Commissioning and monitoring of Independent Mental Capacity Advocate (IMCA) services

SCIE Guide 31

Published: October 2009

Updated: December 2010

About this guide

This good practice guide has been produced by the Association of Directors of Adult Social Services and the Social Care Institute for Excellence (SCIE) to support the commissioning of the Independent Mental Capacity Advocate (IMCA) service. It was developed through consultation with a range of stakeholders including commissioners, local authority and health authority Mental Capacity Act leads and IMCA providers. The first version was published in October 2009 and updated in December 2010.

This guide is supported by SCIE's Mental Capacity Act advisory group. Membership of the advisory group includes representatives of the Department of Health (DH), the Association of Directors of Adult Social Services (ADASS), Action for Advocacy (A4A), the Care Quality Commission (CQC) and the Office of the Public Guardian (OPG).

This good practice guide contains:

• issues to consider when reviewing IMCA contracts
• a revised example service specification
• suggestions for assessing quality
• an example engagement protocol
• suggested tender requirements.

About the development of this guide

Background

This guidance was a joint SCIE/DH commission, based on legislation and government policy, in the context of very little research evidence (except Redley et al, 2008). The project was informed by No Secrets policy and Mental Capacity Act (MCA).

Scoping and searching

Searching was not needed for this topic, as it was based on legislation with very little published evidence (as confirmed by Project Advisory Group).

Stakeholder involvement and consultation

Project Advisory Group included key author (Redley), Association of Directors of Adult Social Services (ADASS), IMCA providers, safeguarding leads, the Public Guardian, Department of Health Mental Capacity Act and safeguarding policy and implementation leads.

Peer review and testing

The document was drafted by SCIE, and several revised versions (informed by consultation with stakeholder groups listed above) were reviewed before being agreed by the MCA Advisory Group.

Additional endorsement

The document was approved independently by ADASS as their policy statement in this area: it is jointly published by SCIE with ADASS.

Context

The commissioning of IMCA services by local authorities takes place in a very challenging financial climate. This makes it critical for local authorities to provide support to the most vulnerable. Many of these people will lack capacity to make important decisions and will be eligible for the IMCA service.

The October 2010 Spending Review settlement protected funds to support the implementation of the Mental Capacity Act, including funding of the IMCA service. The MCA funding has not been cut, and has an inflationary increase up to 2015 (see Local government and the spending review: annex)

The demand for the IMCA service continues to increase nationally year on year as the duties and powers to instruct IMCAs are better understood. Commissioning arrangements need to pay careful attention to both the demand for and quality of the IMCA service.

The Department of Health has supported a number of initiatives to enhance the quality of the IMCA service. These include qualifications in independent advocacy provided by City and Guilds, and Quality Performance Mark for IMCA services provided by Action for Advocacy. The guide makes suggestions about how these can be incorporated into commissioning arrangements.