IMCA Client A
Client A went into hospital following a fall. IMCA was instructed to act in relation to a Long Term Move of Accommodation decision and A’s discharge from hospital. A owned his own home however there was an ongoing court process where his home was due to be demolished as was in a very poor state of repair. A Best Interest decision was required.
Barriers faced in being heard:
Clear disagreement existed between the Health Board and the local authority in relation to A’s capacity around accommodation. IMCA asked ward staff if A had a DoLS authorisation in place, but was told one had not been applied for as the ward felt A had capacity.
The IMCA met with A, who stated his house had already been demolished. He saw he was being stopped from leaving the ward and felt like a “prisoner”.
Advocacy undertaken:
- The IMCA attended a best interest meeting for A. Here it was explained that A’s house had not yet been demolished but it was felt by the social worker that A required support in a warden controlled flat. Residing in hospital was no longer necessary and an interim placement should be sought before A was moved into a new flat. The social worker explained that the step-down interim placements available were residential home settings.
- With this information, the IMCA explained that a meeting with A was required to ascertain his wishes and views further.
- At the same best interest meeting, the IMCA asked why a DoLS authorisation had not been applied for if A was being prevented from leaving the ward. The discharge liaison officer said that she had spoken to the supervisory body about this issue and had been told that a DoLS authorisation was not required for A.
- The IMCA put proposed options to A. He was happy with the suggestion of living in a residential setting on a temporary basis. However, A explained that he would like to be able to access the community and that he was not able to leave hospital.
Outcomes:
The IMCA represented A's wishes and views, and also raised concerns around his de facto detention. A Best Interest Assessor went to see A and recommended to the supervisory body that an authorisation should be put in place.
The IMCA continued to act as a safeguard for A and ensure that not only is he fully represented, but that the MCA 2005 Code of Practice is being adhered to correctly.