What is Independent Mental Capacity Advocacy?

A day in the life of an IMCA. (Independent Mental Capacity Advocate.)

Ever since I was a child I have awoken at around 5am. I get up with my little dog Alf, we have a cuppa and watch Jeremy Kyle. After my bath, Alfie and I have breakfast, go for a walk and then I drive to the top of my road, to work.

I work for Solihull Action through Advocacy as an Independent Mental Capacity Advocate or an IMCA for short. In the UK, IMCA`s have provided a statutory service since a court ruling in 2014 which has become known as The Cheshire West Case. The legislation arose because of an appeal relating to an individual`s liberty (Mr. P) who since 2009 had been cared for in a supported living situation. He received 24/7 one to one care to manage his idiosyncratic behaviours. He was learning disabled, never on his own and was not free to come and go.

The Court of Appeal stated that this was not a deprivation of liberty, but the judge, Baroness Hale did not agree. She said,

“If it would be a deprivation of my liberty to be obliged to live in a particular place, subject to constant monitoring and control, only allowed out with close supervision, and unable to move away without permission even if such an opportunity became available, then it must also be a deprivation of the liberty of a disabled person. The fact that my living arrangements are comfortable, and indeed make my life as enjoyable as it could possibly be, should make no difference. A gilded cage is still a cage.”

If a person is deprived of their liberty in the UK and requires an IMCA then the referral is called a DoLS or a Deprivation of Liberty Safeguarding.

There are many thousands of people across the UK in situations similar to Mr. P`s. They may have a learning disability, dementia, a brain injury or something else that affects their capacity. All of these people now have a statutory right to their own IMCA to represent them, give them a voice and, if they have no relatives or friends able to do so, make best interest recommendations on their behalf.

IMCA is a very challenging and responsible role. We are called in to safeguard extremely vulnerable individuals who do not have the capacity to make their own decisions, so we take it very seriously. A typical referral would be to visit someone either in hospital. or in a care home and talk to them, to the people around them, their friends and family and find out what they would want to happen if they were able to say. Sometimes the decisions are around accommodation, medical matters, money or care plans and reviews.

We write a report and in all cases of IMCA DoLS,  the report goes to someone called the Decision Maker, who authorises the DoLS and makes everything legal. We have to remain informed and up to date with the law so that we can confidently assist families when they are making tough decisions on behalf of their loved ones.

I absolutely love my job, it brings me huge satisfaction to know that I can help as far as possible to ensure that very vulnerable people are safe, happy, cared for and not being ripped off by any unscrupulous individuals, including sometimes I am sad to say, members of their own family.

If you would like to know more about IMCA, then please contact me on:

helen@solihulladvocacy.org.uk

or: 0121 706 4696

Learning to let go.

I work with adults who have learning disabilities and who need support, often because they are going through child protection proceedings. I help them to get their voices heard and to have a say in the proceedings. Lots of the parents I work with have mild learning disabilities and LOTS of them would make wonderful parents if only they had the right help in place. Unfortunately, the right kind of support is unavailable in many areas and so a disproportionate number of parents with learning disabilities, about 65% in the UK, have their children removed into care.

I have observed a recurring theme with most of the parents who I work with, and that is domestic abuse. We used to refer to it as domestic violence but of course abuse takes many forms and does not necessarily include physical violence.  Lots of the parents I work with are in situations where one or both of them drink, then a row occurs, then a fight begins, neighbours call the police and the police bring in social services. It`s very common and so part of my remit is to support parents to recognise when they are making unhelpful life decisions and how to walk away and cool down before a row erupts.

This has led me to ponder why it is that some of us are attracted to complicated, sometimes damaged people?

I have a friend who has been involved with someone who can at best be extremely boring in a drunken, talking rubbish sort of a way and at worst can be a scarily aggressive and destructive nightmare.   Fortunately, there are no children involved.   My friend has loved this man for five years and for much of the time has been happy, yet some of the time spent with him has caused her great anxiety and distress.   Occasionally his behaviour becomes so unmanageable, he repeatedly leaves my friend no alternative except to leave and then she goes back to her abusive partner.

I think one of the things about my friend that I have come to understand is that she is a rescuer.  She sees vulnerable people who may be struggling with life and thinks, `I can fix that.`  When she first spotted her partner I suspect that subconsciously she looked at him and thought, `there`s a challenge, I can soon sort him out!` and to some extent she has.    Lots of the women I work with have similar nurturing aspects to their characters and want to help a vulnerable person become strong.  The thing that they don`t take on board when they first meet someone who needs that spiritual lift though, is to recognise just how toxic people can become when they don`t receive enough love, praise and emotional warmth in their lives, especially when they are children.  (I`ve written a piece called Toxic Narcisism which I will post here some time which goes into this much more deeply.)

When I consider how hard it is for my friend to leave her relationship with such a damaged man, I have to also consider how very much more difficult it must be for someone with a learning disability to sort out their decision making, understand their thought processes, learn strategies to cope and so on.   Last year I ran some classes to help some of the people I work with, begin to take a different path.   Guess who turned up to class?   Women!  Next time I hope to get some dads together and with a male colleague, try and support them to change. I KNOW people can change, all they need is to be open to it.

I don`t know if my friend will ever succeed in leaving her partner, part of me hopes that she does, part of me wishes he would seek help for his issues.  I know on avarage it takes women in the UK around 12 times of trying to leave before they finally make the break but I reckon my friend has gone beyond that!    Her personal belongings have dwindled down so much, she can pack everything into a bin liner and clear off in minutes, it`s quite nice in some ways, a sort of Buddhist detachment from owning stuff which I rather admire.