Deprivation of Liberty Safeguards procedure
Customer update on coronavirus
Deprivation of Liberty
The Department of Health and Social Care have issued guidance and a form for urgent authorisations during the coronavirus outbreak.
The Deprivation of Liberty Safeguards (DoLS) procedure outlines the process followed when a hospital or a care home, known as the Managing Authority (MA), identifies the need to deprive an adult in their care of their liberty.
Authorisation is required from Bracknell Forest Council, as the supervisory body, in order to enact Deprivation of Liberty Safeguards (DoLS).
The supervisory body is the local authority where the person is ordinarily resident. This will usually be the local authority where the care home is located unless the person is funded by a different local authority.
The authorisation must relate to an individual who is 18 years or over and to the hospital or care home in which they are detained.
When there is an intention to apply DoLS to an individual outside of a hospital or care home setting, an application must be made to the Court of Protection.
DoLS application and authorisation process
Making a DoLS authorisation request
In order to safeguard the relevant person from harm, it may be necessary for the MA to take action in the person's best interests and to deprive them of their liberty.
If the MA identifies that the person has been deprived of their liberty, they must complete and submit DoLS form 1 to the Supervisory Body (Bracknell Forest Council's DoLS team) as soon as they are aware that a deprivation of liberty is occurring. MAs must state whether the authorisation being sought is standard or urgent when completing the form.
The DoLS team continuously monitors the expiry dates of current authorisations and will send a reminder to managing authorities to apply.
Social workers may become aware of an individual who is a resident in a care home and may qualify for DoLS, but for whom a DoLS authorisation was not sought. If this occurs the social worker must ask the care home to submit a DoLS form 1 and notify the DoLS Team.
Receiving and recording DoLS authorisation requests
The DoLS referral officer aims to review all new requests within 3 working days, and check that ordinary residence is within Bracknell Forest. They will carry out further checks to make sure that the managing authority’s concerns are likely to meet the DoLS criteria, for example by confirming that:
- the person lacks mental capacity to consent to care and treatment
- the person is subject to 24 hour supervision and control by staff
- staff would need to take steps to stop the person from leaving the care home or hospital if they attempted to
Where the referral officer needs more information to be able to make a decision and prioritise the request, it will need to be provided within 1 working day.
Following initial checks, the referral officer records and allocates the request according to priority.
Standard DoLS authorisation requests
The DoLS team must make a decision on standard requests within 21 days.
Within 14 days of receiving the request, the referral officer will allocate the case to a Best Interests Assessor (BIA) and a Section 12 Doctor (if equivalent assessment is not available). If advised by the BIA, the officer will refer to an Independent Mental Capacity Advocate (IMCA) and monitor the timeframe for an IMCA to be appointed.
The Section 12 Doctor and BIA must arrange to visit and assess the person within 21 days of the receipt of the request. If an IMCA is required, they should be present at these assessments to support the person.
Urgent DoLS authorisation requests
In some circumstances, a MA may need to deprive an individual of their liberty before the DoLS team can respond to a request for a standard DoLS authorisation. If this occurs the MA can use an urgent DoLS authorisation and grant the urgent authorisation itself. The MA completes the Deprivation of Liberty Safeguards Form 1, sends it to the DoLS team and this will allow them to deprive the person of their liberty for up to 7 days.
If an extension is required, the MA can request an urgent DoLS authorisation from the DoLS team for an additional 7 days. The authorisation can only be extended for a further 7 days if the DoLS team agree to this request.
Within 3 working days of receiving urgent DoLS authorisation requests, the DoLS referral officer will allocate the case to a Best Interests Assessor (BIA).
The BIA will make contact with the MA for more information and request the DoLS referral officer to:
- allocate the case to a Section 12 Doctor (an equivalent form 4 can be used if dated within the last 11 months)
- if required, refer to an Independent Mental Capacity Advocate (IMCA) and monitor the timeframe for an IMCA to be appointed
The Section 12 Doctor and BIA must arrange to visit and assess the relevant person within 14 days of the receipt of the authorisation request. If an IMCA is required, they should be present at these assessments to support the relevant person.
