What are Deprivation of Liberty Safeguards (DoLS)?

When working as a nurse or health care assistant in the adult care sector, care homes or hospital setting, you will be caring for adults with a range of physical and mental health conditions. Many of these adults are incredibly vulnerable and need the understanding of caring and professionally trained staff. It is vital that all care staff and nurses keep themselves up to date with all aspects of caring for vulnerable adults and those with mental health conditions and challenging behaviours.

Below we explore Deprivation of Liberty Safeguards (DoLS), how this process protects vulnerable patients, and the range of DoLS courses that are available for nurses.

What are Deprivation of Liberty Safeguards (DoLS)?

The Deprivation of Liberty Safeguards (DoLS) is part of the Mental Capacity Act (2005). DoLS are there to protect vulnerable people who are in care homes, and whose liberty needs to be restricted in order to keep them safe.

This set of safeguards will set out any process that is needed by a care home to deprive a patient’s liberty. This is done for their best interest and will result in an extremely detailed and personalised nursing care plan.

Safeguarding and keeping the patient safe

Safeguarding and DoLS must be in the best interest of the patient. These safeguards are not put in place to benefit care staff. It’s also important to note that once arrangements have been made that they will be constantly reviewed and assessed to make sure that they are relevant to the patient’s needs. Once they are no longer relevant, then the DoLS can be stopped.

Reasons for DoLS

If a patient is continuously supervised to keep them safe, and are under the control of care home staff, so are not free to leave, then a DoLS can be implemented if that patient lacks the capacity to provide consent with regards to their safety.

There are many circumstances when a DoLS is the best course of action. This obviously depends upon individual circumstances. It may be that a patient suffering from dementia may need a DoLS to maintain their safety within the care home environment and to prevent wandering. What is important is that each individual is carefully assessed via a multidisciplinary team approach.

What is standard authorisation?

Care homes and staff looking after individuals in assistant living, need to ask their local authority permission to deprive a patient of their liberty. A total of six assessments is performed before a standard authorisation is permitted. There also needs to be an appointed person to represent this individual. This person can be a family member, friend or advocate. If an individual is living in their own home, then a DoLS can still be implemented, but this is through the Court of Protection. They will determine if an individual is to be deprived of their liberty and if a DoLS should be implemented. They will carry out an independent mental assessment.

Standard authorisation and DoLS in the care home setting

For care homes, the local authority is the supervisory body that takes the lead role in the assessment process. It is the duty of the managing authority, who in this case is the care home, to fill out all requests for a standard authorisation. The supervisory body then has 21 days to decide whether that individual should have their liberty deprived. Assessors will go to the care home and will make their decision based on the following facts:

• The individual is over 18
• The individual is suffering from a mental condition
• The individual lacks capacity
• Consider if the individual would be better sectioned under the Mental Health Act.

If any of these conditions are not met, then authorisation cannot be given for DoLS. This may result in a change of care plan, or the level of staff support that is given to that patient. Perhaps extra staffing may be needed during the night.

If these conditions are met then a DoLS can be implemented. Both the managing authority (care home) and the individual, must be informed of this decision in writing.

When you have concerns about Deprivation of Liberty

If you work in a care home and believe that a patient is being deprived of their liberty, and without the relevant assessment and without a DoLS in place, then you must reassess that care. Could it be less restrictive? If yes then try to implement this. If no, then the correct assessment route must be followed and a standard authorisation sought.

DoLS Training for nurses and health care assistants

Keeping up to date on the latest care practices and legislation is not only necessary for nurses to maintain their PIN number and registration, but CPD for nurses also allows them to give the very best care and treatment to their patients in care homes and hospitals. No matter if you work in the care home environment or in the adult care sector, DoLS training is vital. This staff training within the social care sector is part of the larger Mental Capacity Act training that will greatly benefit the patient and their care environment.

DoLS training companies in the UK ensure that there are safeguarding courses and wider Mental Capacity Act courses for nurses and care staff. All DoLS training should include a vast range of induction level training, refresher courses and advanced level training for all staff.