Deprivation of liberty

When a person lacks the capacity to make decisions about the care and treatment they need, it may be in their best interest to deprive them of their liberty.

The mental capacity act deprivation of liberty safeguards (DoLS) were introduced into the mental capacity act 2005 through the Mental Health Act 2007. The safeguards come into force on 1 April 2009 to ensure that no one is deprived of their liberty without good reason.

What is considered a deprivation of liberty

  • the use of restraint or sedation to admit a person to a home or hospital when they are resisting admission
  • the exercise of complete and effective control over a person’s care, movement, treatments and the contact they can have with others
  • the decision by the hospital or care home not to discharge a person into the care of others or to live elsewhere
  • the loss of individuality or autonomy because the person is under continuous supervision and control.

Assessment for deprivation of liberty

Under DoLS, a managing authority (care home or hospital) must apply to its supervisory body (local authority or primary care trust) to have someone assessed where it is believed that they should be deprived of their liberty in order to prevent them from harm. An application can be made up to 28 days in advance of the date deprivation would begin. Care homes can issue themselves a 7-day urgent authorisation if required, but at the same time, a standard authorisation request must be made to the local authority.

Independent advocates and representatives can be appointed to ensure that an individual receives support during the process.

We (the local authority) are responsible for arranging assessments to see whether it would be in the persons best interests, and either grants or denies the managing authority authorisation to deprive the person of their liberty.

We arrange six assessments:

  • age (whether the person is 18 or over)
  • mental health (whether the person suffers from a mental disorder)
  • mental capacity (whether the person lacks capacity to decide where they should be)
  • no refusals (whether there is conflict with an advance decision, lasting power of attorney or deputy)
  • eligibility (whether the deprivation would conflict with an existing order under the Mental Health Act)
  • best interests (whether deprivation would be in the persons best interests, is necessary to prevent them from harm and is a proportional response to the risk and seriousness of harm).

These assessments will be completed by at least two professionals.

If all the assessments support the authorisation it can be granted for up to 12 months. Once an authorisation has been given, a representative (usually a relative or friend) has to be appointed who has the right to appeal against the decision. The representative must be in regular contact with the person and will represent and support them in all matters relating to the deprivation of liberty safeguards. This includes, if appropriate, triggering a review, or using an organisations complaints procedure on the persons behalf.

If no appropriate representative can be found, the supervisory body must contact the independent mental capacity advocacy service to provide the necessary support to the individual.

Forms

The Department of Health has created a set of forms for the managing authority to use for this process. You can find these forms on the Department of Health's Deprivation of Liberty Safeguards webpage.

The forms and guidance ensure you are supplying all necessary information, failure to do this could cause a delay in your application being processed.

 

For further information please read the following guides:

Large print versions of these documents are available below: