What services do Together’s IMCAs offer?
Our IMCAs work with people who lack capacity to make a specific life changing decision for reasons including, but not limited to, learning disabilities, dementia, mental health needs and acquired brain injury. These decisions concern:
- Serious medical treatment
- Accommodation changes that are for more than 28 days in hospital or 8 weeks in non-hospital accommodation
- Care reviews in relation to accommodation arranged by the LA or NHS
- Safeguarding Adults (i.e. for Protection of Vulnerable Adults Investigations (POVA) cases)
- Deprivation of Liberty
Who is eligible?
Under the Mental Capacity Act (2005) the following criteria need to be met in order for individuals to be eligible to be appointed an IMCA:
1) The person must be assessed as lacking capacity to make the specific decision which the IMCA is referred to for, such as:
- Lacks capacity to consent to or withhold consent for a serious medical treatment
- Lacks capacity to choose a place of residence
- Lacks capacity to fully participate in a care review
- Lacks capacity to consent to formal safeguarding measure/s
2) An IMCA can only be involved if there are no appropriate family or friends that can be consulted on the specific decision. The one exception to this are Adult Safeguarding referrals, where an IMCA may be instructed regardless of whether the person has appropriate relatives or friends.
What services do Together’s IMHAs offer?
Our IMHAs give information on, and help patients to understand, the legislation they are subject to and how this affects their lives. This may include the conditions or restrictions placed on them and their rights under the MHA 2007. IMHAs can also help the patient to understand what medical treatment is being given or proposed and give information on the authority under which the treatment would be given.
Who is eligible?
- Patients who are liable to be detained under the MHA 2007
- Patients subject to guardianship
- Patients on Supervised Community Treatment Orders (SCT)
- Informal patients who are discussing the possibility of treatment to which S57 or S58A applies (neurosurgery for mental disorder or ECT for a patient under 18 years).
How we can help
Our IMHAs will meet with the patient in private to discuss issues or concerns relating to their care and treatment. The IMHA will ensure they fully understand the issues and what information is required before agreeing with the patient the appropriate level of support needed. The IMHA will then act on instruction from the patient.
Part of this work may require the IMHA to meet with any person who is professionally involved with the patient’s treatment. The IMHA will also be able to (on instruction from the patient) inspect any records relating to the patient’s detention or treatment and any Social Services Authority records that relate to that individual.
If the patient lacks capacity, the IMHA can still request access to records, however, in this circumstance the person holding the records must consider whether it is appropriate and necessary for the IMHA to have access to the records.
Accessing the service
Referrals can come from anyone and we will always comply if the request is reasonable, however IMHAs have a duty to respond and visit the patient if the request comes from:
- The patient
- A responsible clinician
- An approved Mental Health Professional
- The nearest relative
Patients can choose not to meet the IMHA or turn down any support offered if they did not make the referral themselves.
Care Act Advocacy
What do Together’s Care Act Advocates offer?
If you receive care services or care for someone who receives services you may have the right to an independent advocate. Our advocates can help you to understand information and processes and explore your options. Advocates can help you to speak up about the care you receive.
Who is the service for?
Under the Care Act (2014) individuals, no matter how complex their needs, must be supported to be involved in planning their support, and making decisions about their care. Where an individual has substantial difficulty in understanding this process, they have a legal right to the support of an independent advocate who will help them to express their wishes and feelings.
You may have the right to support from an advocate if you are:
- An adult who needs care and support
- A young person nearing transition to adult care and support
- A carer of an adult or of a young person in transition
- A young carer
How can we help?
Under the Care Act we can support and represent people in the following;
- a needs assessment under the Care Act,
- a carer’s assessment;
- the preparation of a care and support plan or support plan,
- a review of care and support plan or support plan,
- a child’s needs assessment,
- a child’s carer’s assessment,
- a young carer’s assessment,
- safeguarding procedures.
