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:
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.
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:
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.
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.
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.
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.
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.
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.
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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