What are Deprivation of Liberty Safeguards (DoLS)?
Safeguarding the person's best interests
Deprivation of Liberty Safeguards (DoLS) are a set of checks that are part of the Mental Capacity Act 2005 to protect a person receiving care and support in a care home or hospital whose liberty is limited, by checking that this action is in the person's best interest.
The checks are a safeguard to makes sure that the care being given is in the person’s best interests. DoLS is applied for if the person to be assessed:
- lacks mental capacity to make their own decisions or consent
- is under continuous supervision and control
- is not free to leave the hospital or care home.
Who applies for DoLS?
If the managing authority must ensure any deprivation of liberty is done within the law.
The managing authority is the care home or hospital where the person is cared for. The supervisory body is the local authority.
The managing authority must ensure any deprivation of liberty is conducted within the law. The managing authority applies to the supervisory body for the DoLS check.
DoLS application process
There are six assessments for DoLS to be approved. The assessors will decide whether the person and the care that they receive meet the ‘criteria for authorisation’ - the conditions that allow a person to be deprived of their liberty.
The person must be aged 18 years or over.
2. Mental health
The person must have a ‘mental disorder’, this includes dementia.
3. Mental capacity
The person must lack ‘capacity’, that is the ability to make their own decisions about treatment or care in the place that is applying for the authorisation.
4. Best interests
Is a deprivation of liberty taking place? If so, it must be:
- in the person’s best interests
- needed to keep the person safe from harm
- a reasonable response to the likelihood of the person suffering harm.
An assessment must include whether there are any less restrictive options and if they are more appropriate.
The person cannot be already liable to detention under the Mental Health Act 1983, or meet the requirements for detention under this Act. If they are, the Mental Health Act would apply and not DoLS.
6. No refusals
The authorisation cannot contradict or conflict with any advance decision the person has made refusing treatment, or with any decisions made by, for example, a court-appointed deputy or someone with Lasting Power of Attorney.
If the person and the care they receive meet all the criteria, the assessors will report that the deprivation of liberty should be authorised by the local authority.
Role of the assessors
The supervisory body must decide if an assessment for DoLs is needed. An assessment must be completed by two professionals, the assessors, who are not involved in the care of the person being assessed:
- Best Interests Assessor (BIA), who must be qualified social worker, mental health professional, nurse, occupational therapist, or psychologist, with the necessary training and experience.
- Mental Health Assessor (MHA), who must be a medical doctor with experience in mental health, usually a psychiatrist.
The BIA will write a report to tell the supervisory body if the Deprivation of Liberty Safeguards Authorisation is needed and for how long this should be. They may also add conditions to the DoLS to ensure that the deprivation is as least restrictive as possible.
How long does it take to conduct a DoLS Assessment?
There are two types of DoLS authorisation:
- an urgent authorisation is put in place by the managing authority and allows a person to be deprived for up to 7 days. This can be extended for a further 7 days, until the supervisory body completes the DoLS process.
- a standard authorisation is put in place by the supervisory body and is expected to be completed within 21 days.
How long does a DoLS authorisation last for?
The maximum time a DoLS can be approved for is 12 months.
Relevant Person's Representative (RPR)
Everyone who has a Deprivation of Liberty Safeguards authorisation must have a Relevant Person's Representative (RPR). The supervisory body will make sure a a representative is in place to advocate on the person's behalf.
A RPR is a person who does not work directly with the person being assessed. They visit the person regularly and checks they are being looked after in a way that means they are safe. The representative could be a member of the person's family or a friend.
If the person or their representative disagrees about being deprived of their liberty, they can ask the Court of Protection to decide whether DoLs should be implemented.
Sometimes, if someone does not have a family member or friend to represent them, they can have a paid RPR, which the supervisory body will arrange.
Find out more: How to challenge a DoLs authorisation at the Court of Protection.
Independent Mental Capacity Advocate (IMCA)
Your Independent Mental Capacity Advocate (IMCA) supports you in the DoLS process if you don't have any family or friends to help you.
There are a number of different IMCA roles involved in supporting and representing people who may be subject to the Deprivation of Liberty Safeguards. These are set out in the Mental Health Capacity Act 2005 and Mental Health Act 2007.
Find out more: IMCA roles in the DoLS process.