Herefordshire Safeguarding AdultsBoardDEPRIVATIONOFLIBERTYSAFEGUARDS(DoLS)
POLICY,PROCEDUREANDGUIDANCE
DATE:January 2018
Version 2
It is suggestedthatthispolicyis read inconjunctionwithHerefordshireSafeguardingAdultsBoard’sMentalCapacityAct2005policyandwiththeMentalCapacityAct2005CodeofPractice andDeprivationofLiberty SafeguardsCodeofPractice.TheseCodesofPractice canbedownloadedfrom:
MCA 2005 CodeofPractice:
DoLSCodeofPractice: safeguards
Contents
1.INTRODUCTION
2.PURPOSE
3.SCOPE
4.POLICY STATEMENT
5.DEFINITIONS
6.LEGALCONTEXTANDCAREQUALITYCOMMISSION(CQC)
7.GOVERNINGPRINCIPLES
8.PROCEDURESANDGUIDANCE
9.OUTOF AREAASSESSMENTS ORDINARYRESIDENCEWITHREGARD TOCAREHOMES
10.APPEALS ANDCOURT OF PROTECTION
11.REPORTING A DEATHOF APERSONWHOISSUBJECT TODEPRIVATIONOFLIBERTYSAFEGUARDS
12.COMPLAINTS
13.TRAINING
14.INFORMATIONGOVERNANCE
15.RELATEDPOLICIES, PROCEDURESANDFORMS
16.MONITORING ANDREVIEW
17.IMPLEMENTATION
APPENDICES
Annex1–overviewof the DoLSprocess
Appendix 1 DoLS Code of Practice
Annex2–whatmanaging authorityshould consider
Appendix2
1.INTRODUCTION
1.1ThisPolicy,ProceduresandGuidancehasbeendevelopedonbehalfofHerefordshireSafeguardingAdultsBoardforadherenceandimplementationwithinallorganisationsworkingacross Herefordshire.
1.2TheoverallaimofthepolicyandguidanceistoensuregoodpracticeandacoherentapproachacrossorganisationswithinHerefordshire.
1.3TheDeprivationofLibertySafeguards(DoLS)cameintoforceinApril2009andwereintroducedintotheMCAduetoa2004EuropeanConventionofHumanRightsrulingreferredtoastheBournewoodjudgementcase(HLvUK).HLhadbeenwasadmittedtohospitalundercommonlawinhis“bestinterests”.HiscarerswereunhappywiththedecisionandpursuedtheissuethroughthedomesticcourtstotheEuropeanCourt ofHumanRights. Thejudgementof theEuropeancourtnotedthat:
•HL hadbeendeprivedof his libertywithouta procedureprescribed bylaw(Article 5.1)
•HLhadnomeansofapplyingtoacourttoseeifthedeprivationoflibertywaslawful(Article 5.4)
1.4TheUKmadeamendmentstoprovidealegalprocessfordeprivingaperson,undervery specificcircumstances,oftheirliberty.Thismeansthatwherethequalifyingcriteriaaremet,peoplecanreceivethecare andsupporttheyneedwhilstprotectingtheirrightstoappealandrepresentation.
1.5KeyMessageoftheDeprivationofLibertySafeguards2007(DoLS),introducedinApril2009 asanamendmenttotheMentalCapacityAct 2005(MCA):
•TheDeprivationofLibertySafeguardsextendsthepowersof“restriction”providedbytheMCA(section5),toallowforthelawful“deprivationofliberty”ofpeoplelivinginaregisteredcarehomeorhospitalwholackcapacitytoconsenttohighlyrestrictivecareplans thatareproportionateandnecessaryinordertoprotecttheperson from harm.
•Thesafeguardsprovidetherightofappealandprovisionofrepresentationfortherelevantperson.
1.6InMarch2014,theSupremeCourthandeddownjudgementintwocases,PvCheshireWestandChesterCouncilandPQvSurreyCountyCouncil(2014).Thatjudgement,commonlyknownasCheshireWesthasledtoasignificantincreaseinthenumberofpeopleinEnglandandWaleswhoareconsideredtobe‘deprivedoftheirliberty’forthepurposesofreceivingcareandtreatment.TheSupremeCourtdecidedthatwhenanindividuallackingcapacitywasundercontinuousorcompletesupervision
andcontrol,andwasnotfreetoleave,theywerebeingdeprivedoftheirliberty.Thisiscommonlyknown as the ‘acid test’.
