Information for relatives and carers of people in care homes

The deprivation of liberty safeguards (DoLS) provide legal protection for those vulnerable people who are, or may become, deprived of their liberty within the meaning of Article 5 of the European Convention of Human Rights in a hospital or care home.

The term 'deprivation of liberty' is used to describe situations where individuals who lack capacity to consent to particular treatment or care required in their best interests to protect them from harm but involves placing restriction upon individuals to such a degree or intensity that they may amount to a deprivation of liberty.

Sometimes there is no alternative way to provide care of treatment other than depriving the relevant person of their liberty. In such situations it is necessary to afford that individual the protection of a DoL Authorisation.

The DoLS are an important way of protecting the rights of many vulnerable people in hospitals or care settings registered under the Care Standards Act 2000 and include rights to:

An independent representative to act on their behalf
The support of an Independent Mental Capacity Advocate (IMCA)
Have their deprivation of liberty reviewed if circumstance change
Challenge their deprivation of liberty in the Court of Protection

Recent changes

What amounts to a deprivation has been a very controversial issue over the years. However, the Supreme Court has now made a decision about the meaning of 'Deprivation of Liberty' and it handed down its judgment in March 2014.

This new judgment means that all individuals in care homes or hospital, who lack capacity regarding accommodation decisions, need to be considered to determine if their placement and the care they receive there means that they are being deprived of their liberty and if they are then an authorisation will need to be in place.

Deprivation of Liberty as defined by the Supreme Court

If a person has been assessed as lacking capacity to make decisions about their care and support and where they live and:

They are under continuous supervision and control; and
They are not free to leave

Then they will be deprived of their liberty and for this to continue the care home or hospital will need authorisation.

The process

When the care home or hospital considers that a person may be deprived of their liberty they will send a request for authorisation to the Strategic Safeguarding Adults Service within Sunderland City Council.

Once the request is received two Assessors will be allocated to undertake six assessments.

One will be a Mental Health Assessor (MHA) and the other will be a Best Interests Assessor (BIA).

The MHA will assess whether the person does indeed lack capacity to decide whether or not to live in the care home and receive the care and treatment outlined in their care plan, whether or not they have a mental disorder and whether any other legal framework such as Mental Health Act would be a more appropriate legal framework to use.

The BIA will look at whether or not there is a deprivation of liberty, what are the risks that we wish to safeguard the person from, whether or not the risks are proportionate in depriving the person of their liberty and whether or not using these safeguards are in the best interests of the person.

The BIA will consult with everyone involved in the care of the person including their relatives and will also determine who would be the best person to be the person's representative in this process.

The Relevant Person's Representative

The BIA will, consider, who is the best person to be appointed as the representative for the person being deprived of their liberty. This will usually be a close relative who is able to visit the person on a regular basis.

The representative has the right to request a review of the deprivation of liberty safeguards if they feel the grounds are no longer met for this legal framework. If they disagree with the authorisation they can appeal to the Court of Protection on the person's behalf.

The person being deprived of their liberty and their representative are entitled to the services of an Independent Mental Capacity Advocate who can visit the person and support their relative.

There is no charge for this service.

For further information please contact

Deprivation of Liberty Safeguards (DoLS) Team

Tel: 0191 561 8932
Email: dols.team@sunderland.gov.uk
Secure email: dols.team@sunderland.gov.uk