Session Five The Independent Mental Capacity Advocate (IMCA),

1. Mental Capacity Act 2005: a practice-based courseSupporting older people in care homes and the community as they would like. Session Five The Independent Mental Capacity Advocate (IMCA), Court of Protection and Public Guardian

2. Independent Mental Capacity Advocates (IMCA) Discuss in your groups:- What is the meaning of the word advocate? In what circumstances would you want an advocate?

3. An advocate is: Dictionary definitions: • “one who pleads the cause of another” • (Collins) • “one who speaks on behalf of another person, especially in a legal context” • (Wikipedia)

4. What does an IMCA do? • Provides non-instructed advocacy • The key principles of non-instructed advocacy • The client does not instruct the advocate. • The advocacy is independent and objective. • People who experience difficulties in communication have a right to be represented in decisions that affect their lives. • The advocate protects the principles underpinning ordinary living which assumes that every person has a right to a quality life.

5. When is an IMCA needed? The IMCA service is provided for any person: • aged 16 years or older • who has no one able to support and represent them • who lacks capacity to make a decision about either: • a long-term care move; • serious medical treatment, including stopping or withholding; • adult protection procedures; or • a care review. Do you know how to arrange for an IMCA?

6. Which people need an IMCA? Someone who is ‘un-befriended’ Person has not nominated anyone to consult with No family or friends suitable No LPA No Court Appointed Deputy

7. Adult protection A man who is in his 70s and has dementia was placed in a care home following a long stay in hospital His care manager had made a best interests decision which his family did not agree with and they had requested that he leave the care home, indicating that they may remove him Due to serious concerns about the man’s safety, an adult protection strategy meeting was held and an IMCA instructed Prior to attending the care review, the IMCA met with the man who gave a clear indication that he was happy and did not want to leave the care home The IMCA was able to communicate the man’s views and wishes at the care review meeting Scenario taken from Making Decisions: the Independent Mental Capacity Advocate Service

8. The Court of Protection and the Public Guardian The MCA introduces two new bodies: the Court of Protection the Public Guardian you can find out much more in the Mental Capacity Act Code of Practice, Part 2, Chapter 8

9. Role of the Court of Protection • Hears and settles disputes where other methods have failed • For example - genuine doubt or disagreement about the validity of an advance decision to refuse treatment • Appoints deputies to monitor care of someone who lacks capacity to make certain decisions • Appoints Court of Protection visitors.

10. The role of the Public Guardian Keeps a register of Lasting Powers of Attorney and Enduring Powers of Attorney Monitors attorneys Receives reports from attorneys and deputies Keeps a register of orders appointing deputies Supervises deputies appointed by the Court Directs Court of Protection visitors Provides reports to the Court Deals with enquiries and complaints about the way deputies or attorneys use their powers Works closely with other agencies to prevent abuse

11. Summary The role of the IMCA provides further safeguards in law for people who lack capacity to make serious decisions about their health and welfare and who do not have another source of support. The Court of Protection and Public Guardian help to monitor how the MCA is enacted and have specific roles in providing a further layer of safeguarding for vulnerable people.