2.PURPOSE
2.1TheDeprivationofLibertySafeguards(DoLS)providealegalframeworktoprotectthosewhomaylackthecapacitytoconsenttothearrangementsfortheirtreatmentorcare,inacarehome,hospitalorhospice,andwherelevelsofrestrictionorrestraintusedindeliveringthatcarearesoextensiveastobedeprivingthepersonoftheirliberty.Whilststaffneedtoconsideremergingcaselaw,theCodeofPracticeshouldremainthe mainpointofreferencefor staffworkingwith deprivationoflibertyissues.
2.2Thesesafeguardsprovidearobustandtransparentframework,preventingarbitrarydecisionswhichdepriveapersonoftheirlibertyandprovidingopportunitytochallengedeprivationoflibertyauthorisations.Thesafeguardsthereforeprotecttherightsofvulnerableindividuals.
2.3ThisdocumentprovidesaframeworkforthemanagementoftheDeprivationofLibertySafeguardsacrossHerefordshireandaimstosetouttheprocessesandproceduresthatmustbefollowedbythosethathaveadutyofcaretowardsapersonwho is, or maybecome deprivedoftheirliberty. This includesbothManaging AuthoritiesandtheSupervisoryBodies.
2.4Thepolicycoverstheprocessesinvolvedwithrequesting,assessing,grantingandreviewingstandardauthorisationsfordeprivationoflibertyfromtheperspectiveofboththeManagingAuthoritiesapplyingfortheauthorisation,andtheSupervisoryBodywhoassess andgranttheauthorisation inHerefordshire.
2.5TheSupervisoryBodywill deliver the duties required bytheDeprivationofLibertySafeguards.TheSupervisoryBodyforHerefordshireresidents is HerefordshireCouncil.
3.SCOPE
3.1Thepolicyapplies to all staffworkingacross Herefordshire.
3.2TheDeprivationofLibertySafeguardsandtheprocessescontainedwithinthispolicyapplyto all personsthatmeetall ofthefollowing criteria:
•Agedover 18
•Lack thecapacitytoconsenttothearrangementsfortheircare ortreatment
•Are receiving care ortreatmentwithin a hospital or registeredcarehome
•Arereceivingcareortreatmentincircumstancesthatamounttoa deprivationoflibertyin order toprotectthem fromharmand it appearstobe in theirbest interests
•HaveamentaldisorderbuttheirdetentionisnotalreadyauthorisedundertheMentalHealthActorinconsistentwithanobligationplacedonthemundertheMentalHealthAct 1983.
3.3Alargenumberofthesepeoplewillbethosewithsignificantlearningdisabilities,orolderpeoplewhohavedementia,buttheycanalsoincludethosewhohavecertainotherneurological conditions (forexampleasaresultof a braininjury).
3.4AllservicesmustcomplywiththeHerefordshireSafeguardingAdultsBoard’spositiveapproachestobehaviourthatchallenges(includingrestrictivephysicalinterventions) guidance.
3.5ThispolicydoesnotcoverproceduresforManagingAuthoritiestoidentifyadeprivationoflibertyoranyprocedurespriortothesubmissionofarequestforastandardauthorisation.Theseprocedureswillneedtobeproducedinternallyforeachcarehomeorhospitalunit.However,keyresponsibilitiesforManagingAuthoritiesareidentifiedinSection8ofthispolicyandtheLawSocietyhasissuedcomprehensiveguidancetohelpsolicitorsandfrontlinehealthandsocialcareprofessionalsidentifywhenadeprivationoflibertymaybeoccurringinanumberofhealthandcaresettings.This isavailablefrom:
4.POLICYSTATEMENT
4.1ItistheintentionofHerefordshireSafeguardingAdultsBoardtoempowerandprotecttherights andliberties ofHerefordshire’smostvulnerablecitizens.
5.DEFINITIONS
Best InterestAssessor(BIA)
Theassessorresponsibleforconductingarangeofassessmentstoascertainwhetheranauthorisationfordeprivationoflibertywillbegranted(seeSection8.5belowforthedifferentassessments thatcanbeconductedbytheBIA).Aprofessional(whoistrainedasaBIA)isappointedtothisroleonlyforthedurationoftheassessment/reportingprocess bytheSupervisoryBody.
