NEWS
Concerns over spike in Deprivation of Liberty Safeguard applications
Deprivation of Liberty Safeguard (DoLS) applications to some council social care departments from hospital and residential settings have increased ten-fold in the first half of 2014-15, compared to the entirety of 2013-14.
For example, during Q1 of 2014- 15, figures from the Health and Social Care Information Centre (HSCIC) revealed that DoLS applications to Dorset County Council (Dorset CC) were 1,176 – compared to 228 in the whole of the previous year.
The council granted 167 applications, declined 242 and the remaining 767, for the most part, were ‘pending’ action.
Paul Greening, Mental Capacity Act manager at Dorset CC, told us: “We’re doing five times as many assessments this year as we were doing last year. But at the moment we don’t have a full-time best interest assessor (BIA) – ours have other jobs but as part of their role they do DoLS assessments.”
The changing DoLS landscape DoLS are
part of the
subject to continuous supervision and control? 2) Is the person free to leave – how would staff react if the person did try to leave?
So a person under continuous supervision and control who is not free to leave is being deprived of their liberty. In short, the Supreme Court ruling means every individual is entitled to their own assessment rather than a general one.
Since DoLS apply only in hospitals and care homes, the Care Quality Commission is certain that many more applications will be made to the Court of Protection for those in domestic settings with support.
Frontline action
More money has been allocated to deal with DoLS applications, Greening told us. “But, ultimately, the pressure it puts on the team is immense and without additional resources from somewhere that is going to have an impact.”
Mental
Capacity Act 2005, ensuring people in care homes, hospitals and supported living are looked after in a way that does not “inappropriately” restrict their freedom.
In March, the Supreme Court ruled, as part of the Cheshire West cases, that to determine whether a person is objectively deprived of their liberty there are two key questions as an ‘acid test’: 1) Is the person
Another local authority team that has seen a spike in its DoLS applications is Poole Borough Council. During Q1 of 2014-15, the local authority saw applications increase to 250, up from 88 in the previous year.
David Vitty, head of adult social care at Poole, told us: “We’ve experienced a major increase since the Supreme Court ruling and we’ve had very little time to adjust to this additional burden.”
Best interest In both cases, at Dorset CC and
Just one ‘quality assessment’ of a DoLS application takes at least a full day’s work for a qualified professional, Vitty said.
Each DoLS assessment requires a doctor present, for which there are fees. “So the already-stretched social care budget has to make provision to pay for medical colleagues to take part in the assessments,” he said.
Last resort
George McNamara, head of policy and public affairs at the Alzheimer’s Society, added that applications to restrict the freedom of people with illnesses such as dementia and autism should only be made as a last resort.
He told NHE in an interview: “But we know, for example, that over half of the applications were for
Poole, the councils have put more people through training and are looking to put more through in the future.
However, despite training more BIAs, both councils added that there has ‘inevitably’ been a backlog in dealing with DoLS applications.
BIAs are mainly social workers who have to do a qualification course at university, refreshed every 12 months. They play a crucial role in DoLS cases in determining whether a person has or will be deprived of their liberty and whether this would be in their best interests.
someone with dementia – so much more needs to be done across health and social care to make sure these safeguards are better understood and recognising when it’s appropriate to be used.”
The Association of Directors of Adult Social Services has written to the government outlining the impact of this sharp increase in DoLS applications.
David Pearson, president at ADASS, said: “An urgent change in the law and more resources (£88m is required) are needed to ensure that this new work is funded: this at a time when social care has had to make 26% savings over four years.”
Phillipa Bruce-Kerr, a partner at law firm Harrison Clark Rickerbys, said: “This is placing a burden on the local authority legal teams, and some practitioners suggest that this is in turn impacting on the willingness of the local authorities to undertake other legal actions in the context of their Welfare and Safeguarding obligations as limited resources can only go so far.”
The government has not yet
agreed to the ADASS proposals, but has referred them to the Law Commission for what is likely to be a lengthy review.
This is an extract from a longer investigation into DoLS by our sister title Public Sector Executive.
The full piece is available at:
www.publicsectorexecutive.com
national health executive Nov/Dec 14 | 11
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