The Deprivation of Liberty Safeguards (DOLS) provide protection for people who are in hospitals or care homes and are deprived of their liberty for the purpose of providing treatment or care, but lack capacity to consent to these arrangements; these could include people with dementia and those with severe learning disability.
Deprivation of liberty is likely to occur when the person is not allowed to leave; the person has little or no choice about their life within the care home or hospital; the person is prevented from maintaining contact with the world outside.
The hospital/care home (the managing authority) will have to apply to the PCT/Council (the supervisory body) for a 'standard' authorisation to deprivation of liberty. The supervisory body must assess each case and agree or refuse 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. They need more care and protection than others, to ensure they don’t suffer harm.
Sometimes, caring for and treating people who need extra protection 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, 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 are a new law from 1st April 2009. They apply to anyone who:
Is aged 18 or older
Is suffering a disorder or disability of the mind
Lacks the capacity 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 new Deprivation of Liberty Safeguards say that a hospital or care home must apply to the council (for care homes) or to the Primary Care Trust (for hospitals) for authorization. The council or Primary Care Trust are known as the Supervisory Body. The Supervisory Body must assess the person concerned to see whether they:
are deprived of their liberty
come under the new law
are being deprived of their liberty in their best interests
If the Supervisory Body authorizes a deprivation of liberty, this will be for a limited time (up to a maximum of 12 months) and the Supervisory Body will 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 authorization, and ask for a review of the authorization when necessary. This Representative could be a family member, a friend or a paid advocate.
Of course, sometimes a person’s family or friends might not agree with an authorization. The Safeguards also allow people the right of appeal against a decision in a court of law.
Hospitals and Care Homes (these are called Managing Authorities) 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 authorization of the deprivation of liberty
The Council and the Primary Care Trust (these are called Supervisory Bodies) have a duty under the Safeguards to:
(a) assess any person for whom the Managing Authorities request a deprivation
(b) authorize 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) keep records of who is being deprived of their liberty
Please see related documents to the right to view the Joint Policy and Procedures for Dudley MBC and the PCT.
(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 available to the right.
Visit the Dudley Safeguarding website for the latest DoLS documentation.
For advice contact the Head of Safeguarding: Anne Harris - 01384 815870
Enquiries to the DoLS office: 01384 324542 or email Nia.Allen@dwmh.nhs.uk
All forms to be sent to:
MHA Admin/DoLS Office
Henry Lautch Centre
Bushey Fields Hospital
Bushey Fields Road