NB:ABIAisnotrequiredtocompletethebestinterestdecisionmakingprocessotherthanundertheDeprivationofLibertySafeguards.
Deprivation ofLiberty(DoL)
DeprivationofLibertyisatermusedintheEuropeanConventiononHumanRightsaboutcircumstanceswhenaperson’sfreedomistakenaway.Caselawisdefiningitsmeaninginpractice.Thereisnosimpledefinitionofdeprivationofliberty,however,authoritativeguidanceastothebroadapproachtoadopthasnowbeengivenbytheSupremeCourtinPvCheshireWestandChesterCouncil;PQvSurreyCountyCouncil[2014]UKSC19,commonlyknownas‘CheshireWest.’Thecourtdecidedthatapersonlackingtherelevantcapacitymetthe‘acidtest’ofbeingdeprivedoftheirlibertyinanysettingwheretheywereundercontinuous(orcomplete)supervisionandcontrol andnotfreetoleave.
SeeChapter2oftheDoLS(DeprivationofLibertySafeguarding)CodeofPracticeforamoredetailedunderstandinginconjunctionwiththeLawSocietyguidance2015
Hospital
Thisincludesbothprivateandpubliclyfundedhospitalsandhospices.InthecaseofNHShospitals,theNHSTrustorauthoritythatmanagesthehospitalistheManagingAuthority.Inthecaseofindependenthospitalsandhospices,theManagingAuthorityisthepersonregisteredunderTheHealthandSocialCareAct2008inrespectofthehospital.
IndependentMentalCapacityAdvocate(IMCA)
Thisisatrainedpersonwhoprovidessupportandrepresentationtoaperson,wholackscapacitytomakespecificdecisions,aboutwheretheyliveandtheirhealthcareandtreatment,wherethepersonhasnooneelsetosupportthem.IMCAsappointedunderDoLSarerequiredtohaveadditionalDoLSspecifictraining.SeeDoLSCodeofPractice 7.34 –7.41for details onthe roleoftheDoLSIMCA.
ManagingAuthority
Thepersonorbodywithmanagementresponsibilityforthehospitalorcarehomeinwhich a personis, ormaybecome,deprivedoftheirliberty.
MentalCapacity
Mentalcapacityisalwaysreferredtoasissue,timeandsituationspecificanddescribesaperson’sabilitytomakeadecisionaboutaparticularmatteratthetimeitneedstobemade.
Wheretheterm‘lackofcapacity’isusedthroughoutthisdocumentitrefersspecificallytotheabilitytodecidewhetherornottoconsenttocareortreatmentthatinvolvescircumstancesthatamounttodeprivationoflibertyatthetimeatwhichthatdecisionneeds tobemade. A legaldefinition is contained inSection2oftheMental CapacityAct2005.DetailsonhowtoundertakeamentalcapacityassessmentcanbefoundinTheMental CapacityAct CodeofPracticeChapter 4.
Registered CareHome or ServiceProviderproviding RegulatedActivities
ServiceprovidersarerequiredtoregisterwiththeCAREQualityCommissionwhencarryingout regulatedactivities as definedin The CareAct.
The MentalHealthAssessor(MHAs)
TheMentalHealthAssessormustbeadoctorwhoiseitherapprovedundersection12oftheMental HealthAct1983 or is a registered medicalpractitionerwith at least 3 yearspost-registrationexperienceinthediagnosisortreatmentofmentaldisorder.TheMHAisappointedbytheSupervisoryBodyandisaseparateassessortotheBIA.Theyareresponsibleforundertakingassessmentsthatrelatetothementalhealthoftherelevantpersonandareusuallyresponsiblefortheeligibilityassessment.Theymaybeappointed toalsoundertakethemental capacityassessment.
Relevant Person
A personwho is, ormaybecome, deprivedof theirlibertyin ahospital or carehome.
Relevant Person’s Representative
Aperson,independentoftherelevanthospitalorcarehome,appointedtomaintaincontactwiththerelevantperson,andtorepresentandsupporttherelevantpersoninallmattersrelatingtotheoperationofthedeprivationoflibertysafeguards,includingsupportinganappealtothe CourtofProtection.
