The Independent Mental Capacity Advocacy Service is a statutory service provided under the Mental Capacity Act (2005), which aims to empower and protect people who lack capacity to make decisions for themselves.  Advocacy Focus are commissioned by Trafford Council to deliver an IMCA service across Trafford.

What is lack of capacity?

Whenever the term ‘a person who lacks capacity’ is used, it means a person who is without the ability to make a particular decision at the time it needs to be made due to a disturbance or impairment of the mind or brain. This may be because they have a mental health diagnosis, or cognitive condition, is unconscious or barely conscious, perhaps as a result of an accident, or use/misuse of drugs or alcohol.

A person’s capacity may vary over time or may depend on the type of decision that needs to be made.

Some people may always lack capacity to make some decisions, for example, due to a condition or severe learning disability that has perhaps affected them from birth.  Some such people may, however, go on to learn new skills that enable them to gain capacity and make decisions and take actions for themselves as their lives progress. 

What is the role of an IMCA?

The role of an IMCA is to:

  • Ascertain as far as possible the person’s wishes and feelings.
  • Support a person who lacks capacity to participate in the decision making process.
  • Obtain and evaluate relevant information on behalf of the service user.
  • Consult with staff, professionals and others who know the person well.
  • Decide whether to ask for a second medical opinion where it is a serious medical treatment decision..
  • Explore alternative options and choices and ensure they are considered for the individual.
  • Secure the individuals rights
  • Challenge professionals where appropriate
  • Our IMCAs can also support service users through the Court of Protection processes, and have significant experience in supporting service users in the role of a 'Litigation Friend'.

Who is eligible for an IMCA?

  • People who lack the capacity to make specific decisions about serious medical treatment and/or changes to accommodation. The individuals will have no suitable family or friends available for appropriate consultation.
  • Perpetrators of 'safeguarding adults' proceedings.
  • Those involved in a review of an accommodation decision, where it is felt that the person would benefit from an IMCA.
  • A hospital or Care Home requesting authorisation to deprive a person of their liberty.
  • A person who is deprived of their liberty.

What is deprivation of liberty?

When a person lacks the mental capacity to make decisions about the care or treatment they need, and may be at risk if that care is not provided, it is sometimes in their best interests to deprive them of their liberty to keep them safe and prevent harm. Legislation exists to ensure that no one is deprived of their liberty without good reason, and that if someone does indeed need to be deprived of their liberty in these circumstances, that person still has specific rights.

One of these rights is to have a Relevant Person’s Representative (RPR) to protect their interests throughout the process.  An RPR can be a friend or family member, but it is often a Paid RPR from Advocacy providers. Sometimes family and friends find it difficult to support their loved ones to challenge there deprivation of liberty as they feel the care home/or hospital is the best place for their loved one to stay.

IMCA and deprivation of liberty safeguards

Section 39 of the Mental Capacity Act 2005 sets out the different IMCA roles:

  • Section 39A IMCAs are instructed when there is an assessment in response to a request for a standard authorisation, or a concern about a potentially unauthorised deprivation of liberty.
  • Section 39C IMCAs cover the role of the RPR when there is a gap between appointments.
  • Section 39D IMCAs support the person, or their RPR, when a standard authorisation is in place.

Who can make a referral?

Referrals for an IMCA can be accepted from any third party.  However, we can only take formal instructions from the decision maker who is responsible for the overall decision.  All referral in relation to DoLS must be made by the Supervisory Body.

Advocacy in action

How we helped Betty

Betty* had a diagnosis of a severe Learning Disability and Autism, staff at her supported living accommodation noticed that two of her teeth had become loose and took her to the dentist, the dentist had concerns that leaving these teeth intact could pose a risk of Betty swallowing these and choking. The dentist proposed that Betty had all her teeth removed under general anaesthetic, as she had advanced gum disease with little possibility for any future improvement. The dentist assessed Betty’s capacity and found that she lacked capacity in this area. As Betty has no family or friends, it was decided that a referral should be made to the IMCA service. Continue reading...

Make a referral

  • To refer, please complete an IMCA referral form and email it to  [email protected]
  • If you are unsure whether a referral is appropriate, please contact us on 0300 323 0965 for more advice.

Upon receiving a referral, if the service user is eligible for the service, an IMCA will make contact with them within 3 working days.  For DoLS cases, the IMCA will make contact sooner.

Video Resources

Advocacy Focus and the pan Lancashire MCA Practice Group have created a series of informative videos to raise awareness about the Mental Capacity Act. The MCA Practice Group recognised the need for health and social care professionals to be brought up to speed on specific parts of the Mental Capacity Act and how these affect eligible adults in need of advocacy or support.

Advocacy Focus’ Operations Director, John Hutchison, was part of the production team who scripted each of the eight short videos in the series, and was also involved in the editing and production to ensure that all stakeholders could relate to and access the material effectively.

The videos offer helpful guidance on subjects including: 'IMCA Advocacy Services,' ‘Lasting Power of Attorney,' ‘Best Interest Decision Making,' ‘Mental Capacity Assessment’ and numerous other aspects of the Mental Capacity Act.

  • To view the videos, please click here
  • To view the E-book, please click here