Interim statement providing an update on issues that emerged from the Law Commission’s consultation on the Deprivation of Liberty Safeguards (DoLS), which set out a replacement scheme called ‘protective care’. The paper sets out the background to the review of DoLS. It then outlines the ‘protective care’ scheme described in the consultation paper, which consists of three aspects: the supportive care scheme, the restrictive care and treatment scheme, and the hospitals and palliative care scheme. It then summarises the main messages from the consultation, which received 583 written responses and involved the Law Commission attending 83 events across England and Wales. The results of the consultation found a case for replacing the DoLS. Most consultees found the DoLS to be overly legalistic and found it had failed to deliver improved outcomes for people who lack capacity and their carers. Most consultees welcomed the new provision proposals, but concerns were raised about the financial implications. During the next phase of the review, the Law Commission will produce draft legislation and a final report. The document invites views on the new name for the scheme.
Outlines the key parts and processes of liberty protection safeguards.
This is a final stage impact assessment for the Mental Capacity (Amendment) Bill. It
evaluates options for reforming the Deprivation of Liberty Safeguards (DoLS) system.
Sets out in detail the Government’s provisional view of each individual proposal, broadly agreeing with the Liberty Protection Safeguards model. As the Government has commissioned a review into the Mental Health Act, proposals that relate to the interface between the Mental Health Act and Mental Capacity Act will be considered as part of that review. The Government also wants to ensure that Liberty Protection Safeguards fit with the conditions and future direction of the health and social care sector, so it will continue to work through the detail of the recommendations and engage further with stakeholders particularly on implementation. The Government will bring forward legislation to implement the model in due course.
An overview of the Mental Capacity (Amendment) Bill, and the amendments made during the Bills Lords stages, ahead of its Second Reading in the Commons on 18 December 2018. The aim of the Bill is to reform the process for authorising arrangements which enable people who lack capacity to consent to be deprived of their liberty (for the purpose of providing them with care or treatment). This briefing summarises some of the main concerns raised by Peers about the Bill during its passage through the Lords. These include: the definition of deprivation of liberty; the role of care home managers in carrying out assessments, with particular concerns raised about potential conflict of interests in care homes and independent hospitals; the appointment and role of Independent Mental Capacity Advocates (IMCAs); and provisions relating to reviews by Approved Mental Capacity Professionals (AMCPs) and referral to the Court of Protection.
Interim statement providing an update on issues that emerged from the Law Commission’s consultation on the Deprivation of Liberty Safeguards (DoLS), which set out a replacement scheme called ‘protective care’. The paper sets out the background to the review of DoLS. It then outlines the ‘protective care’ scheme described in the consultation paper, which consists of three aspects: the supportive care scheme, the restrictive care and treatment scheme, and the hospitals and palliative care scheme. It then summarises the main messages from the consultation, which received 583 written responses and involved the Law Commission attending 83 events across England and Wales. The results of the consultation found a case for replacing the DoLS. Most consultees found the DoLS to be overly legalistic and found it had failed to deliver improved outcomes for people who lack capacity and their carers. Most consultees welcomed the new provision proposals, but concerns were raised about the financial implications. During the next phase of the review, the Law Commission will produce draft legislation and a final report. The document invites views on the new name for the scheme.
Although the Mental Capacity Act (MCA) has implications for other aspects of Prader-Willi syndrome (PWS), this article focuses on the possible relevance of the MCA in the management of the over-eating behaviour and risk of life-threatening obesity associated with the syndrome. Although people with PWS are capable of making decisions about many areas of their life, dysfunction in areas of the brain that control eating behaviour and energy balance means that they will rarely have the capacity independently to make decisions about eating. Even if they can make a decision at one point in time, this may not be the case at other times, particularly in the absence of supervision or environmental restrictions on access to food. The document covers the existing legal provisions and ethical considerations for people with PWS, including decision-making capacity and Deprivation of Liberty.
These materials have been created to help support health and social care professionals working with individuals whose decision-making capacity is limited, fluctuating, absent or compromised. Demographic changes mean there are increasing numbers of people living with conditions which may impact on their decision-making capacity, and as such it is vital that professionals are confident in their understanding use of the Mental Capacity Act 2005. This tool brings together information from a range of professionals working in the field of mental capacity to provide a comprehensive guide to practice. It is part of a wider research project funded by the Burdett Trust for Nursing. Sections include: 1. Reflecting on values and bias in mental capacity decision-making; 2. The history and current context of mental capacity legislation and policy; 3. The concept of mental capacity; 4. Best interests; 5. Supported decision making; 6. Deprivation of liberty: human rights; 7. MCA in clinical decisions for care and treatment; 8. MCA and the Office of the Public Guardian (OPG) role.
Purpose: Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI). Design/methodology/approach: A total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed. Findings: Three distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted. Research limitations/implications: The findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system. Originality/value: To the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.
This study explores the experiences of professionals who worked with care home residents with impaired mental capacity in England and Wales during the COVID-19 pandemic. It explores (i) how competing risks were balanced and (ii) how the Mental Capacity Act (MCA) functioned in care homes under pandemic conditions, with particular focus on its associated Deprivations of Liberty Safeguards (DoLS) and Independent Mental Capacity Advocacy (IMCA) systems. Between March and May 2021, an online survey and five focus groups aimed at professionals who worked in or with care homes during the pandemic, were held. The study explored issues pertaining to residents with impaired mental capacity, alongside several other topics on which the authors report elsewhere. For this paper, the researchers filtered data to only include responses from ‘capacity professionals’. The resulting sample comprised 120 (out of 266) survey participants and 18 (out of 22) focus group participants. The researchers performed manifest content analysis on the filtered data and found that (1) participants reported a ‘massive discrepancy’ between the ways different care homes balanced the risk of COVID-19 infection with the risks associated with severe restrictions. (2) Some suggested this was due to vague guidance, as well as care home type and size. Participants told us the pandemic (3) obstructed smooth operation of statutory safeguards designed to protect residents’ human rights and (4) resulted in confusion about the remit of the MCA during a public health crisis. The findings raise concerns about the impact of pandemic-related measures upon care home residents with impaired mental capacity. The researchers urge further exploration and analysis of (a) the variability and inconsistency of restrictions applied at care homes, (b) the strain placed on key safeguards associated with the MCA, (c) uncertainty about the remit of the MCA during a public health crisis and (d) the human rights implications hereof.
CDC’s case law digest service provides essential updates on the latest judicial decisions affecting disabled children and young people and those with SEN.
These official statistics provide findings from the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) data collection for the period 1 April 2019 to 31 March 2020. DoLS are a legal framework that exist to ensure that individuals who lack the mental capacity to consent to the arrangements for their care, where such care may amount to a “deprivation of liberty”, have the arrangements independently assessed to ensure they are in the best interests of the individual concerned. The data is collected from local authorities in England, who are the supervisory bodies for authorising deprivations of liberty of adults in care homes and hospitals. There were 263,940 applications for DoLS received during 2019-20, relating to 216,980 people. The number of applications has increased by an average of 13.9% each year since 2014-15. The proportion of completed applications in 2019-20 that were not granted was 51.0%. The main reason was given as change in circumstances, at 62.0% of all not granted cases. The proportion of standard applications completed within the statutory timeframe of 21 days was 23.6% in 2019-20. The average length of time for all completed applications was 142 days.