Restraint
Theuse orthreatofforcetoundertakean actwhichthepersonresists,ortherestrictionoftheperson’slibertyofmovement,whetherornottheyresist.Restraintmayonlybeusedwhereitisnecessarytoprotectthepersonfromharmandisproportionatetotheriskofharm.Restraintcanincludephysicalrestrainte.g.movingthepersonorblockingtheirmovementtostopthemleaving,mechanicalrestraintinvolvingtheuseofequipmentsuch as usingabelttostop thepersongettingoutoftheirchairor bedrails tostopthepersonfromgettingoutofbed,chemicalrestrainte.g.usingmedicationtorestrainandpsychologicalrestrainte.g.tellingapersonnottodosomethingordepriving aperson oflifestyle choicesbytelling themwhattimeto go to bedor getup.
StandardAuthorisation
Thisisthelawfulauthoritytodeprivearelevantpersonoftheirlibertyintherelevanthospitalorcarehome,givenbytheSupervisoryBody,aftercompletionofthestatutoryassessmentprocess.
SupervisoryBody
Alocalauthoritythatisresponsibleforconsideringadeprivationoflibertyrequest,commissioningtheassessmentsand,wherealltheassessmentsagree,authorisingdeprivationofliberty.WithinHerefordshiretheSupervisoryBodyisHerefordshireCouncil.
UrgentAuthorisation
ThisisanauthorisationgrantedbyaManagingAuthorityforamaximumofsevendays.ItgivestheManagingAuthoritylawfulauthoritytodepriveapersonoftheirlibertyinahospitalorcarehomewhilethestandarddeprivationoflibertyauthorisationprocessisundertaken.Underexceptionalcircumstances,itmaysubsequentlybeextendedbyamaximumof afurthersevendays bythe SupervisoryBody.
6.LEGAL CONTEXT ANDCARE QUALITYCOMMISSION(CQC)
6.1SomeofthemostrelevantLegislation,CodesofPracticeandStatutoryInstrumentsare asfollows:
- Care Act2014
- Mental HealthAct2007
- HumanRights Act1998
- TheEuropeanConventiononHumanRightsand itsfiveprinciples
- DisabilityDiscrimination Act1998
- Data Protection Act2017
- Care Standards Act2000
- HumanTissueAct2004
- Mental CapacityAct 2005
- Mental CapacityAct CodeofPractice2007
- Mental HealthActCodeof Practice2015
- Deprivationof LibertySafeguards(DoLS)2007
- Deprivationof LibertySafeguardsCodeofPractice2008
6.2TheCareQualityCommission(CQC)hasdevelopedEssentialStandardsofQualityandSafetywhichhealthandsocialcareorganisations,dentistsandGPsmustreachto
be compliantwith the MCA 2005 and to avoidsanctions.Furtherdetails are available at:
6.3CQChasadutytomonitortheoperationofDoLSinEnglandandtoreportontheoperationofDoLStotheSecretaryofHealth.TheCommissionmaycancelaregistrationinrespectofacaresettinginEnglandwhereDoLSlegislationhasnotbeencarriedout in accordancewithrequirementsof theenactment.
6.4ManagingAuthoritieshaveadutytocompleteastatutorynotificationtoCQCwhenapplyingtodepriveapersonoftheirlibertyandoftheoutcomeoftheapplication.Thenotificationformandguidanceareavailableat regulate/registered-services/notifications/notifications-non-nhs-trust-providers.
7.GOVERNINGPRINCIPLES
7.1Thefollowingprincipleswillbeadheredtobyallthosewithadutyofcaretowardsanindividualwhois,ormaybedeprivedoftheirliberty.ThisincludestheManagingAuthorityandSupervisoryBody:StaffwilladheretothefivestatutoryprincipleswhichunderpintheMentalCapacityAct 2005:
Apersonmustbeassumedtohavecapacityunlessitisestablishedthattheylack capacity;
Apersonisnottobetreatedasunabletomakeadecisionunlessallpracticable steps tohelp him to do so have been takenwithoutsuccess;
Apersonisnottobetreatedasunabletomakeadecisionmerelybecausehe makesan unwisedecision;
Anactdone,ordecisionmade,underthisActfororonbehalfofapersonwho lackscapacitymust be done, ormade, in his bestinterests;and
Beforetheactisdone,orthedecisionismade,regardmustbehadtowhetherthepurposeforwhichitisneededcanbeaseffectivelyachievedinawaythatislessrestrictiveoftheperson’srightsandfreedomofaction.
- StaffwillrefertotheCodesofPracticewheneverissuesofcapacity,bestinterestdecisionmakinganddeprivationoflibertyoccur.
