Deprivation of Liberty Safeguards (DoLS) – where do we go from here?

Publication Date09 Feb 2015
AuthorChris Lennard
SubjectHealth & social care,Vulnerable groups,Adult protection
Deprivation of Liberty Safeguards (DoLS) –
where do we go from here?
Chris Lennard
Chris Lennard is a Registered
Nurse, based at Pirton Grange
Specialist Care Centre,
Pirton, UK.
Purpose – The purpose of this paper is to give a brief background to the Deprivation of Liberty Safeguards
(DoLS), and studies which factors Best Interests Assessors consider when making a judgement on
Deprivation of Liberty. It examines some of the reasons why professionals may be under-using DoLS,
including lack of knowledge, complex processes and paperwork, and the pejorative nature of the word
deprivation, and looks at a possible way forward.
Design/methodology/approach – The paper looks at the evidence to the House of Commons and House
of Lords Committees on the Mental Health Act and Mental Capacity Act, as well as previous and current
research papers. It examines the nuances of difference between restriction and deprivation, and the
cumulative impact of several restrictions, which may, in fact, amount to a deprivation, illustrated by case
studies from the author’s own practice.
Findings – It makes the case that health and social care professionals should err on the side of caution,
by making precautionary DoLS applications, arguing that MCA DoLS is a forerunner of good practice, and
that good care planning allied to judicious application of the MCA leads to better, more robust and more
defensible decision making.
Originality/value – And it points the way to a possible future, citing the recommendations of the Select
Committee on the MCA for a clearer link between DoLS and the principles underpinning the MCA, and for
simplifying and clarifying the legislative provisions and the associated paperwork.
Keywords Mental health, Safeguarding, DoLS, MCA, Learning disability,Nursing
Paper type Viewpoint
The author studied for his degree in mental health nursing between 2006 and 2009, during
which time both the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards
(DoLS) came into force. Since qualifying, he has worked in three contrasting settings – on an
acute inpatient mental health ward in the NHS, in a nursing home for people with a learning
disability in the private sector, and in a specialist care home for people with Huntington’s
Disease and Acquired Brain Injury. He has acted as both Mental Health Act (MHA) lead and
MCA lead, and has delivered training on the MCA and on the DoLS.
During this time, he has noted a wide variation in knowledge and awareness by staff of the MCA
in general and the DoLS in particular, and a reluctance to use the latter. This corresponds
with evidence from across England and Wales from statutory bodies and academics alike. The
Care Quality Commission (CQC) (2014a), in its annual survey, reported a worrying lack of
understanding and awareness by staff of the MCA and the DoLS, while two-thirds of care
homes and hospitals that make applications fail to notify the CQC of the applications or their
outcomes, as required by Health and Social Care Act regulations. Liberty (2013) cites
unexplained low rates of applications to local authorities, complete lack of awareness from
care staff about the Safeguards and an inability to identify when an authorisation is required
under the MCA.
DOI 10.1108/JAP-05-2014-0017 VOL. 17 NO. 1 2015, pp. 41-50, CEmerald Group Publishing Limited, ISSN 1466-8203

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