can be essential to make sure the right decisions are made.

One of the roles of the IMCA is to make sure that the views of people who know the person are considered before making any decision. It is particularly important that the views of health and social care staff are included for people who have an IMCA. This is because the person is unlikely to have family and friends who can share their knowledge of the person.

Health and social care staff should feel confident sharing any information they have about the person with an IMCA. The IMCA is likely to ask the following questions:

  • how best to help the person to communicate?
  • what the person’s support needs are?
  • what the person’s views and wishes might be?
  • who else the IMCA should speak to, for example, a staff member who has a special relationship with the person?
  • what decision they think would be in the person’s best interests?

Can the IMCA look at records?

One of the legal powers of IMCAs is to be able to look at and take copies of relevant records. This includes health records, records held by local authorities and records held by care homes. See Section 35(6) of the Mental Capacity Act for the specific details of this power.

If an IMCA asks to see specific records they should be made available to them if they are relevant to the decision. If the person who holds the records thinks particular records are not relevant to the decision, they would have to justify their reasons for withholding them.

The records IMCAs may request to see could include:

  • care assessments and care plans
  • medical records including medication charts
  • daily log books
  • staff rotas to check on the level of support provided.

Will I get a copy of the IMCA report?

IMCAs are required to write a report for the person who instructed them. This and any other representations made by the IMCA must be considered by the decision maker in making their decision.

The report may contain anything the IMCA thinks is relevant to the decision that is being made.

Any requests for copies of the report should be directed to the person who receives the report (usually the decision maker) and not the IMCA service. The person who receives the report can share it if they believe it would be in the person’s best interests to do so.

What should I do if I have concerns about the IMCA?

If you have concerns about the way an IMCA is working, you should first raise this matter directly with the IMCA. It may be there is a misunderstanding of the IMCA’s role.

If it is not possible to resolve concerns with the IMCA the following options should be considered:

  • raising the matter with the IMCA’s manager
  • making a formal complaint to the IMCA service
  • bringing the matter to the attention of the local authority that commissions the IMCA service.