When a person is unable to make decisions about their care due to a mental impairment, they may find themselves in situations where their freedom is restricted. In these cases, Deprivation of Liberty Safeguards (DoLS) exist to protect them and ensure their rights are respected.
If you or a loved one is in a care setting and may be deprived of liberty, it’s important to understand what DoLS are, how they work, and what rights they offer. In this article, we’ll explain everything you need to know about DoLS in simple, easy-to-understand language.
What Are Deprivation of Liberty Safeguards (DoLS)?
Deprivation of Liberty Safeguards (DoLS) are a set of legal protections designed to prevent the unlawful deprivation of a person’s liberty, particularly in hospitals or care homes. They were introduced as part of the Mental Capacity Act 2005 to safeguard individuals who lack the mental capacity to consent to their care and treatment.
The goal is to ensure that any restrictions placed on a person’s freedom are in their best interests and that they are as minimal as possible.
The primary purpose of DoLS is to make sure that people are not held in care homes or hospitals against their will, unless it is absolutely necessary. If a person is at risk of being deprived of their liberty, the DoLS framework ensures that they are properly assessed and that their situation is regularly reviewed.
Who Do Deprivation of Liberty Safeguards Protect?
DoLS apply to individuals who are aged 18 or over and have an impairment of, or disturbance in, the functioning of the mind or brain. This might include conditions such as dementia, brain injury, or learning disabilities. These individuals might be unable to make decisions about their care and treatment, and in some cases, their freedom may be restricted for their own safety or well-being.
If you are caring for a family member or loved one who falls into this category, it’s important to understand that their rights are protected under the DoLS framework. The safeguards ensure that any decision made to restrict their liberty is justified, necessary, and in their best interests.
When Are Deprivation of Liberty Safeguards Used?
Deprivation of liberty is defined as a situation where a person is under continuous supervision and control and is not free to leave. This might occur in situations where the person is in a care home, hospital, or other residential setting, and their care arrangements restrict their ability to move freely.
Some common scenarios where DoLS may apply include:
- A person with dementia who may not be aware of their surroundings and could wander outside the care home if not supervised.
- A person with a learning disability who may need constant supervision to ensure their safety.
- Someone receiving life-sustaining treatment in a hospital but unable to consent to their care due to their condition.
The key aspect is that the person must lack the mental capacity to make decisions about their care and treatment. If they are able to understand and consent, DoLS do not apply.
How Do Deprivation of Liberty Safeguards Work?
To ensure that the safeguards are properly implemented, a series of assessments and authorisations take place before any deprivation of liberty can occur. Here’s an overview of the DoLS process:
Assessment Process
When a person is suspected of being deprived of their liberty, an assessment is carried out by trained professionals. This involves two key assessments:
- Mental Capacity Assessment: A doctor or healthcare professional assesses whether the person has the mental capacity to make decisions about their care. The assessment follows the Mental Capacity Act 2005’s two-stage test:
- Stage 1: Is there an impairment in the person’s mind or brain? This could be due to a condition like dementia, a stroke, or an acquired brain injury.
- Stage 2: If there is an impairment, does it prevent the person from making a decision? The assessor will look at whether the person can understand, retain, and weigh the information necessary to make an informed decision.
- Best Interests Assessment: A trained professional, often a social worker or nurse, assesses whether the care arrangements are in the person’s best interests. They consider factors such as:
- The person’s wishes and feelings, if known.
- The views of family members, friends, or carers.
- Whether the person could regain capacity in the future.
- The need for the restrictions, ensuring they are the least restrictive possible.
Authorisation
Once the assessments have been carried out and if deprivation of liberty is deemed necessary, authorisation must be granted by a local authority. This authorisation ensures that the restrictions placed on the person are in line with the law and that their rights are protected.
There are two types of authorisation:
- Urgent Authorisation: This is used in emergency situations where immediate action is needed to protect the person. It lasts for seven days, after which a standard authorisation must be applied for.
- Standard Authorisation: This is a longer-term authorisation, typically lasting for 12 months, and is subject to ongoing reviews to ensure the deprivation of liberty remains necessary.
Supervision and Reviews
Once an authorisation is granted, the person’s situation is regularly reviewed to ensure that the deprivation of liberty remains necessary. Reviews are carried out at least every 12 months. This ensures that the restrictions are still appropriate and in the person’s best interests.
It’s also important to note that the person involved has the right to challenge the decision if they believe the deprivation of liberty is unjust. They can ask for a judicial review in the Court of Protection, which has the power to overturn decisions if they are not in the person’s best interests.
Key Principles of Deprivation of Liberty Safeguards
The DoLS framework is built on a set of key principles that guide decision-making:
- Least Restrictive: Any restriction on a person’s liberty must be the least restrictive possible. If a person can be cared for safely with less restrictive measures, these should be used instead.
- Best Interests: All decisions regarding a person’s care and treatment must be made in their best interests. This includes considering their preferences, family views, and whether the care arrangements will improve their quality of life.
- Right to Liberty: The person’s right to freedom is a fundamental human right, and any deprivation of liberty must be a last resort. The restrictions must be proportionate to the person’s needs and circumstances.
What DoLS Can’t Do
DoLS are not a tool to forcibly remove someone from their home to a care home or hospital. If an individual is to be moved against their will, this would require an order from the Court of Protection. Additionally, DoLS cannot be used in certain cases where the person has the capacity to make their own decisions, even if they might need some assistance in doing so.
The Role of Family and Advocates in DoLS
If you or a loved one is subject to DoLS, you have the right to be involved in the decision-making process. Family members or friends who are familiar with the person’s wishes can help to ensure their preferences are taken into account.
In addition, the person affected by DoLS is entitled to an independent advocate. This advocate helps to represent their views and ensure their rights are protected throughout the process.
Conclusion
Deprivation of Liberty Safeguards (DoLS) are vital legal protections for individuals who may be deprived of their liberty due to a lack of mental capacity. The process ensures that the deprivation of freedom is justified, necessary, and as minimal as possible, with the person’s best interests at heart.
If you are involved in the care of someone who may be subject to DoLS, it’s important to understand their rights and the safeguards in place to protect them. Whether you are a family member, carer, or healthcare professional, being informed about DoLS can help ensure that the person’s care arrangements are in line with their rights and well-being.
If you feel that a person’s liberty is being restricted unjustly, or that their best interests are not being properly considered, you have the right to challenge the decision and seek legal advice. The safeguards are there to ensure that the vulnerable are protected, and their rights respected.
