Deprivation of Liberty Safeguards
Deprivation of Liberty Safeguards (DoLS) is a law that protects vulnerable adults in hospitals or care homes who might be deprived of their liberty.
This information is for both staff in hospitals and care homes who may need to apply for Deprivation of Liberty authorisation and for people directly affected by or concerned about these decisions.
Hospitals and care homes cannot deprive anybody of their liberty without formal deprivation of liberty authorisation.
Hospitals and care homes must apply for standard authorisation to deprive someone of their liberty to their relevant local authority or primary care trust.
All requests for authorisation to NHS Bristol and Bristol City Council go through Bristol DoLS Service.
If you don’t agree with a decision about deprivation of liberty, you should first talk to the hospitals or care homes. If you still are not happy about the decision, talk to the DoLS Service.
What is deprivation of liberty?
There is no simple definition of ‘deprivation of liberty’. It depends on the circumstances of each individual case. Court judgements suggest factors to look for that can help identify deprivation of liberty:
- Someone resists being admitted to a place and they are restrained and or sedated so that they can be admitted.
- Staff have complete control over the care and movement of someone for a considerable time.
- The institution has decided that someone cannot be released into the care of others, or allowed to live somewhere else.
- Carers ask for someone to be discharged to their care and this is is refused.
- Someone is not able to maintain social contacts because of restrictions placed on their seeing other people.
- Someone loses independence because they are under continuous supervision and control.
On their own, these factors do not mean there is a deprivation of liberty. However, the more factors present and the greater their impact, the more likely it is that a person is being deprived of their liberty.
A list of the factors to consider can be downloaded below. This list is not exclusive and more factors are likely to be added following new court cases.
The DoLS Code of Practice provides more information about how to identify a deprivation of liberty.
Applications for deprivation of liberty authorisation
There are two special terms used in the DoLS process:
- Hospitals and care homes are called 'managing authorities'.
- The ‘supervisory body’ gives authorisation. This could be the primary care trust or a local authority.
Before making an application
Hospitals and care homes must consider options for delivering care or treatment that avoid deprivation of liberty altogether.
Making an application in cases that do not involve depriving a person of their liberty may place undue stress upon the person being assessed and on their families and carers. Please check with the Bristol DoLS service if you are not sure if the case involves derivation of liberty.
Making an application
When deprivation of liberty is the least restrictive option and is in the best interest of the relevant person, the hospital or care home must apply for a standard authorisation of deprivation of liberty.
Applications should be made to the correct supervisory body. Bristol DoLS Interagency Policy and Procedures (link) contains some guidance on identifying the correct supervisory body. There are special arrangements for making applications to the supervisory bodies outside Bristol.
To make an application please use the appropriate standard DoLS form and send (fax or recorded delivery mail) together with all supporting evidence (care plan and risk management plan) to the DoLS Service - contact details below.
You can also apply by email to email@example.com using SecureSend service. SecureSend will allow you to create a password to protect the confidential information in your email. Important: you must either send the password in a separate email or tell it over the phone once you have confirmed your email is safely received by DoLS Service. For help on using SecureSend go to How to use SecureSend.
The supervisory body will perform six assessments in order to determine whether the deprivation of liberty can be authorised.
What if the application is authorised?
If the supervisory body authorises a deprivation of liberty, this will be for a limited time (up to maximum of 12 months) and the supervisory body will put conditions in place to ensure the person's welfare.
The supervisory body will also appoint a representative for the person being deprived of their liberty. The representative’s role is to provide support and to represent the person deprived of their liberty in all matters regarding authorisation and request a review of the authorisation where necessary.
The safeguards also ensure that the person deprived of their liberty and their family, carers and friends have right to appeal against a decision in a court of law.
Review of authorisation
If circumstances change then the hospital or care home should apply for a review.
The person concerned, or their representative, can also request a review.
The supervisory body must also carry out a review when statutory review grounds are met.
What should I do if I am concerned that a person is being deprived of their liberty?
First, you should discuss your concerns with the hospital or care home. They may be able to change this person’s care or treatment arrangements to ensure that the deprivation of liberty is avoided, or may be able to explain why the person is not actually deprived of their liberty unlawfully. A standard letter is available for this purpose but this request does not have to be in writing.
If you disagree with the managing authority’s response to your concerns you can contact the DoLS Service directly and request to investigate an unauthorised deprivation of liberty.
Please visit Health and Social Care’s training courses web page to find out more about DoLS and MCA training or to book a specific course.