IMCA south tYNESIDE

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IMCA south tYNESIDE
Briefing Session The role of the Independent
Mental Capacity Advocate in relation to the
Mental Capacity Act and Deprivation of Liberty
Standards
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What is Advocacy?

• Advocacy is speaking and/or acting on behalf of
  people to secure the services they need and the
  rights to which they are entitled.
• Advocacy aims to ensure that people's opinions,
  wishes or needs are expressed and listened to.
• Advocates are independent from other services the
  person might access.

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Non-Instructed Advocacy

• Where the person is unable to give clear
  instructions.
• The Advocate will get to know the person and how
  they communicate.
• Talk to people who know them.
• Represent the persons preferences, values and
  beliefs.
• Ensure their rights are protected and any
  decisions made are person centred.

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What is IMCA?

• Statutory Advocacy under the Mental Capacity Act,
  2005 which came into force April 2007
• The IMCA has rights under the act to access
  medical records which are relevant to the
  decision.
• The decision maker must consider the IMCA report
  when making the decision
• The IMCA has the right to challenge the decision

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IMCA Criteria

• Over 16.
• Must not have family or friends who are willing
  or appropriate to consult with.
• Must have been assessed as lacking capacity to
  make a decision about one of the following

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MUST Refer To IMCA

• Serious Medical treatment
• Change of Accommodation

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Serious Medical treatment

• Involves
• giving new treatment, stopping treatment or
  withholding treatment that could be offered where
• there is a fine balance between likely benefits
  and burdens
• a decision between treatment options is finely
  balanced
• or proposed treatment is likely to have serious
  consequences for the person
• Serious consequences include
• Serious and prolonged pain, distress or side
  effects
• Potentially major consequences e.g. stopping
  life sustaining treatment
• Serious impact on persons future life choices
  e.g. ability to have children

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Serious Medical treatment

• Examples in MCA Code of Practice
•   Chemotherapy and surgery for cancer
•   Electro-convulsive therapy
•   Therapeutic sterilisation
•   Major surgery (such as open-heart surgery or
  brain/neuro-surgery)
• Major amputations (for example, loss of an arm or
  leg)
•  Treatments which will result in permanent loss
  of hearing or sight
•  Withholding or stopping artificial nutrition and
  hydration
•  Termination of pregnancy
• Other Examples (Serious for the individual)
• Vaginal examination for lady who wont tolerate
  interventions
• Dental examination requiring use of general
  anaesthetic

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Change of Accommodation

• hospital for more than 28 days
• provided by NHS body for 8 weeks or more
• provided by local authority for 8 weeks or more
• Responsible bodies do not have to refer if
  detained under Mental Health Act but should refer
  if person has been discharged (s.117) or if
  decision not covered by MHA (e.g. treatment for
  physical health)

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Must Consider Referring

• Care Review
• Regarding review of accommodation arranged by
  responsible body
• Safeguarding Adults
• Referral can be made in this instance even
  if family or friends are involved.

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Safeguarding Adults

• IMCA instruction must be considered where a
  person lacks capacity to consent to one or more
  of the proposed protective measures
• The IMCA could support either an alleged victim
  or perpetrator who lacks capacity
• Consideration should be given to the most
  appropriate time to instruct an IMCA this may
  be at the strategy stage or planning stage

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Safeguarding Adults

• Need to consider whether IMCA involvement is of
  particular benefit to the individual
• i.e. where
• - there is serious exposure to risk e.g. death,
  physical injury, serious emotional distress
• - there is a life-changing decision involved
• - there is a conflict of views between
  professionals
• - there is a risk of financial abuse which
  could have a serious impact on the persons
  welfare e.g. theyd have to change accommodation

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Role of IMCA

• Respond within 2 working days.
• Meet with the person, speak with anyone who knows
  them.
• Talk to any professionals involved with the
  person.
• Attend any relevant meetings.

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Role of IMCA

• Find out as much as possible about the persons
  wishes, values and beliefs.
• Submit a written report to the decision maker.
• Recommend any other courses of action that may
  help to support the decision making process.
• Enable the decision maker to make decisions in
  the best interest of the person.

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What happens if the decision does not seem
appropriate?

• IMCA encouraged and supported to challenge
  decisions which seem to go against the persons
  wishes, values and beliefs.
• They will be encouraged and supported to seek
  second opinions in these instances.

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The IMCA will not

• Assess capacity
• Make the decision
• Recommend a specific outcome

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REFERRAL FORM

• The IMCA referral form has qualifying criteria
  which must be met before the referral can be
  accepted.
• It is very important that all sections of the
  form are fully completed.

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IMCA role in Deprivation of Liberty Safeguards

• 39A IMCA must be consulted during DOLS
  assessment process if no appropriate
  friends/family
• 39C IMCA must be instructed where there is a
  gap in provision of an RPR
• 39D a person who is deprived of their liberty
  or their unpaid RPR has a right to request extra
  support from an IMCA
• Paid Relevant Persons Representative IMCAs are
  also commissioned to act as paid RPRs in South
  Tyneside

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Contact Details
Dianne Soulsby (first contact) Your Voice
Counts The Old Bank Swinburne Street Gateshead NE8
1AX (0191) 478 64 72 mail_at_yvc.org.uk www.yvc.or
g.uk Download referral form from website