- Staffwillcarryouttheirdutytoensureoptimumcareforindividualsthatmeetstheirneedsandupholds theirHumanRights.
- Staffat alllevelswillworkcollaborativelywithcolleaguesacrossorganisations,toensureefficientandconsistentworkingpractices,toensuretimelyandeffectivecommunication andinformationsharingandtomaximiseefficiencyofresources.
- Everyeffortwillbemadebythosewhoaresupportingandcaringforanindividualtopreventdeprivationofliberty.Thisincludesbothcommissionersandproviders of care.
- Thedignityandwellbeingoftherelevantpersonwillbeparamountatalltimes.Apersonalisedapproachwillbetakenthatmaximisesfreedom,minimisescontroland supportsandencouragescontactswithfamily, carers andfriends.
- StaffwillworkinaccordancewiththeprinciplesoftheDataProtectionAct2017and will share andrecord onlythatdatawhich is necessary.
- Staffwillconsidersafeguardingwithineveryaspectoftheirresponsibilities.Ifanyactoromissionconstitutesabuseofanadultwithcareandsupportneeds,asdefinedbyAdultSafeguarding:Multi-agencypolicyproceduresfortheprotectionofadultswithcaresupportneedsintheWestMidlands,theymustreport this in accordancewith thepolicyandprocedure.
- Staffwillseektoengagewiththoseinvolvedincaringfortheperson,anyonenamedbythemasapersontoconsultandthosewithaninterestintheperson’swelfareandensuretheyare consulted indecision-making.
- Everyeffortshouldbemadetoresolvedisputessurroundingadecisiontodepriveapersonoftheirlibertylocallyandinformally.BoththeManagingAuthorityandSupervisoryBodyshouldbewillingtoengageinconstructivediscussion.
- StaffofboththeSupervisory Body andManagingAuthoritywillmaintain succinct,systematicandaccuraterecords,whichdemonstratebothgood,safepracticewithin the law.
- Allorganisationsandservicesinvolvedwithdeprivationoflibertyshouldseektodevelopgoodpracticebymonitoringandreviewingtheirprocessesaspartoftheorganisation’sgovernancestructure.
8.PROCEDURESANDGUIDANCE
8.1ManagingAuthorities–RequestinganAuthorisation
TheManagingAuthority,thehospitalorcarehome,mustseekauthorisationfromtheSupervisoryBodyinordertobeabletolawfullydeprivesomebodyoftheirliberty.TheSupervisoryBodyisdefinedonthebasisofordinaryresidenceguidance.TheSupervisoryBodyforHerefordshireresidentsisHerefordshireCouncil.TheHerefordshireDoLSServicewillprovidesupportandguidancetomanagingauthorities.TheDoLSServiceforHerefordshireCouncil canbecontactedon01432383645,.
Annex1oftheDoLSCodeofPracticesetsoutanoverviewoftheDoLSprocess–SeeAppendix1.
8.2ReferralsbytheManagingAuthorityshouldbemadebycompletingForm1toapplyforastandardauthorisationandgrantanurgentauthorisationifrequired.Thisformisavailablefrom theHerefordshireDoLSservice.
8.3Managingauthoritieswillneedtoensuretheyhaveproceduresinplacetoidentifywhetherauthorisationfordeprivationoflibertyisrequired,andifadeprivationoflibertyisalreadyoccurringtograntanurgentauthorisation.Proceduresshouldclearlyidentifywhoisresponsiblefordecisionmakingandfortakingactionatthisstageincludingsigning applications:
•InthecaseofanNHShospital,themanagingauthorityistheNHSbodyresponsiblefor therunning ofthehospital inwhich the relevantperson is,oris tobe,resident.
•Inthecaseofacarehomeoraprivatehospital,themanagingauthoritywillbetheperson registered or required to beregistered.
•Failuretoidentifyadeprivationoflibertyand/ortofollowtheproceduressetoutunderHerefordshireDoLSServiceisanactoromissionthatconstitutesabusewhichwillbedealt withundersafeguarding procedures.
8.4ManagingAuthoritieswillneedtoensureeveryefforthasbeenmadetoavoidadeprivationoflibertyoccurring.AdviceandinformationisavailablefromtheSupervisoryBody,butitistheManagingAuthority’sresponsibilitytomakeanapplication when they suspect a deprivation of liberty is occurring. If the Managing Authority fails to put in a referral, the Supervisory Body may decide to instigate an assessment, if it believes one is required. Appendix 2sets outwhatmanagingauthoritiesshouldconsider beforeapplyingforauthorisationof adeprivationofliberty.
