Deprivation of Liberty Safeguards
The Deprivation of Liberty Safeguards (DOLS) provide a legal safeguard for people who are in hospitals or care homes and are deprived of their liberty for the purpose of providing treatment or care in their best interests. The person must have a “disorder or disability of mind” as detailed in the Mental Health Act 1983 (for example dementia, learning disability) and be assessed as lacking the mental capacity to consent to these arrangements.
Deprivation of liberty is likely to occur when the person has little or no choice about their life within the care home or hospital and is not free to leave and is under continuous supervision and continuous control by the staff and their care plan.
The hospital/care home (the Managing Authority) applies to the Local Authority for a ‘standard’ authorisation for a deprivation of liberty. The supervisory body must assess each individual situation and agree or refuse the authorisation.
Some people who live in hospitals and care homes can’t make their own decisions about their care or treatment because they lack the mental capacity to do so. The level of care and support may need to be more restrictive to ensure the person does not suffer harm.
Sometimes, caring for and treating people who need a higher level of support may mean restricting their freedom. For instance, it might be necessary to stop a person from leaving the hospital or care home, or staff might have to make most of the choices for a person inside the care home. If there are a lot of restrictions like this, it may be that the person is being deprived of their liberty.
Hospitals and care homes should always try to avoid this and look at the least restrictive options, but sometimes there is no alternative to deprive a person of their liberty because it is in their best interests.
The Deprivation of Liberty Safeguards applies to anyone who:
- Is aged 18 or older
- Is suffering a disorder or disability of the mind
- Lacks the mental capacity to give consent to their care/treatment
- Is receiving care or treatment that might amount to a deprivation of liberty under Article 5 of the European Court of Human Rights.
If there is no alternative but to deprive such a person of their liberty, the Deprivation of Liberty Safeguards say that a hospital or care home must apply to the Local Authority for authorisation. The Local Authority are known as the Supervisory Body. The Supervisory Body must assess the person concerned to see whether they:
- are deprived of their liberty
- are being deprived of their liberty in their best interests
- it’s the least restrictive practicable option
- it’s necessary to prevent harm.
If the Supervisory Body authorises a deprivation of liberty safeguards, this will be for a limited time (up to a maximum of 12 months) and the Supervisory Body may put conditions in place to ensure the person’s welfare. The Supervisory Body will also ensure that the person being deprived has a ‘Representative’ who will keep in touch with the person, support them in all matters regarding the authorisation, and ask for a review of the authorisation when necessary. This Representative could be a family member, a friend or a paid Advocate.
Sometimes a person, the person’s representative or Advocate might not agree with an authorisation. The Safeguards also allow people the right of appeal against a decision in a court of law.
Hospitals and Care Homes (the Managing Authority) have a duty under the Safeguards to:
- (a) provide care and treatment in ways that do not deprive a person of their liberty , or if this is impossible…
- (b) apply to the Supervisory Body for authorisation of the deprivation of liberty.
The Local Authority (the Supervisory Body) have a duty under the Safeguards to:
- (a) assess any person for whom the Managing Authorities request a deprivation of liberty assessment;
- (b) authorise a deprivation if it is necessary in the best interests of a person to whom the Safeguards apply;
- (c) set any necessary conditions to ensure the person’s care/treatment regime meets their needs in their best interests;
- (d) set a timescale for how long a deprivation can last;
- (e) appoint a Representative for the person
- (f) keep records of who is being deprived of their liberty.
(i) Discuss the issue with the hospital or care home. They may be able to change a person’s care or treatment to ensure the person is not being deprived, or may be able to explain why a person is not actually deprived of their liberty.
(ii) Request that the Supervisory Body reviews the person, to see whether they are being deprived of their liberty. This request can be in writing, or by phone.
Contact details for these requests (for care homes and for hospitals) are:
For advice contact the MCA/DOLS Lead: Christine.Conway@dudley.gov.uk
Any additional enquiries and electronic submission of completed forms: 01384 324542 or email d.dols@nhs.net