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Case Studies

IMCA Case Study

The Mental Capacity Act 2005 introduced the role of the Independent Mental Capacity Advocate (IMCA). IMCAs are a legal safeguard for people who lack the capacity to make specific important decisions: including making decisions about where they live and about serious medical treatment options. IMCAs are mainly instructed to represent people where there is no one independent of services, such as a family member or friend, who is able to represent the person.

Williams Story…

William lives with his family but whilst in hospital following a fall it was identified William lacks capacity in regards to where he should live and because there are safeguarding concerns surrounding his family members he was referred by his social worker to an n-compass Independent Mental Capacity Advocate (IMCA) regarding the issue of his long term accommodation.

Issues and support

The advocate was able to speak with William about the possible accommodation options and observe his reactions such as facial expressions when pulling up photos of his current accommodation and family members (photos that would make him upset).

The advocate attended a Best Interests meeting and went onto speak with William’s social worker and those who took care of him during his time in hospital.

A report was submitted by the IMCA regarding William's future accommodation outlining the work that had been undertaken including the benefits and burdens of the different accommodation options available and highlighting William's wishes.

Once William was ready for discharge from hospital he was moved into a Care Home that met his needs and is close to his Wife's grave which he is taken to visit once a week, with this being what William told his advocate was most important to him.

IMHA Case Study

Independent Mental Health Advocacy (IMHA) is a statutory service introduced in 2009 under the 1983 Mental Health Act as amended in 2007. The purpose of an IMHA is to support qualifying patients detained under the Act to understand and exercise their rights.

Jenna's Story…

Jenna has a learning disability in addition to issues with her mental health. Her verbal communication is very limited but she is able to communicate effectively using different techniques. Until recently Jenna was living in supported accommodation.

Issues and support

Jenna was admitted into hospital under Section 3 of the Mental Health Act (1983) due to deterioration in her mental health. Hospital staff were struggling to engage with her which was causing a delay in Jenna being treated.

Not long after Jenna was admitted to hospital she was referred to n-compass Advocacy for support from an Independent Mental Health Advocate (IMHA). Jenna's advocate spent time becoming familiar with her individual communication needs and was able to gain information from her around her wishes and feelings allowing the advocate to provide support to Jenna in ward rounds and Care Programme approach reviews to ensure her voice and needs were heard.

Eventually and through improved communication between Jenna and the hospital staff a care plan was agreed and Jenna began her road to recovery eventually leading to a planned and successful discharge. This included Jenna returning to her supported living accommodation where she is surrounded by familiar people with family close by. All of these people are playing a part in Jenna being able to sustain her recovery.

Care Act Case Study

The principle of the Care Act means that the Local Authority has a duty to ensure people are actively involved in identifying their own needs, developing their care and support plan and leading in their reviews. Independent Care Act Advocacy (ICAA) is provided under the Care Act 2014 and is a statutory service to support and represent people who have substantial difficulty in being involved and have no-one appropriate to support them.

Debbie's story…

Debbie has autism and currently lives with her Mother. Debbie says her Mother doesn't let her do the things she wants to do. Debbie wants to move into supported living to be more independent and has asked her Social Worker for a review of her care and support plan to accommodate this.

Because Debbie and her Mother disagree about where Beverley should live the Social Worker referred Debbie to an n-compass Independent Care Act Advocate to support her involvement in the review and ensure her views and wishers are heard.

Issues and support

Prior to the review the advocate spent sometime getting to know Debbie and what matters to her the most allowing them to prepare for the upcoming review.

During the review Debbie, with her advocates support, was able to explain to both her Mother and the social worker why she wants to move into supported living, where she wants to live and what she needs in order for the move to be successful. Debbie was also able to explain that she feels moving out of her Mothers house will be positive for their relationship because they will be able to visit each other and do what normal mothers and daughters do e.g. Go shopping. Mum was really surprised to hear this and became quite emotional explaining that she hadn’t realised how much thought and planning Debbie had put into the decision and was ready to support a move.

There was a second meeting with the social worker, accommodation provider and care provider as well as the advocate, Debbie and Debbie's Mother. There was discussion about when the accommodation would be ready and the provider was able to update the meeting with the latest news. There was also a discussion about the support hours and how these will work. All parties talked about these and Debbie was able to talk openly and freely about how she expects it to work. The advocate, upon Debbie's request, raised the issue of funding and how the cost of the flat and Debbie's care would be worked out. Debbie was able to give details of her outgoings to the support worker and they were going to work it out from there.

Generic Case Study

In addition to the statutory advocacy we provide, n-compass also offers short term, issue based generic advocacy to adults needing support to access health and social services.

Steph's story…

Steph has long term mental health issues and has been trying to engage and get the support she feels she needs from her care coordinator and other mental health professionals. So far she feels this has not happened and relations between her and her care co-ordinator have deteriorated.

Issues and support

Steph contacted n-compass for independent generic advocacy support. Her allocated advocate then contacted her and they arranged to meet to talk through her issues. Steph explained that out of frustration she has become really angry with her care co-ordinator and for this reason does not think her care coordinator can help her. The advocate explained that Steph can ask for a new care coordinator and that the advocate was happy to help her express this.

A meeting was arranged with the manager of the mental health team with Steph explaining what she felt she needed from the team to enable her mental health to improve and to avoid returning to the inpatient facility. At this point Steph started to get angry about the lack of support she felt her care coordinator provided and so the advocate asked Steph is she wanted to take a break which she agreed to do. After the break Steph felt calmer and was able to explain that before meeting her advocate she didn’t realise she could ask for a new care coordinator and that this is what she wanted. The manager explained that she also thought this would be a good idea and already had someone in mind that was available for an introduction.

A short time after the meeting Steph and the new care coordinator spent a little time talking as way of introduction and arranged to meet up again the next week to talk about Steph's care plan.

The advocate asked Steph if she felt comfortable going to the next meeting alone giving her and the new care coordinator an opportunity to get to know each other a little better. Steph went along to the meeting alone and contacted her advocate afterwards thanking her for her help and explaining that the new care coordinator is really good and she no longer needs support from n-compass.

Feedback

"The advocate always seems able to pick through the details of what is happening in a person's life, highlighting the relevant issues and bringing these to the attention of the relevant people to get the best possible outcome for the client." - Wirral

"n-compass privdes excellent patient focused Advocacy and respects the patient's rights and views." - St. Helen's professional

"Your input was superb, exactly what I needed; an independent person to help me to question and comment and move things forward." - Blackburn with Darwen client

"Thank you so much for coming to the meeting with social services, I felt more confident going prepared and with an independent person." - Lancashire client

Testimonials

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n-compass provides excellent patient focused Advocacy and respects the patient’s rights and views.”

St. Helens Professional

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"Thank you so much, this has given me so much confidence and I feel now that I will get the sort of treatment I need, in the way I need it to be."

Fylde Service User

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"Thank you for your support... I now feel strong enough to make my own decisions and my aim is to continue to act independently with other areas of my life."

Lancaster Service User

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"Your input was superb, exactly what I needed; an independent person to help me to question and comment and move things forward."

Blackburn with Darwen Service User

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