DoLS - a practical guide for professionals
What are the Deprivation of Liberty Safeguards?
The Deprivation of Liberty Safeguards (DoLS) provide legal protection for vulnerable people in hospital or a care home, whether placed under public or private arrangements. They are part of the Mental Capacity Act (MCA).
The DoLS apply to anyone aged 18 and over:
- who suffers from a mental disorder or disability of the mind, such as dementia or a profound learning disability
- who lacks the capacity to consent to the arrangements made for their care or treatment
- for whom receiving care or treatment in circumstances that amount to a deprivation of liberty may be necessary to protect them from harm.
An additional section of the MCA introduces a formal legal process and safeguards for situations where deprivation of liberty is an unavoidable necessity in the best interests of a person who lacks capacity to consent to their care and treatment. These safeguards were originally named after the hospital involved in the landmark Bournewood case.
A Joint Supervisory Body, comprising the Primary Care Trust (PCT) and Local Authority, has been established locally in line with Department of Health guidance. This body is responsible for assessing cases and authorising or refusing admissions that would result in a deprivation of liberty.
Professional guidance
The Law Society has issued comprehensive guidance on the law relating to DoLS. These safeguards ensure that people who lack capacity and live in care homes, hospitals, or supported living environments are not subject to overly restrictive measures in their daily lives.
Commissioned by the Department of Health, the guidance can help frontline health and social care professionals identify when a deprivation of liberty may be occurring in different health and care settings. It uses case scenarios to explain the law following the landmark Cheshire West (2014) Supreme Court judgment.
You can access:
- the complete guidance
- individual chapters for specific care settings
- quick reference sheets highlighting liberty-restricting factors and key questions for practitioners.
Understanding the Supreme Court “acid test”
Following the landmark Cheshire West judgement (March 2014), the Supreme Court confirmed two key questions to determine if someone is deprived of liberty:
- Is the person subject to continuous supervision and control? (all three aspects are necessary)
and - Is the person free to leave? (the person may not be saying this or acting on it but the issue is about how staff would react if the person did try to leave)
If both apply, the person is deprived of liberty, regardless of:
- their compliance or lack of objection
- the normality of the placement
- the reason or purpose behind the placement.
The judgement is significant in determining whether arrangements made for the care and/or treatment of an individual lacking capacity to consent to those arrangements amount to a deprivation of liberty.
It is important to remember that the safeguards are there to protect very vulnerable people from arbitrary decision-making and ensure that they have a voice.
S21A challenges - When to issue court proceedings
Section 21A of the Mental Capacity Act provides a legal route to challenge DoLS authorisation. This guidance explains when it is appropriate to issue court proceedings under S21A, helping professionals understand the circumstances that warrant a challenge and the steps involved.
Key resources
- Deprivation of Liberty in Health and Social Care - CQC Briefing for Health and Social Care Providers (2014)
- Revised Test for Deprivation of Liberty Safeguards - Letter to Provider of Care
- Deprivation of Liberty after Cheshire West: Key Questions for Social Workers and Medical Practitioners
- Identifying Whether your Service Users or Young People may be Deprived of their Liberty - Flowchart and Guidance
- MCA14 - Accessing the Court of Protection: Good Practice Guidance (2014)
-
Additional resource
- Putting DoLS into practice - this SCIE resource describes good practice in the management and implementation of the DoLS.
-
Contact the DoLS Service
- The DoLS Service coordinates and commissions the assessments and reviews on behalf of Gloucestershire County Council and NHS Gloucestershire. For advice and guidance:
- Email: dolsservice@gloucestershire.gov.uk
Deprivation of liberty outside of hospitals and care homes
The DoLS only apply in hospitals and care homes.
Where a deprivation of liberty may be taking place outside these settings, authorisation must be sought in accordance with one of the following legal regimes: a deprivation of liberty authorisation or Court of Protection order under the Mental Capacity Act Deprivation of Liberty Safeguards, or (if applicable) under the Mental Health Act 1983, or, in some rare situations, under the inherent jurisdiction of the High Court.