Care for vulnerable adults who can't make decisions for themselves

When is someone deprived of their liberty?

Some adults, who are in hospitals, care homes and certain other types of accommodation, can't make their own decisions about their:

• living arrangements
• treatment
• care.

This is because they lack the mental capacity to do so. For example someone with:

• a severe brain injury
• dementia
• a learning disability.

These people need more care and protection than others to make sure their wellbeing is maintained and they do not suffer any harm. Treating and caring for people who need extra protection may mean restricting what they can or cannot do. This is called deprivation of liberty.

A person is likely to be deprived of their liberty if they:

• don’t have the capacity to decide on their living and care arrangements
• are under continuous supervision and control
• are not free to leave the hospital, care home or other accommodation, because harm will occur.

An example would be stopping a person leaving a care home because they are very likely to have a serious accident.

It is illegal to deprive someone of their liberty in a care home or hospital without a DoLS.

What is a deprivation of liberty safeguard (DoLS)?

A DoLS sets out when and how certain restrictions can be used. It could be granted to help give a care home or hospital the right to keep a person from leaving, so they don’t come to harm. DoLS do not apply to people detained in hospital under the Mental Health Act.

DoLS assessments determine if it is in the person’s best interests to be kept in the care home or hospital to receive the care or treatment they need. If it is, a DoLS will be authorised.

How to apply for a DoLS

If a care home, or other setting, needs to deprive someone of their liberty, they must apply to our DoLS supervisory body to authorise this deprivation as in the person's best interests. In certain circumstances, the application may need to be made to the court of protection.

What to do if you think someone is being deprived of their liberty without authorisation

Contact the care home or hospital

If you believe someone is being deprived of their liberty without authorisation, or you want an existing authorisation reviewed, you can discuss it with the care home or hospital manager. They can make the authorisation or DoLS review request.

Contact us

You can also email DOLS@lewisham.gov.uk or call us on 020 8314 7172 or 020 8314 3365.

Reviewing a DoLS

A DoLS can be reviewed at any point to see if a person still meets the requirements, or if any conditions need to be changed. The DoLS office will carry out reviews if it is necessary, or if it is requested by:

• the person being deprived of their liberty
• the person’s representative, hospital or care home.

An independent mental capacity advocate (IMCA) may be appointed if someone needs an advocate, especially if they have no one to consult with during the DoLS assessments or authorisation.

Your rights

Every person subject to a DoLS must have a representative. This can be a:

• family member
• friend
• paid representative.

The DoLS office will appoint the representative when the DoLS is authorised.

In Lewisham, the IMCA and the paid relevant person’s representative (PRPR) services are provided by an organisation called Advocacy For All.

For more information view an easy to read document and our guide for family, friends and carers.

You may also be interested in:

• Standard forms and guidance from Central Government
  https://www.gov.uk/government/collections/dh-mental-capacity-act-2005-deprivation-of-liberty-safeguards
• SCIE website mental capacity section
  http://www.scie.org.uk/mca/
• The Law Society guidance for frontline health and social care professionals to identify when a deprivation of liberty may be occurring in a number of health and care settings.
  http://www.lawsociety.org.uk/support-services/advice/articles/deprivation-of-liberty/