As a person’s liberty can only be taken away in certain circumstances, the Mental Capacity Act 2005, includes the Deprivation of Liberty Safeguards (DoLS) which apply to people in care homes or hospitals in England and Wales. The Deprivation of Liberty Safeguards are a set of checks that aim to make sure that any care that restricts a person’s liberty is both appropriate and in their best interests.
For the last 3 years of her life, Mum lived in a specialised dementia unit. The care home where she lived had locked key pad doors to stop residents from leaving as they no longer had the mental capacity to keep themselves safe.
Before a person can be lawfully deprived of their liberty, the care home or hospital must apply for an authorisation from the relevant authority, who then carry out 6 assessments which must all be met.
Deprivation of Liberty Safeguards
- Age assessment – This is to confirm they are over 18.
- No refusals assessment – To make sure that an authorisation to deprive someone of their liberty does not conflict with any other existing authority in place for decision-making.
- Mental capacity assessment – To establish whether they lack mental capacity to decide for themselves where their accommodation should be.
- Mental health assessment – To confirm that they have been diagnosed with a mental disorder within the meaning of the Mental Health Act 1983.
- An eligibility assessment – To confirm that they are not detained under the Mental Health Act 1983 or subject to a requirement that would conflict with the Deprivation of Liberty Safeguards. This includes being required to live somewhere else under Mental Health Act guardianship.
- A best interests assessment – To see whether they are being, or are going to be, deprived of their liberty and whether it is in their best interests.
If a person’s care is authorised following a Deprivation of Liberty Safeguards assessment, a ‘relevant person’s representative’ (RPR) must be appointed, often a family member or friend. The maximum length of time each authorisation should last is 12 months.
Mum’s was granted a Deprivation of Liberty authorisation, so every 12 months we had to go through a process where Mum was assessed. This involved the authorities talking to and observing Mum, them talking to her RPR (which was me) and other family members. We would then receive a number of forms which included background information about Mum, her current mental capacity and why it would be inappropriate for her to live in the community. These forms then had to be signed by her RPR and returned.
While I appreciate the need to protect vulnerable people who lack the mental capacity to live independently, the whole process was quite stressful and highly labour intensive and I was glad when it was over for another 12 months.
In July 2018, the government published a Mental Capacity (Amendment) Bill which will see DoLS replaced by the Liberty Protection Safeguards (LPS). This passed into law in May 2019. Under LPS, there will be a streamlined process to authorise deprivations of liberty. I have to say that it doesn’t suprise me that they have streamlined the process as it seemed very labour intensive for healthcare professionals and stressful for those living with dementia and their families.
For more details visit – Mind UK