Independent Mental Capacity Advocates (IMCA) help people who are assessed to lack capacity about medical treatment or where they live and have no family or friends that it would be appropriate to consult with about those decisions.
The Mental Capacity Act 2005 is a comprehensive legal framework for decision making for people who lack capacity to make particular decisions for themselves. It is accompanied by a Code of Practice and is based on common law and good practice. It puts the needs and wishes of the person at the centre of any decision making process.
The IMCA service is available for people over 16 who fit certain criteria and who are facing a specific issue where a decision has to be made in their best interests.
The person must:
An IMCA is needed when a decision needs to be made about any of the following:
If the above applies then a decision maker must, by law, refer to the IMCA Service.
The Act also now allows IMCA’s to be involved, under certain circumstances, when an application is made to deprive someone of their liberty. Please see
The decision maker is the person who has the ultimate responsibility for making the best interest decision. This is usually a consultant for serious medical treatment decisions or a care manager for accommodation decisions. Before being referred the client must have been assessed and deemed to lack capacity (as required by the Mental Capacity Act). Referrals are not accepted without the decision maker’s knowledge. IMCA’s work directly to the decision maker and copies of their confidential reports are forwarded to the decision maker only.
The decision maker or appointed staff member should make the referral directly to our service.
We provide paid Relevant Person’s Representative’s (RPR), if there are no relatives or friends available or appropriate to fulfil this role.
Referrals for the RPR service can only be made by the Bromley DOLS office. You can contact us for more information by clicking here.
Sometimes a vulnerable person who lacks capacity needs to be restricted in order to provide treatment or care which is necessary in their best interests to protect them from harm. The degree and level restrictions may amount to a deprivation of liberty (DOL).
On 1st April 2009 it became a requirement by law to apply for an authorisation in order to deprive someone of their liberty. To do this the managing authority (the hospital or care home which is, or will be, depriving the person of their liberty) must put in an application to the supervisory body. The supervisory body (SB) will then carry out a series of 6 assessments to decide if it is right to deprive the person (known as the relevant person) of their liberty.
Under certain circumstances, a DOLS IMCA can be instructed to act in a number of different ways. When there is no family member, friend or appropriate person (known as the relevant person’s representative – RPR) to support the relevant person (RP) through this process the SB will appoint a DOLS IMCA. Once the application has been approved the SB can also instruct a DOLS IMCA either to support the RP, the relevant person’s representative (RPR) – or both, or to act as the RPR themselves if no representative is available.
A DOLS IMCA is a specialist advocate. They work with people from all vulnerable client groups with all nature of impairments that can leave someone lacking capacity. They are independent of the SB, and they safeguard the rights of people who lack capacity. The role of a DOLS IMCA is different to that of a general IMCA in 3 ways:
The SB can instruct a DOLS IMCA to take on one of the following roles:
To act when the RP is unbefriended (has no RPR). The SB will instruct a DOLS IMCA to represent the person during the assessment process, with a particular focus on the ‘best interest’ assessment. The assessment process must be completed within 7 days for urgent authorisations, where a DOL is already happening or 21 days for a standard authorisation where there is a proposed DOL. The 39A DOLS IMCA role is similar to the original IMCA role including:
The 39A DOLS IMCA also has additional rights and responsibilities including access to authorisations and assessments plus the right to take the RP’s DOLS case to the Court of Protection.
To act, after the authorisation has been granted, as the RPR (where none is available). The IMCA will represent and assist the RP during the period of the authorisation.
To support the RP, the RPR or both – after the authorisation has been granted. The IMCA will represent and assist the person, their representative, or both during the authorisation period.
To refer for an RPR or an IMCA DoLS, we need the following information from the DoLS Office:
DoLS office to send Form 11, plus forms 1, 3, 4 and 5 to firstname.lastname@example.org
DoLS office to send Form 11 and Form 1 to email@example.com