Deprivation of Liberty
Some people living in care homes, hospitals and other settings can’t always make their own decisions because they lack the mental capacity to do so. They need extra care and protection to ensure they don’t suffer harm. Caring for people who need extra protection may mean restricting their freedom to the point of depriving them of their liberty, for example, preventing a person from leaving their accommodation to keep them safe or giving medication to keep them calm.
The Deprivation of Liberty Safeguards (DoLS)
The Deprivation of Liberty Safeguards are an amendment to The Mental Capacity Act 2005, and they say that people must be cared for in the least restrictive way for their own protection and in their best interests. For any deprivation of liberty to be lawful, care homes and hospitals must make a request to Hull City Council for a formal assessment about whether depriving someone of their liberty is necessary. Sometimes there are less restrictive ways of keeping someone safe, and we will always try to find those ways.
The Safeguarding Team, acting as Supervisory Body on behalf of the council, would carry out the assessments.
A restriction on someone amounts to a Deprivation of Liberty if -
- they are subject to continuous supervision and control
- they are not free to leave – with the focus being not on whether a person seems to be wanting to leave, but on how those who support them would react if they did want to leave.
A Deprivation of Liberty assessment should also be considered if any of the following are happening -
- frequent use of sedation/medication to control behaviour
- regular use of physical restraint to control behaviour
- the person concerned objects verbally or physically to the restriction and/or restraint
- there are objections from family and/or friends to the restriction or restraint
- the person is confined to a particular part of the establishment in which they are being cared for
- the person is already subject to a deprivation of liberty authorisation which is about to expire
Any deprivation that is authorised by the council will be for as short a time as possible. The maximum period would be 12 months. If someone is living somewhere other than a care homes or hospital and may need to be deprived of their liberty, the Court of Protection need to authorise this and Hull City Council’s Safeguarding Team should be contacted for advice.
When are DoLs safeguards used
Deprivation of Liberty Safeguards are only used where it is absolutely necessary to prevent harm to someone and we will always look for the least restrictive way, to ensure they have as much control over their lives as possible. Care homes and hospitals should always consider the least restrictive alternatives for the care they provide. Where this is not possible, an application for Deprivation of Liberty authorisation must be made.
The DoLs process
Care home/hospital managers must identity those people at risk of being deprived of their liberty and request Deprivation of Liberty authorisation from the Safeguarding Team. An assessment is carried out by an Independent Assessor and only if all qualifying requirements are met will an authorisation will be approved.
These are -
- the person is 18 or over
- the person is suffering from a mental disorder
- the person lacks capacity to decide for themselves about the restrictions which are proposed so
- they can receive the necessary care and treatment
- the actions requested are the least restrictive option but would nevertheless deprive the person of their liberty
- the proposed restrictions would be in the person’s best interests
- the person cannot be considered for detention under the Mental Health Act
- there is no valid advance decision to refuse treatment or support that would conflict with any DoLS authorisation
Family, friends and relevant professionals will be consulted as part of the assessment process and an authorisation will only be granted if it is necessary, unavoidable and in the best interests of the individual being assessed.
A Relevant Person’s Representative
If someone is being assessed under the Deprivation of Liberty safeguards, they must have someone to represent them. This person is called a Relevant Person’s Representative and will usually be a family member or friend who knows them well. They are given the legal power to represent them and make sure their wishes and feelings are considered. In cases where no friend or family member is willing or available, an independent paid representative can be appointed by the Supervisory Body (Hull City Council). Reviews take place as requested to ensure the authorisation is still necessary.
Who can be a Relevent Person's Representative
People who may be deprived of their liberty are entitled to have a family member, friend or someone they know to act on their behalf to ensure they are cared for appropriately. This is called being a Relevant Person’s Representative or an RPR for short. All unpaid Relevant Person’s Representatives and people being deprived of their liberty have a statutory right to be supported by a specialist Independent Mental Capacity Advocate (IMCA) and this will be arranged for them if it is required.
Death whilst subject to Deprivation of Liberty Safeguards
If someone dies whilst they are subject to Deprivation of Liberty authorisation, the coroner must be notified. The doctor attending the care home or hospital will do this. If the death is a natural death, then the coroner can proceed to inquest without the need for a jury. If the death is ‘unnatural’, such as via an avoidable fall, or any other situation where neglect may be a factor, then a jury may be required.
When an authorisation can be challenged / reviewed
Deprivation of Liberty Safeguards authorisation can be challenged in the Court of Protection and a Review of Deprivation of Liberty Safeguards can be requested through the Professional Zone.