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Key learning point

All relevant people involved in the key care and support planning processes, and all independent advocates, are expected to understand and apply the Mental Capacity Act.

Slide 11


  1. The MCA introduced Independent Mental Capacity Advocates (IMCAs). Under the MCA, when people meet the IMCA criteria, local authorities and the NHS have a duty to instruct an IMCA for changes in accommodation and serious medical treatment decisions. For care reviews and adult protection procedures, local authorities and the NHS have powers to appoint an IMCA (where they consider it beneficial).

  1. IMCAs are independent and work for advocacy providers who are not part of a local authority or the NHS. The MCA requires ‘decision-specific’ assessments of capacity. The IMCA will stop being involved in a case once the decision has been finalised and they are aware that the proposed action has been carried out. They will not be able to provide on-going advocacy support to the person. If it is felt that a person needs advocacy support after the IMCA has withdrawn, it may be necessary to make a referral to a local advocacy organisation.

  1. The right to an IMCA applies to decisions about long-term accommodation moves to or from a hospital or care home or a move between such accommodations (and serious medical treatment decisions). An IMCA safeguards the rights of people who:

  • are facing a decision about a long-term move;

  • lack capacity to make a specified decision at the time it needs to be made; and

  • have nobody else who is willing and able to represent them or be consulted in the process of working out their best interests, other than paid staff.

  1. An IMCA cannot be involved if a person has capacity (or the proposed long-term change in accommodation is a requirement under the Mental Health Act 1983).

  1. Individual IMCAs must:

  • have specific experience (related to working with people who need support with making decisions, advocacy experience and experience of health and social care systems)

  • have IMCA training

  • have integrity and a good character

  • be able to act independently.

  1. They must also understand how to support and represent people who have dementia and learning disabilities, or other mental impairments which mean decision making is impaired.

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