The Deprivation of Liberty Safeguards, which were introduced as amendments to the Mental Capacity Act 2005 on 1 April 2009, are designed to protect vulnerable people against overly restrictive care while they are in hospitals or care homes.
This second annual report on Deprivation of Liberty Safeguards uses data provided every three months by English Primary Care Trusts (PCTs) and Local Authorities (LAs), the organisations responsible for managing the process for authorising requests to deprive someone of their liberty in 2010/11. Requests from care homes are handled by LAs and requests from hospitals are handled by PCTs.
Key findings:
- The total number of applications made was still much lower than expected for the second year (8,982 in England compared with the number predicted for in England and Wales which was around 18,600). This compares to the 7,157 applications made in 2009/10; just over 34 per cent of the predicted number for that year.
- The number of successful applications resulting in an authorisation to deprive a person of their liberty was about the expected number (4,951 in England compared to the 5,000 predicted for in England and Wales), though a much higher percentage of applications than expected were successful (55% compared with the predicted 25%). In the previous year 3,297 applications were approved – a 46% approval rate compared to the 25% expected.
- About 2% of applications that were not authorised involved situations where the person was nevertheless judged as being in a situation that amounted to a deprivation of liberty. In these cases the hospitals and care homes could be acting illegally, if that person was not swiftly cared for or treated in less restrictive circumstances. This is half the percentage in 2009/10 (4%).
- Of those authorisations that were granted, more then half (55%) were for a person who lacked capacity because of dementia.
- From quarter 2 in 2011, there was a change to recording, whereby it was only possible to have one disability per person. The number of applications for learning disabilities in quarters 2 to 4 represented 14% of the total.
- 57% of those applications made to a Local Authority were granted when applying for a deprivation of liberty compared to 50% in Primary Care Trusts.
- Authorisations granted for people in care homes were generally for longer periods than for people in hospitals (62% of authorisations granted by Local Authorities were for more than 90 days compared with 23% of Primary Care Trust authorisations).
- There is a big difference in the number and rate of applications in different parts of England, with the highest number and rate of applications being made in the East Midlands (1,644 applications and 46 applications per 100,000 population) compared to the England rate (22 applications per 100,000 population) and the lowest number of applications made in the North East (579) with the lowest rate being in the East of England with just 13 applications per 100,000 population.
Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) – Second report on annual data, 2010/11. The Health and Social Care Information Centre, 20th July 2011.
It is really useful to receive this type of information as I know in our Trust we are delivering essential training around DoLS.
Thanks for your comment. This is a really important issue and one that Trusts need to take seriously, and it sounds from your comment like this is happening in your area.
The document though talks about differences between actual and expected numbers of applications as well as differences in numbers of applications between different parts of the country. I wonder if there is any relationship between training, types of training and follow up and those area by area differences? What do you think?