The Deprivation of Liberty Safeguards (DoLS) are an amendment to the Mental Capacity Act 2005. It is a care home’s legal requirement to make a DoLs application to their local authority if it is deemed necessary to deprive a resident of their liberty in order to keep them safe from harm, in the event that they lack capacity to consent to their care and treatment. It is the responsibility of the managing authority to ensure that any deprivation of liberty is lawful.
The CQC aim to regulate and monitor the application of DoLS and have previously found that those homes that have a poor understanding of DoLS are likely to receive a “requires improvement” or “inadequate” rating. In the past year there have been 195,840 DoLS applications to local authorities, many of which are classified as “urgent considerations”. In order to respond in a timely manner to these applications, a large amount of pressure is being placed on local authorities which contributes to the increasing cost of the DoLS regime.
The CQC State of Care Report highlights that lack of understanding around when to apply for “urgent considerations”, having minimal procedures in place with regards to DoLS, and the inconsistent levels of training often leads to enforcement action in care homes. These situations raise concerns regarding the protection of basic human rights.
Care homes that are rated good or outstanding overall place a heavy emphasis on the best interests of the individual and took an individualised approach to capacity considerations. Training on DoLS should be part of a mandatory training programme in care homes for all levels of staff to ensure that human rights are protected and it is vital that this can be evidenced to CQC inspectors.
Excellent understanding and quality trainings on DoLS is imperative to not only comply to the legal requirements surrounding capacity, but to demonstrate good practice and to improve a care home’s rating following CQC inspections.
“There continues to be large variation in practice. There needs to be a greater effort to train staff on DoLS and how to use them effectively, as well as maintaining the right procedures and processes. This is critical for ensuring that people receive good quality care and treatment that is in their best interests, and that they are not deprived of their liberty unlawfully. It is important that we make sure that everyone, irrespective of their mental capacity, can experience care that considers their needs and preferences. While there are significant challenges in the system, until reform takes place it is important that the current system is complied with to protect people’s interests, and to avoid compromising the quality of the care they receive.” CQC, State of Care 2015/16, October 2016
To read more about the CQC State of Care Report, click here.