Deprivation of Liberty Safeguards (DOLS)

Deprivation of Liberty Safeguards (DoLS) Overview

The Deprivation of Liberty Safeguards (DoLS) are an important amendment to the Mental Capacity Act 2005, aimed at protecting individuals who lack the capacity to consent to their care or treatment arrangements, ensuring their rights and welfare are safeguarded. The following details are key to understanding the responsibilities and roles involved in the assessment process under DoLS:

Key Points

• Legal Obligation for Assessors: Supervisory bodies have a legal obligation to appoint assessors to undertake the necessary evaluations under DoLS.
• Registered GP Not Obligated to Perform Assessments: While the registered GP is central to the care of the individual, they are not required to perform the assessment functions related to DoLS.
• Minimum Number of Assessors: There must always be a minimum of two assessors to carry out the necessary evaluations.
• Mental Health and Best Interest Assessors Must Be Different: The roles of the Mental Health Assessor and the Best Interest Assessor must be carried out by separate individuals to ensure independence and objectivity.
• No Requirement to Report Deaths to the Coroner: Under the current guidelines, there is no longer a requirement to report a death that occurs while under DoLS to the Coroner.
• Private Charge for GP Reports: If the GP decides to provide a DoLS report, they are entitled to charge privately for the service.

What is Deprivation of Liberty?

Deprivation of Liberty occurs when a person is under continuous supervision and control and is not free to leave, and they lack the capacity to consent to these arrangements. For a care home or hospital to lawfully deprive someone of their liberty, they must apply for a Standard Authorisation from the Local Authority, which can only be granted after a series of assessments.

The Six Key Assessments Under DoLS

To ensure that deprivation of liberty is carried out in a lawful and ethical manner, the Mental Capacity Act 2005 outlines six assessments that must be completed to determine if DoLS is appropriate for an individual. These assessments must be carried out by appropriately trained assessors, each with specific roles:

1. Age Assessment
   This assessment confirms that the individual is 18 years of age or older, which is a requirement for DoLS. This assessment is typically conducted as part of the Best Interest Assessment.

2. No Refusal Assessment
   This confirms that the DoLS does not conflict with any pre-existing decision-making authority, such as a Lasting Power of Attorney. It ensures there are no refusals or objections that would render the deprivation of liberty unlawful. This is typically part of the Best Interest Assessment.

3. Mental Capacity Assessment
   This assessment verifies that the individual lacks the mental capacity to make decisions about their own care or treatment, including the ability to consent to their deprivation of liberty. It can be conducted as part of either the Mental Health Assessment or the Best Interest Assessment.

4. Mental Health Assessment
   A doctor must confirm that the individual has a mental disorder as defined by the Mental Health Act 1983. The doctor conducting this assessment must be approved under Section 12 of the Mental Health Act or be a registered medical practitioner with at least three years of experience in diagnosing or treating mental health conditions.

5. Eligibility Assessment
   This assessment confirms that the individual is eligible for DoLS under the current guidelines. Notably, the GP does not carry out this assessment.

6. Best Interest Assessment
   This confirms that depriving the individual of their liberty is in their best interest. The Best Interest Assessor must be independent of the individual’s care and treatment, meaning the registered GP of the individual cannot undertake this role.

Conclusion

The DoLS process is designed to ensure that individuals who lack capacity to make decisions about their care or treatment are appropriately safeguarded. It provides a series of assessments carried out by independent, qualified assessors, ensuring that the deprivation of liberty is both lawful and in the best interests of the individual. GPs play an essential role in the overall care of individuals but are not required to perform the specific assessments under DoLS unless they choose to provide a report for which a private charge may be levied.

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