DEPRIVATION OF LIBERTY
DoLS (England and Wales)
The Mental Capacity Act 2005 (MCA) is a law
that protects your rights if you become unable to make decisions
for yourself about:
- your money
- how your health is looked after
- how you are looked after in other ways.
Deprivation of Liberty Safeguards (DoLS) are a
set of rules within the Mental Capacity Act. These rules apply if
you can't make certain decisions about how you are cared for. This
could be because of memory problems, a head injury, mental
illness or a learning disability.
These rules only apply if:
- You are looked after in a hospital or care
- The staff keep you under continuous
supervision and stop you leaving
- You or others, such as your family, are unhappy about
Why would staff want to do
this? Basically, to keep you safe. So they may also need
- stop you from doing some things that you want to do
- insist on a particular treatment or type of care that you don't
Whatever staff do has to be unavoidable, in your
best interests and must follow a set of rules. The
DoLS rules are there to protect you. They make sure that what the
staff do is needed - and to stop them if they are not.
What is “deprivation of liberty”?
This is a legal term – but rather
If you live in a care home, or hospital, you
would expect to be prevented from doing things which could be
dangerous. If there are a lot of things that you can't do,
this is called a “deprivation of liberty”.
For example, someone with dementia might need
help with their washing, dressing or keeping themselves clean, even
if they don't want that help. Such things don't need any legal
special permission. However, if there are a lot of other
things that they are stopped from doing, it becomes more serious –
the person is said to be deprived of their
This can only happen legally with the
authority of a DoLS authorisation (unless you’re detained in
hospital under the Mental Health Act – see leaflet Being Sectioned or it is
authorised by a judge).
When “normal care” becomes “deprivation of
liberty” is not always clear. The courts have identified
certain pointers which suggest that someone is more likely to be
deprived of their liberty, rather than just restricted.
- if you want to leave
and you’re being stopped from doing so, either by staff or a locked
door, for more than a few hours;
- if you have to be given
medication to stop you leaving;
- if the staff of the home or
hospital take control of your life so that they decide if and when
you can have visitors, speak on the phone, go out of the building
and so on.
This should be seen as a serious matter. The
rules are there to make sure that you are protected.
Can I be deprived of my liberty at home?
No, only in a care home or hospital.
What’s the process?
Step 1 – the alert
Usually staff from the care home or hospital
(called the Managing Authority) where you are receiving
care will contact the Local Authority (this is called the
They will tell the Local Authority that they
think they will have to deprive you of your liberty. If they
don't do this, anyone (including a member of your family or a
friend) can tell the Local Authority that they think you are being
deprived of your liberty.
Step 2 – the assessments
The Local Authority will assess your situation
– this must be done within 21 days. If they think that you do have
to be deprived of your liberty, for your own safety, they will
grant what is called a “Standard Authorisation”.
If a more urgent decision is needed, the
Managing Authority of the care home or hospital can issue an
“Urgent Authorisation”. This lasts for no more than 7
days, but can rarely be extended for up to a further 7
days. During this time the Local Authority must finish the
full assessment for a Standard Authorisation.
What are the assessments and who does
At least two trained professionals are:
The “Best Interest Assessor” (BIA)
This is most often a qualified social worker,
but it could be a nurse, occupational therapist or
psychologist. This person decides if you are being deprived of
your liberty. They can also advise on how to reduce the
restrictions on you and how long the authorisation should be
The “Mental Health Assessor”
This will be a doctor and will usually be a
psychiatrist, geriatrician or general practitioner with experience
in dealing with mental disorders. They will have had extra training
in the DoLS process.
This person decides if you suffer from a
“mental disorder” or not. This covers a range of conditions,
but includes dementia, long-term effects of brain injury and a
In order to reach the right decision, the
BIA (see above) will need to go through all your assessments
and care plans. They also have to ask you what you think
- and also anyone who is important to you. This could be
family members, carers, advocates or anyone who has been legally
appointed to make decisions on your behalf such as a Lasting Power
The BIA will also advise on who could
represent and support you while the authorisation is in
place. This is often a close family member or friend and is
called the Relevant Person’s Representative.
What are the criteria?
For an authorisation is to be
granted, the BIA and the Mental Health Assessor must decide if
the six criteria are met:
- You must be aged 18 or over.
- You must suffer from a mental disorder.
- Either the BIA or the Mental Health Assessor will decide
whether or not you are able to make decisions about the care you
receive in the hospital or care home. This is called the Mental
a. If you are not able to make the decisions
about care, the BIA will decide if what is being done means that
you are being deprived of your liberty. If this is so, it must
be in your best interests and a reasonable way to keep you
safe. This is called the Best Interests
b. If what is being done is unnecessary or
is too severe, then the authorisation cannot go ahead - you must
not be deprived of your liberty. The hospital or care home has to
act on the recommendations of the BIA.
a. If it is thought that you need care or
treatment for your mental disorder in hospital, then the Mental
Health Act has to be used and DoLS no longer applies. This is
called the Eligibility Assessment.
b. If you are on a Mental Health Act
Guardianship Order or Community Treatment Order, you can only
be given a DoLS authorisation if it does not conflict with these
6. The No Refusals Assessment
a. you have made an advance
decision about care or treatment.
b. the authorisation would conflict
with any decisions made by someone who is legally permitted to make
them on your behalf. This could be a deputy appointed by the
court, someone with Lasting Power of Attorney.
For each of the assessments, the relevant
assessor completes a standard form and submits it to the Local
Authority. A copy of the authorisation is then given to the
people involved in your care, including your representative.
How long can I be deprived of my liberty
The Best Interest Assessor will say how long
they think it should last – it can be up to one year. They will
usually suggest that the authorisation is in place for the shortest
time possible.This may only be just long enough so that the
hospital or care home can arrange for extra help so that your care
is not as restrictive. The Local Authority usually accepts the BIA
suggestion, but can shorten the time. The authorisation can be
renewed, if necessary. The process for renewal is exactly the same
as the initial process and all the six criteria have to be met.
Can I be forced to accept medical treatment under this
No. DoLS is nothing to do with medical
treatment. You can only be given medical treatment against your
will if you lack capacity to make a decision about a specific
treatment. If you have capacity to make the decision, then your
consent is required before you can be given the treatment. If you
lack capacity, then the authority to give you the treatment comes
from the Mental Capacity Act (see the Mental Capacity Act
Can I appeal against being deprived of my
In the first instance, you should discuss your
concerns with the staff or the manager looking after you, and with
your family or friends. If you or anyone else is unhappy about
your situation then you/they can ask for a review. A
review should also happen if your
circumstances change. It is a check to make sure that you are being
treated in the right way.
If you have no-one to speak up for you, then
you have a right to the help of an Independent Mental Capacity Act
Advocate (IMCA) (the staff should help you to contact an IMCA or
the Local Authority will tell you how to contact them). You do not
pay for this service.
If you are still deprived of your liberty, and
you disagree that you meet the criteria, an appeal can be made to
the Court of
Protection and a judge will make the final
decision. The Court of Protection is a specialist court for
people who cannot make some or all decisions for themselves. You
can apply for help to pay for the costs of going to Court of
The Code of Practice tells you more about
the Deprivation of Liberty Safeguards.
Expert review: Dr Tony Zigmond.
Series Editor: Dr Philip Timms
User and Carer input: Members of the RCPsych Public Education
© September 2014. Due for review: September
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