IMCA involvement in accommodation decisions and care reviews

Where an IMCA observes potential poor practice or abuse

When meeting the person or visiting services the IMCA may have concerns about care practices or abuse. This could be in regard to the person for whom they were instructed or other service users.

Where there is potential abuse the IMCA's responsibilities to make an alert are set out under safeguarding adults proceedings. What can be more difficult are situations where there is potential poor practice. Concerns could arise from the appearance of the person or the way staff are seen to interact with them. Examples include:

Where the IMCA has been instructed to represent the person for whom they have concerns it is possible to follow these up as part of their role. For example, to talk to the manager of the care service or the relevant social worker. The IMCA in such situations also has the option to keep the case open until their concerns are adequately resolved, including by complaints processes.

Where the concerns relate to other service users the potential for the IMCA to follow these up is more limited. This is because it may be inappropriate to ask personal questions about people with whom they have no formal role. Good practice in these situations is for the IMCA to ensure that any concerns are brought to the attention of people who are in a position to investigate them and take action if necessary. Most often this will be the local authority or PCT funding the service. To do this requires finding out the person's name and which statutory organisation has responsibility.

Practice example

One afternoon, while waiting in the lobby to meet the manager of a care home for older people, a man walked past Terry, an IMCA, wearing just his pyjama-bottoms. The resident also had what appeared to be a black eye. When Terry met the manager a short while later he expressed his concerns about both seeing what appeared to be a resident dressed inappropriately for the time of day in such a public area, and the black eye. Alison, the manager, explained that this particular resident often chose to dress this way – and that the bruising around the eye happened when he tripped over the previous day. Terry asked whether Alison had raised an adult safeguarding alert with the relevant local authority care manager about the injury. She said she had not done so: she didn't see it as serious enough. Terry said that he would have expected an alert to have been made. He suggested that Alison should do this. He also asked her to give him the name and contact details of the care manager.

When Terry returned to his office he rang the care manager who had been told of the black eye and was investigating it as part of the safeguarding procedures. Terry talked about his concerns regarding the alert not being made without his prompting and also the man's inappropriate dress.

Terry made a record of this situation and discussed it with his manager. Together they agreed that they did not need to take any further action but that they would cooperate with the local authority in any ongoing enquiries.