Iaith Gwaith Cymraeg

IMCA Client H

H had been a resident at a Cardiff nursing home since 2012. A referral was made to the IMCA Team in respect of a proposed Long Term Move of Accommodation decision.

Barriers faced in being heard:

The IMCA attended the home and reviewed H’s file. The IMCA also spoke to staff and met with H.

While accessing H’s care file and records, the IMCA noted that a Capacity Assessment in respect of a Long Term Move of Accommodation had not been carried out, a DoLS Authorisation was not in place, and there was a DNAR in place since October 2016. H had no family or friends who are willing or able to be consulted with on the decision but there had been no consultation held with and IMCA.

The IMCA was informed by staff at the home that H had been in bed, in a darkened room, with the curtains drawn and the lights out and without any evidence of mental or physical stimulation since 2012. H was able to communicate but staff reported that he had made a conscious decision not to engage.

Advocacy undertaken:

  • The IMCA identified that there was no documentary evidence in H’s notes or in the Care Plans of best interest meetings being held to discuss H’s situation.
  • The IMCA contacted the DoLS team and H’s GP to discuss H’s situation.
  • The IMCA attempted to contact The Health Board Nurse Assessor on several occasions in order to raise concerns about the lack of mental and physical stimulation but was unable to speak with her about this case for some weeks.


Following IMCA involvement a DoLS Authorisation was applied for and authorised and a referral for a Paid RPR was made by the DoLS team.

Following concerns raised by the appointed IMCA, H’s GP agreed to review the DNAR in place, and a SMT referral was made to the IMCA team.

The IMCA was informed by Health Board staff that new owners had taken over the nursing home and that the plan was to leave H where he was to give the new owners a chance to take over his care. The IMCA advised the Health Board that although her role in relation to a Long Term move of accommodation had ended, IMCA involvement would continue in relation to the SMT decision.