Deprivation of liberty safeguards (DoLs)
Date issued: October 2022
Review date: October 2024
Ref: D-324/JS/Learning Disability Team/Deprivation of liberty safeguards (DoLs) v2
PDF: DOLS final October 2022 v2.pdf [pdf] 922KB
The Mental Capacity Act:
The Mental Capacity Act 2005 is a law about making decisions and what to do if someone is unable to make a decision for themselves.
Deprivation of Liberty Safeguards are part of the Mental Capacity Act.
Lacking capacity:
When we are poorly it can be hard to make decisions. Being ill, having an infection or long term health condition can affect how we make our choices.
Some people with learning disabilities or Dementia may find it hard to make decisions too.
When people cannot make decisions for themselves they are known as lacking capacity.
Making decisions:
People who are staying in hospital should be treated or cared for in a way that means they are safe. They have a right to be involved in decisions about their care and treatment.
You can usually make choices about your stay in hospital. Hospital staff will always try to help you understand your choices.
Sometimes people are not able to understand a choice about their medical care. They might be able to make some decisions, but not others.
Patients may want to make a choice that’s not safe or could harm them. Hospital staff sometimes need to stop people from making choices that unsafe.
Stopping you from making a choice about your medical care is called a Deprivation of Liberty.
Important things to know about Deprivation of Liberty Safeguards:
Deprivation of Liberty Safeguards only apply to people who lack capacity over the age of 18.
Hospital staff will only stop a person from making a decision if it is the best way to make sure they get the treatment they need.
Specialised hospital staff :
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must check and prove that the person is unable to make a decision and therefore lacks capacity
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must make a decision in the person’s best interests (what is best for you)
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must think about the least restrictive way of caring for the patient. See example on page 6.
Rules to protect you:
A best interest meeting will be held for a patient if they are unable to make a decision for themselves. Family members or people who know the person well will be invited to this.
If they do not have anyone who can do this for them the hospital staff will ask an IMCA to get involved.
IMCA stands for Independent Mental Capacity Advocate. An IMCA’s role is to support and represent the person.
The hospital will ask someone from the council to check that the right decision has been made for the patient deprived of their liberty.
Two people will visit the patient in hospital. They do not work for the hospital and one of them will be a doctor. Their job is to make sure the patient has been treated fairly.
An example of a Deprivation of Liberty:
Dave is confused. He doesn't understand how poorly he is and why he needs to stay in hospital.
Hospital staff have tried to explain to Dave why he needs to stay in. He would not be safe if he goes home. He cannot get the treatment he needs at home.
Dave’s doctor arranges for a best interest meeting with people who know Dave well. Everyone agrees he needs to stay in hospital.
Dave tries to walk out of the hospital as he just wants to go home. Dave is not free to go home so has to be stopped if he tries to leave.
It is decided that Dave will have someone with him at all times. They will support him, help him to relax and ensure he is safe.
What to do if you are unhappy:
If a person is unhappy that their liberty has been deprived they are entitled to say so.
Patients can talk to their ward staff and ask them to review their case. Staff will look at the decision to see if it is right for the person.
A health or social care professional may need to do an assessment of the patient to see if they have capacity. They will explain all decisions made.
Patients also have the right to ask a judge in the Court of Protection to look at their case. The judge will decide if the person has capacity to make decisions for themselves.
A judge will review the person’s case if they have disagreed with the decisions that have been made.
For more information:
If you would like more information about Deprivation of Liberty Safeguards please contact:
Hospital Safeguarding Team on 01752 439053
Complex Discharge Team on 01752 437473
The Court of Protection on 0300 456 4600
The Advocacy People advocacy service on 0330 440 9000