8.5TheManagingAuthorityneedstodecidewhetheradeprivationoflibertyisalreadyhappeningorislikelytooccurwithinthenext28days.TheHerefordshireDoLSServicecanprovideadviceandguidance.TheManagingAuthority needstocompleteForm1toapplyforastandardrequestandurgentauthorisationifthedeprivationoflibertyisalreadyoccurring.Theurgentauthorisationmakesthedeprivationoflibertylawfulforaperiodofupto7days(startingwiththedateitisgranted).TheForm1requirestheManagingAuthoritytoprovideinformationnecessaryfortheprocess.ItisimportantthattheManagingAuthorityclearlystates thepurposeof theauthorisation,settingoutdetailsofthecareand/ortreatmentthat is,oris tobe,provided.
8.6ShouldtheManagingAuthoritybelievethatadeprivationoflibertyisnotyetoccurringbutthatitislikelyitwillbewithinthenext28days,theydonotgivethemselvesanurgentauthorisation,butjustrequestastandardauthorisation.Ifatanytime,beforetheassessmentshavebeencompletedandtheSupervisoryBodyhasgivenitsdecision,thesituationchangesand thereisbeliefthatadeprivationofliberty isoccurringthenanurgentauthorisationmustbegrantedbytheManagingAuthorityandsent totheSupervisoryBody.
8.7TheManagingAuthority muststatewhetherthereisanybody thatitisappropriatetoconsultaspartoftheassessmentprocess.Ifthereisno-oneappropriatetoconsult,otherthanthepeopleengagedinprovidingcareortreatmentfortherelevantpersoninaprofessionalcapacity,theManagingAuthoritymustnotifytheSupervisoryBodywhenitsubmitstherequestonForm1.TheSupervisoryBodymusttheninstructanIMCAusingForm30torepresenttheperson.
8.8TheManagingAuthorityshould,ifjudgedappropriateandpracticable,informtherelevantperson,theirfamily,friendsandcarersandanyIMCAalreadyinvolvedintherelevantperson’scase,ofthisprocessandthereasoningfortheiractions.Acopy oftheForm1 needstobekept in theperson’sconfidential care records.
dagreehowtherequestandsupportingdocumentsshouldbesent toensuredataprotectioncompliance.
8.10The StandardAuthorisationProcess
TheSupervisoryBodyisresponsibleforconsideringrequestsforauthorisations,commissioningtherequiredassessmentsandwherealltheassessmentsagree,authorisingthedeprivationofliberty.Appendix3describestheStandardAuthorisationprocess.
8.11Uponreceiptofanapplicationfor a standardauthorisation,theHerefordshireDoLSServicewillacknowledgereceipt,decidewhetheritisappropriatetoproceedwiththerequest,checktheform,andrequestanyinformationthatismissingfromtheapplication.IftheHerefordshireDoLSServiceconsidersthattheapplicationhasbeenmadetoofarinadvance,thisshouldberesolvedwiththeManagingAuthorityandtheapplicationprocessshould bestoppedanda new applicationshould be made atamoreappropriatetime.IftheformshavebeensubmittedtothewrongSupervisoryBodytheyshouldbepassedtothecorrectauthorityas soonas possible.
8.12Ifanurgentauthorisationhasbeengranted,theSupervisoryBodyhas7daysinwhichtocompletetherequiredassessmentsandrespondtotheManagingAuthority’srequest.Ifarequestforastandardauthorisationhasbeenreceivedwithoutanurgentauthorisation,theSupervisoryBodyhas21daysinwhichtocompleteallassessmentsand respondtotheManaging Authority’s request.
8.13TheHerefordshireDoLSServicewillappointtheBestInterestAssessorandMental HealthAssessor.
8.14BestInterestsAssessors(BIA)–ProfessionalswhohavesuccessfullycompletedtheirBestInterestAssessortrainingandmaintainedtheirrequiredcontinualprofessionaltrainingwillbeappointedtoundertakeassessments,eitheraspartoftheirsubstantiverole,orcommissionedindependently.ThechoiceofAssessorwillbegovernedby:
•ensuringcompliancewith regulations;
•knowledgeoftherelevantperson;
•skills and specialistknowledge for therelevantperson’sneeds;
•expedienceofresources;
8.15MentalHealthAssessors–doctorapprovedunderS12oftheMentalHealthAct1983,whohascompletedthestandardDoLStrainingformentalhealthassessorsandrequiredannualupdatetraining.
