Jocelyne is in her eighties and was living alone in her own home when she was admitted to hospital after experiencing a fall. Following her initial recovery Jocelyne was moved to a temporary rehabilitation bed in a care home. Jocelyne's social worker, Alan, referred her to an Independent Mental Capacity Advocate (IMCA) because when he assessed Jocelyne's capacity to make a decision regarding her care and long-term accommodation he concluded that she lacked capacity to make this decision for herself, and had no family or friends able to support her. 

Susannah, a POhWER IMCA, spoke to Alan who explained that when he met Jocelyne she was confused and unable to show she understood any of her care and support needs or communicate where she wanted to live after hospital discharge. Alan told Susannah there was no formal diagnosis of cognitive impairment from her hospital records but he was waiting to hear from Jocelyne's GP. Alan also said that a neighbour had reported a significant deterioration in Jocelyne's cognition over the months prior to her fall. 

Susannah met with Jocelyne at the temporary care home. She asked Jocelyne where she would like to live and Jocelyne clearly expressed her wish to move permanently to a care home. Jocelyne stated she didn't feel she could manage living on her own any longer and was able to tell Susannah about the support she receives from staff, explain that she likes having her meals made for her, and tell Susannah that she felt safer knowing there were staff around 24 hours a day in case of another fall. Susannah and Jocelyne discussed what would be important to Jocelyne if she did move. Jocelyne asked to view any potential placement before she moved and to have a garden she could sit out in. She also asked if it would be possible to move with her sister, Ellen, who had been placed in an assessment bed at a different care home. She said she would really like to live in the same place as Ellen, or nearby, as they were very close and finding it hard to visit each other.

Susannah met with the Alan again and explained that she had found no evidence of an impairment or disturbance in the functioning of Jocelyne’s mind or brain and that she appeared to have capacity to make this decision independently. Susannah therefore requested a further capacity assessment and fed back on Jocelyne's expressed wish to be discharged to a care home, her views in terms of what would be important to her including access to a garden and the possibility of living with or near to her sister. 

Alan again met with Jocelyne and revisited the capacity assessment. He agreed her presentation had improved dramatically and she now had capacity to make a decision on her long-term accommodation herself. 

As Ellen also wished to live with Jocelyne, a joint plan was made so both sisters could be moved to a dual-registered care home in line with both of their wishes to live together. Both sisters were happy with the care home and excited to live there together.

Susannah ensured that Jocelyne's rights under the Mental Capacity Act were protected and that the presumption of capacity was applied. Her human right to respect for her private and family life was also protected as Jocelyne was supported to move to live with her sister in line with her wishes.