IMCA

• Are independent of the authority making the decision;

• Provide support for the person who lacks capacity;

• Represent the person's wishes, feelings, values, and beliefs and ensure that these are considered in the decision that has to be made.

• An IMCA must be appointed for someone who lacks capacity if that person has no one to whom it is appropriate to consult whenever:

• Serious medical treatment is being proposed, or It is proposed to arrange or change accommodation in a hospital, care home or other long-term accommodation and/or the person will stay in hospital for a period longer than 28 days or the person will stay in the care home for more than 8 weeks

• An IMCA may also be appointed for someone who lacks capacity, in Safeguarding Adults cases or in care/accommodation reviews.

What will an IMCA do?

• See the person in private, if possible.

• Have access to care and health records relevant to the decision

• Consult with professionals and others who know the person

• Ascertain the person’s likes and dislikes, wishes, beliefs, and values

• Find out what has been done to help the person make a decision

• Consider alternative options

• Write a report on their findings to the decision maker.

• Challenge the judgements of the decision maker.

• In cases of proposed serious treatment, seek a second medical opinion.

Mental Capacity Act Principles

• A person is assumed to have capacity unless it is proved otherwise;

• A person cannot be treated as lacking capacity until all practical steps have been taken to help the person to make the decision;

• Any decision made on behalf of someone lacking capacity must be in the person’s best interests;

• Consideration must be given to finding the least restrictive option;

• An unwise decision does not indicate lack of capacity.

Two-Stage Test of Capacity.

Is there an impairment of, or disturbance in the functioning of, the person’s mind or brain?
If so, Is that impairment or disturbance sufficient to make the person unable to make the decision in question at the time it has to be made?

Deprivation of Liberty Safeguards (DoLS)

The IMCA role was extended in 2009 with the Deprivation of Liberty Safeguards, where it can be authorized for a person to be deprived of their liberty for care and treatment if this is deemed to be in their best interests following an assessment. In this situation, the IMCA is involved during the assessment process and after the authorisation, again if the person lacks capacity and has no family or friends who are appropriate and practicable to consult.