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The Mental Capacity Act 2005 introduced the role of the independent mental capacity advocate (IMCA). This is essentially a new safeguard for adults when they lack the capacity to make critical health and welfare decisions, particularly those without family or friends to represent them. IMCAs can have a statutory role in adult protection cases that is detailed in this paper. Advocacy Partners (AP) was one of seven organisations piloting this service in England before the service was introduced nationally in April 2007. AP is now commissioned to provide the IMCA service in 10 local authorities in the South East. Of the 270 cases referred to Advocacy Partners that have met the criteria for an IMCA since the Act was implemented, 38 were referred as part of adult protection proceedings. This early experience of IMCA involvement in adult protection cases is discussed.

Sense, the leading national charity that supports and campaigns for children and adults who are deafblind, set up the Capacity to Communicate Project in response to the new role of independent mental capacity advocates created by the Mental Capacity Act 2005 (HM Government, 2005). The project provided training and information, harnessing best practice around communication and advocacy for people who lack capacity and who have little or no formal communication, in particular those with a dual sensory loss. As part of the training, advocates were asked to submit a written assignment. These case studies, including some adult protection cases, have given us valuable information about the nature and process of independent mental capacity advocacy and what can be done to improve this relatively new statutory role, in particular developing better understanding, skills and processes around communication in order to represent and protect vulnerable adults.

This paper aims to show the particular difference Independent Mental Capacity Advocates (IMCA) can make towards specific decisions which some acquired brain injury clients, who are eligible for the IMCA service, experience.

A case study is highlighted in which the role of the IMCA is described against the background of a selective literature review on the history of advocacy in relation to its emergence as a profession. This analysis references issues of spirituality and culture.

Themes raised in the case are discussed with reference to ongoing research and these are related to the best interests of clients, and to reflexivity as a basis for the professionalisation of advocacy.

IMCA practitioners are instructed in well‐defined “best interests” situations, where an individual has no capacity, support or representation, or requires safeguarding measures in relation to certain decisions. In these cases, social, cultural, emotional, religious or spiritual factors can contribute to the decisions which need to be made.

The emerging role of the IMCA in the “best interests” process is outlined, including how health and social care professionals, or decision‐makers, may relate to, benefit from, or respond to challenges by the IMCA in supporting clients in decisions made on their behalf.

Healthcare professionals and those advocating, including IMCA, could more intentionally weigh up the values and beliefs of clients using, for example, the “best interests checklist” or by referring to “spiritual assessment”, as used increasingly by mental health ward staff and chaplains.

The Mental Capacity Act 2005 provides that independent mental capacity advocates (IMCAs) must be consulted before certain decisions are made on behalf of people who lack capacity. This article describes the principles in the Act under which such decisions are made, the role of IMCAs and proposals for the establishment of the IMCA service.

Local authorities and primary care trusts receive regular instructions to put new legislation into practice, and to ensure appropriate training. This article takes the implementation of the Mental Capacity Act as a case study of how commissioners are involved in such changes, and reports on two models. The MCA is an example of the gains that can be made if commissioners think about implementation across agencies, and between public and private sectors.

The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and treatment generally not amounting to a deprivation of their liberty (although such could be authorised under its powers by the new Court of Protection). From a planned date of April 2009, the MCA is to be enlarged by the provisions of the Mental Health Act 2007 (MHA 2007) to encompass deprivation of liberty, with the addition of a new framework of Deprivation of Liberty Safeguards (DOLS). The MHA 2007 also revised significant aspects of the Mental Health Act 1983 (MHA), which were implemented in November 2008. The interface between the MCA, as amended to include DOLS, and the revised MHA is complex and potentially ambiguous. This paper describes in detail some issues that may arise at the interface of the two acts, and seeks to inform professionals involved in the use of these legal frameworks of the resulting complexity.

Major changes are taking place in the law for those working in the mental health field. This article looks at the impact of the Mental Capacity Act (2005) (most of which was implemented in October 2007) and the Mental Health Act (2007) (the main provisions of which came into effect in October 2008). Key elements of each of these two acts will be covered. The ‘Bournewood Safeguards’ inserted into the Mental Capacity Act (2005) by the Mental Health Act (2007) will also be described.

The purpose of this paper is to ascertain what efforts Adult Safeguarding Leads (ASLs), generic advocates, and Independent Mental Capacity Advocates are making to involve service users in decisions about protective measures, and to investigate whether the Adult Safeguarding service is delivering outcomes, which are valued by its users.

Semi-structured interviews with a sample of key stakeholders.

ASLs are making efforts to involve service users in the complex and demanding process of safeguarding. These efforts, however, are shaped by their understandings of the difference between “residential” and “community” settings.

The study is based in a single County Council, albeit in a large county, and involves a limited number of service users.

Clarification is needed of what it may mean to adopt a person-centred approach to adult safeguarding, and the responsibilities of ASLs when individuals with capacity to make decisions about this aspect of their lives are unwilling to engage with the safeguarding process.

The findings improve the understanding of how ASLs understand their responsibilities towards the users of their services and endeavour to involve them in the adult safeguarding process. Based on this understanding, those with responsibility for managing Adult Safeguarding services should be better able to support improvements in professional practice.

The increased involvement of adults at risk in the safeguarding process has become a prominent issue within English safeguarding policy. However, there is evidence to suggest that actual levels of involvement are still low. The purpose of this paper is to present findings from a PhD study in relation to the benefits of advocacy in supporting this involvement in adult safeguarding for older people.

Participants in the study included advocates and social workers who had experience of working with older people through the safeguarding process within two North East England local authorities. A critical realist approach through in-depth interviews was taken with all the participants.

The research findings in relation to the benefits of advocacy in supporting older people going through safeguarding processes are reported. The practical limitations and factors which help and hinder advocacy support within the process are also considered. The theoretical implications for power, empowerment, and advocacy are also explored.

A key limitation of this research is that it did not include older people who had been through safeguarding amongst the participants.

Key implications for practice and policy are discussed.

The paper provides an overview and critique of empowerment in adult safeguarding and the role that advocates play in promoting this key principle.