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Understanding Deprivation of Liberty Safeguards (DoLS)

This article provides an overview of DoLS and the acid test, aiming to inform and guide healthcare professionals, caregivers, and family members in navigating the complex terrain of care provision for those who lack decision-making capacity.

In the realm of care and support for individuals lacking the capacity to make their own decisions, Deprivation of Liberty Safeguards (DoLS) serve as a crucial legal framework within England and Wales. These safeguards aim to protect the rights and freedoms of individuals in care settings. The introduction of the “acid test” further refines our understanding of what constitutes a deprivation of liberty. Here we explore DoLS, the acid test, and their significance in ensuring ethical and legal care practices.

DoLS are set in place to ensure that individuals who cannot consent to their care arrangements in a hospital or care home are protected if those arrangements deprive them of their liberty. The safeguards provide a legal route for care providers to lawfully deprive someone of their liberty, provided it’s in the person’s best interest, and there’s no less restrictive way to provide the necessary care and treatment.

The Acid Test

The Supreme Court’s landmark ruling introduced the “acid test” for determining a deprivation of liberty. According to the acid test, an individual is considered to be deprived of their liberty if they are under continuous supervision and control and are not free to leave, regardless of their compliance or understanding of the situation. This definition emphasises the importance of freedom and autonomy, underscoring that the perception or compliance of the individual does not diminish their rights.

Applying DoLS – The Process

1. Assessment and Authorization: When a care home or hospital believes a person’s care might deprive them of their liberty, they must apply for a DoLS authorization from the local authority.

2. Six Assessments: To grant authorization, six assessments are conducted, including assessments of age, mental health, mental capacity, eligibility, best interests, and no refusals. These ensure that the deprivation of liberty is necessary and in the person’s best interest. You can read more about the six assessments here on the Social Care Institute for Excellence article

3. Rights and Reviews: Individuals under DoLS have the right to an advocate and the legal right to challenge the deprivation of liberty through the Court of Protection.

Together, DoLS and the acid test protect vulnerable individuals from unjust or unnecessary restrictions on their freedom. They ensure that any deprivation of liberty is legally sanctioned, carefully reviewed, and truly in the individual’s best interests. This framework reinforces the principle that care and treatment must respect the dignity and autonomy of all individuals, regardless of their capacity.

Deprivation of Liberty Safeguards and the acid test play a pivotal role in the care and protection of individuals lacking the capacity to make decisions about their living arrangements and care. By setting stringent criteria for what constitutes a deprivation of liberty, these legal safeguards uphold the values of dignity, autonomy, and respect within care settings, ensuring that the rights of the most vulnerable are protected.

You can read further information about DoLS on the CQC websites publication – Deprivation of Liberty Safeguards

Andrew Smith & Lindsey Gray