We can support people by:
- helping them to understand their rights and to express their views,
- assisting in the preparation for, or attending meetings concerning their support,
- helping them to be involved in planning their support, and making decisions about their care.
Accessing the service
Referrals for Care Act Advocacy must come via Adult Social Care or NHS practitioners. They must determine if a person has a ‘substantial difficulty’ in any of the following:
- understanding relevant information
- retaining information
- using or weighing up the information
- communicating their views, wishes and feelings
You can only access the service if you have a substantial difficulty, and there is no-one appropriate to support you.
Referrals should be made as soon as is clear that someone will have substantial difficulty being involved and that there is no appropriate individual identified to support them. Advocacy should be considered from the first point of contact, request or referral.
If a referral is not made immediately, perhaps because advocacy was not required at that time, a referral can be made at any stage in the care and support process.
If you think you need the support of an advocate you can call us to talk about it and find if you can be referred.
NHS complaints advocates
What services do our NHS complaints advocates offer?
The NHS Complaints Advocacy Service is a free and independent service that can help you make a complaint about a National Health Service (NHS).
Most of us use the NHS at some point in our lives and many of us use them quite regularly.
The NHS work hard to make sure that people are satisfied with their services and receive good quality treatment.
But things can go wrong.
You may want to complain about a service you have received from the NHS, or you might want to complain on someone else’s behalf. There are different ways to do this.
Our information will help you understand what your options are and how to get the best resolution for you.
Who is the service for?
By law, anyone who wishes to complain about an NHS service is entitled to receive advocacy to help them make their complaint.
How we can help:
We can provide you with information and a self-help pack so you can make a complaint yourself, or you might decide that you need support to make a complaint. Our advocates can work with you to ensure you understand your options and help you to achieve the outcome you are seeking.
Together for Mental Wellbeing has developed some step-by-step guidance to help you feel confident about raising any concerns yourself. You can download the guidance here.
- First Steps – things to think about before making a complaint to the NHS
- Making a Complaint – guidance on the process for making a complaint to the NHS, as well as what do to if you are unhappy with the response
- Help and Support – information on where to go for further guidance and support for making a complaint.
A set of resources are also available to help you in the complaints process:
- Consent Form – for gaining consent to progress an NHS complaint on behalf of a friend, relative or partner
- Accessing Medical Records Guidance – which may be helpful for providing evidence when making your complaint
- Complaint Letter Template – as well as tips for writing the letter and keeping track of correspondence
- Log Sheet – for keeping a record of important conversations and agreements throughout the complaints process
You can ask for an advocate to assist you at any point in your complaint. If you would like an advocate to work with you, please contact the local team.
- Give you an opportunity to speak confidentially to someone independent of the NHS
- Explore the options available to you at every stage of the complaints procedure
- Help you with writing effective letters to the right people
- Prepare you for meetings and attend with you
- Contact and speak to third parties if you wish us to
- Help you to think about whether you are happy with the responses you receive from the NHS organisation.
Your advocate will not try to persuade you to take a particular course of action and will always respect your decisions.
Accessing the service
Anyone can make a referral for the NHS Complaints Advocacy service. If you are making a referral for someone other than yourself you will need their consent to do so.
People are eligible for advocacy support if:
- They are over the age of 18, live in Warrington and/or are registered with a Warrington GP
- They are a vulnerable person where one or more of the following applies:
- Mental health needs
- Leaning difficulty/disability
- Sensory or physical impairment
- Older person
- Long term health condition
- Acquired brain injury
- Socially isolated or disadvantaged
- Advocacy relates to a specific issue
Advocates are independent and experienced in helping people to speak up, secure their rights, represent their interests and obtain services they need.
Advocates work to:
- Help parents understand information being shared by a range of professionals involved in the child protection and family court process
- Support professionals to provide easy read information
- Help parents understand and secure their rights within the process
- Help parents make informed choices
- Ensure that parents have their voice heard by supporting them to express their views and wishes
Advocates are independent, qualified and experienced in understanding the rights of parents within the child protection process.