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Deprivation of Liberty Safeguards

Deprivation of Liberty Safeguards (DoLS) protects vulnerable individuals staying in a hospital or care home setting who lack the capacity to consent to the care or treatment that they need.

What is deprivation of liberty?

It may be necessary to make decisions for or place a restriction on an individual, for example deciding an individual’s daily routine in order to keep them safe so that the wider healthcare team can provide an individual with the care they need. It is possible that this approach takes away some freedom from an individual and may amount to a ‘deprivation of liberty’.

A deprivation of liberty occurs when an individual is under continuous supervision and control and is not free to leave, and the person lacks capacity to consent to these arrangements.

Continuous supervision and control – the care that people receive in hospital usually involves both supervision and control. The healthcare team will monitor patients and make decisions about activities and may also control other areas such as meals, leisure time and bedtimes.  Although this care is often what a person needs it can deprive that individual of their freedom if they have not consented to it. If an individual is being supervised and controlled on a continuous basis (i.e. needs to be monitored for significant periods of the day, but not necessarily 24 hours a day), this could count as a deprivation of liberty.

Not free to leave – if a person is not free to leave the setting where they are being cared for, they may be deprived of their liberty. It is important to note that this can be hypothetical. The individual may not be physically able to leave by themselves, but the question is still the same – if they tried to leave, would they be stopped? If the answer is yes, e.g. they did not consent to this care and are not free to leave – then they are being deprived of their liberty.

Lacking capacity to consent – if an individual has freely chosen and consented to the care and treatment they are receiving they have not given up any of their freedom. A deprivation of liberty can only occur in cases where an individual lacks the ability to decide where they will live and what care they will receive.

In order to have capacity to decide, a person must be able to:

  • Understand the information about the decision – e.g. the options for care and living arrangements
  • Retain that information long enough to be able to make a decision
  • Weigh up the information available and understand the consequences of the decision
  • Communicate the decision – this could be by any possible means, such as talking, using sign language or even simple muscle movements like blinking an eye or squeezing a hand
Deprivation of Liberty Safeguards (DoLS) process

At Renovo, we have implemented a strict DoLS process to ensure that any individual who is deprived of their liberty is protected.   DoLS offer protection to ensure that, when someone’s freedom is restricted, it is both in their best interests and, where possible, done in the least restrictive way.

If a situation arises where an individual may need to be deprived of their liberty whilst they are a patient at our hospital or resident at one of our home settings the healthcare team must seek permission.

The key components of the DoLS process are:

  • To provide the person with a representative – a person who is given certain rights and who should look out for and monitor the person receiving care
  • To give the person (or their representative) the right to challenge a deprivation of liberty through the Court of Protection
  • To provide a mechanism for a deprivation of liberty to be reviewed and monitored regularly