4. The Independent Mental Capacity Advocate (IMCA) Service

Click here to view information about Coventry Advocacy Agencies.

Click on the link to view contact details and referral forms for the IMCA Service for Coventry City Council staff (on SharePoint)

In most situations, people who lack capacity will have a network of support from family members or friends who take an interest in their welfare, or from a court appointed deputy or an attorney appointed under a Lasting Power of Attorney (see Court Appointed Deputies and Lasting Power of Attorney). However, some people who lack capacity may have no one to support them with major, potentially life-changing decisions, so the Act creates the role of an Independent Mental Capacity Advocate (IMCA) to represent and support them.

An IMCA is a specific type of statutory advocate who will only have to be involved if there are no family or friends who can be consulted. It is a legal requirement to refer to the IMCA if the person meets the criteria in this section. An IMCA will not be the decision-maker, but the decision-maker will have a duty to take into account the information given by the IMCA.

An IMCA must be involved if:

• the decision is about serious medical treatment;
• it is proposed to move a person into long-term care lasting more than 28 days in a hospital or 8 weeks in a care home or a long term move (8 weeks or more) to different accommodation is being considered, for example, to a different hospital or care home.

An IMCA can also be involved if it is thought to be in the person’s best interests in the following two situations:

• in the case of an adult safeguarding enquiry or review where the person has substantial difficulty in engaging in the process and does not have an appropriate person to support and represent them, a Care Act advocate must be allocated. An IMCA could also be involved  but this is discretionary. Staff should discuss and consider with the Care Act Advocate cases where the IMCA already knows the person well or there is likely to be a need for further IMCA involvement, such as an accommodation move, medical treatment or some other benefit to the person to retain the involvement of the IMCA. In practice if there are two advocates involved one will take the lead and try to minimise any duplication of visits;
• there is a care and support plan review. As in the above case the allocation of an IMCA is  discretionary as opposed to the person having a right to a Care Act advocate .

There is a useful flowchart  and presentation about the links between Care Act and Independent Mental Capacity advocates in the Resources section

An IMCA does not have to be involved if treatment is to be given under the Mental Health Act 1983/2007, or the person concerned is required under that Act to go into the hospital or home in question.

The duties of an IMCA are to:

• support the person who lacks capacity and represent their views and interests to the decision-maker;
• obtain and evaluate information;
• obtain a further medical opinion, if necessary.

In certain circumstances decision-makers in the NHS and local authorities must instruct IMCAs before making decisions (except in emergency situations). In Coventry the IMCA service is provided by Voiceability.

See Flowchart: Should I refer my client to an Independent Mental Capacity Advocate?

See also Jamal’s Case Study and Resources for more detailed guidance and sources of information on the IMCA service.