Mental capacity considerations and BIAs
The Section 12 Doctor must visit the relevant person to assess whether they lack mental capacity or whether they should be detained under the Mental Health Act. They must complete the Mental Capacity, Mental Health and Eligibility Assessment form (form 4).
The BIA must visit the relevant person to establish whether the DoLS criteria are met. If the BIA establishes that the criteria for DoLS have been met, they must complete the Age, Mental Capacity, No Refusals, Best Interests Assessments and Selection of Representative form (form 3).
If the BIA believes that the criteria for DoLS have not been met they must complete the Best Interest Assessment – No Deprivation form (form 3A). The DoLS referral officer will complete the Authorisation Not Granted form (form 6) and send it to the MA and any consulted person (representative).
Both the Section 12 Doctor and BIA must submit their completed assessments to the DoLS Team. Before submitting their respective forms they must satisfy themselves that they have:
- completed all the required sections of the assessments
- completed the assessment to a good standard (including spelling and grammar)
- made their recommendations based on the required criteria, and explained the reasons for them
DoLS authorisation process
In order to process the DoLS authorisation, the DoLS referral officer must:
- check that the forms submitted by the Section 12 Doctor and BIA have been completed correctly to a good standard and upload assessments
- refer to appropriate services, if a paid representative is recommended on form 3 (seAp holds the current contract with Bracknell Forest)
They must then complete one of the following and seek authorisation from signatories as soon as possible:
- Standard Authorisation Granted form (form 5) if the recommendation is to approve the arrangements
- Standard Authorisation Not Granted form (form 6) if the recommendation is that the relevant person does not meet the criteria
Once authorisation is complete, the officer will send forms 3, 4 and 5 or 6 to the relevant person at the MA (via secure email). The MA is to keep these documents on file.
Copies of all forms are also sent to the representative for their records and for them to formally accept their role. They should sign and return form 5 to the DoLS team within 14 days. If the representative fails to return a signed copy of form 5, the referral officer will contact to remind them.
Role of the DoLS signatory
The DoLS signatory must read the assessments and scrutinise the grounds for the authorisation. They may add or remove conditions or shorten the period the authorisation is granted. The maximum period for authorisation is 12 months.
The authoriser may request further information from the assessors to support their decision making.
Once satisfied, the DoLS signatory should complete the “Evidence of Supervisory Body Scrutiny” and sign form 5 or 6 within 3 days of receipt.
Reviewing DoLS Authorisations
It may be necessary to review DoLS authorisations if the MA requests a review by submitting a form 10. This could be due to many reasons, for example:
- the relevant person no longer meets the age, no refusals, mental capacity, mental health or best interest requirements
- the person is no longer eligible because they now meet the criteria for an application for admission under section 2 or section 3 of the Mental Health Act 1983
- there has been a change in the person’s circumstances and because of the change, it would be appropriate to amend, delete or add a new condition to the DoLS authorisation
- the reason or reasons the person now meets the qualifying requirements are different from the reasons given at the time the standard authorisation was granted
- the person’s representative requests that the DoLS authorisation be reviewed
On receipt of form 10, the supervisory body may appoint a:
- Section 12 Doctor to consider the service user’s mental capacity
- BIA to verify if the criteria for DoLS are met
Depending on the recommendation, the referral officer will either complete the Standard Authorisation Granted form or the Standard Authorisation Ceased form.
All forms are sent to the relevant person at the MA and representative.
What happens when a DoLS authorisation ends?
When an authorisation ends a MA cannot lawfully continue to deprive a person of their liberty.
If the MA considers that a person will still need to be deprived of their liberty, they need to request a further standard authorisation to begin immediately after the expiry of the existing authorisation.
When a standard authorisation ends, Bracknell Forest Council must inform in writing:
- the relevant person
- the relevant person’s representative
- the managing authority
- every interested person named by the BIA in their report as somebody they have consulted in carrying out their assessment
Performance and monitoring
We monitor the following performance standards:
- number of referrals received (standard or urgent)
- authorisations granted or not granted
- no form 5 signed and returned by representative
- validation report
- authorisations with paid representative