A record number of Deprivation of Liberty Safeguards (DoLS) applications were received by councils during the past year – although there is significant variation between regions, official figures have shown.
In all, councils reported 195,840 DoLS applications between April 1, 2015 and March 31, 2016 – the most since the DoLS were introduced in 2009. This represents 454 DoLS applications received per 100,000 adults in England.
The DoLS are a legal framework that aim to ensure that individuals who lack the mental capacity to consent to the arrangements for their care, where such care may (because of restrictions imposed on an individual’s freedom of choice or movement) amount to a ‘deprivation of liberty’, have the arrangements independently assessed to ensure they are in the best interests of the individual concerned. Health and care providers must formally apply to their local council and satisfy six assessment criteria.
The number of DoLS applications varied between regions, with the northeast reporting 900 applications per 100,000 people, while London had just 319 per 100,000. The remaining regions received between 400 and 500 applications per 100,000 adults in 2015-16.
In the report, it is suggested this disparity is down to varying structures in populations and different interpretations of the safeguards in each region.
The majority (51%) of DoLS applications had dementia listed as their primary disability. In addition, 11% listed learning disability as the primary disability, and 9% as mental health needs (excluding dementia).
NHS Digital figures show that DoLS monthly applications remained relatively stable during 2015/16, having experienced significant month-on-month growth in 2014/15 in the wake of the ‘Cheshire West’ decision in March 2014 – this peaked with 14,930 applications in March 2015.
The Supreme Court judgement of March 2014 – commonly known as ‘Cheshire West’ – clarified what constitutes a deprivation of liberty and marked a significant change to established practice. The acid test states that an individual who lacks the capacity to consent to the arrangements for their care and is subject to continuous supervision and control and is not free to leave their care setting, is deprived of their liberty and should be the subject of a DoLS application (where they are in a care home or hospital setting). The Supreme Court also ruled that the individual’s objection to the arrangements that amount to a deprivation of liberty is not a relevant consideration (even if the individual is not objecting, a DoLS application is required).
There were 105,055 completed DoLS applications reported in 2015-16 – a 68% increase on the 62,645 reported in 2014-15. It follows a 380% increase in completed applications between 2013-14 and 2014-15 (from 13,040 in 2013-14).
Of the completed applications in 2015-16, 76,530 (73%) were granted. While the proportion of authorised completed applications has generally shown an upward trend since DoLS were introduced in 2009, the 2015-16 figures are down 10% on those granted in 2014-15.