•SeeDoLSCodeofPractice4.13andtheregulationsat informationregarding eligibilityand conflictofinterest.
8.16Iftherelevantpersonhasno-oneappropriatetoconsultotherthanthoseengagedinprovidingcareand/ortreatmentinaprofessionalcapacity,then,withoutdelay,thesupervisorybodymustappointanIndependentMentalCapacityAdvocate(IMCA).IMCA’scanbeappointedtoprovideadvocacyinputfortherelevantpersonand/ortheir
representativeatvariousstagesintheDoLSprocessundercertaincircumstances.TheywillinformtheBIA’sdecisionmakingandmayalsoprovidepaidrepresentationwhenrequired.TheycanbringchallengetotheauthorisationbyapproachtotheCourtofProtection.FurtherinformationontheroleandfunctionoftheIMCAseeSec3.22–
3.28 oftheDoLSCodeofPractice.TheSupervisoryBodywillinstructtheIMCAandtheIMCAwillprovidetheirreport.OurcurrentproviderofIMCAservicesisOnsideAdvocacyTelephone0190527525,email:
8.17WheretheSupervisoryBodyandtheManagingAuthorityarethesameorganisation,itcanactinbothcapacities.However,insuchasituation,theBIAcannotbe anemployeeof theSupervisoryBody/Managing Authority, or provideservices toit.
8.18There are sixassessments whichneedto be completed beforeaSupervisoryBodycan give an authorisation:
8.18.1AgeAssessment.
Thisassessmentistoestablishiftherelevantpersonisaged18orover.ThisiscompletedbytheBIAandrecordedwithinthebestinterest’sassessmentonForm3.Ifthisassessmentdoesnotmeettherequirementsforauthorisationbecausetherelevantpersonisundertheageof18,theManagingAuthoritywillneedtoreferthecasetoHerefordshireCouncil’schildren’sservicesforconsiderationofuseoftheChildrenAct1989,theMentalHealth Act1983 or referraltothe CourtofProtection.
8.18.2MentalHealthAssessment.
ThisassessmentmustbeconductedbyaMentalHealthAssessor.ThepurposeistoestablishwhethertherelevantpersonissufferingfromamentaldisorderwithinthemeaningofS1(2)oftheMentalHealthAct1983andtheassessorsviewontheimpactofthedeprivationonanymentaldisorder.ItisrecordedonForm4.Ifthisassessmentdoesnotmeettherequirementforauthorisationbecausetherelevantpersondoesnothaveamental disorder as definedbytheMental HealthAct1983,theManagingAuthoritycannotlegallydetaintherelevantpersonwithouttheirpermission.Theresponsibleworker/team/commissionerwillbenotifiedinorderthat they cansupporttheManagingAuthoritytoworkwiththerelevantpersontoplantheiron-goingcareand/ortreatmentwithouttheuseofDoLS.
8.18.3MentalCapacityAssessment.
Thisestablisheswhethertherelevantpersonlacksthecapacitytoconsenttothearrangementsfortheircareand/ortreatmentinthehospitalorcarehome.ThisassessmentcanbeconductedbyeithertheBIAortheMentalHealthAssessorandcanbeundertakenbyanassessorwithpreviousknowledgeoftherelevantpersonifthis
wouldbebeneficial.Specialistadvicemaybesoughtforclientswithspecificcommunicationneeds.ThisisrecordedonForm3or4dependentuponwhethertheBIAorMentalHealthAssessorareundertakingtheassessment.Ifitisfoundthatthepersondoeshavethementalcapacity tomakedecisionsabouttheircareand/ortreatmentinthehospitalorcarehome,itisunlawfultodeprivethemoftheirliberty.Theresponsibleworker/team/commissionerwillbenotifiedinorderthattheycansupporttheManagingAuthoritytoworkwiththerelevantpersontoplantheiron-goingcareand/or treatment withouttheuseofDoLS.
8.18.4No RefusalsAssessment.
Thisestablisheswhetheranauthorisationfordeprivationoflibertywouldconflictwithotherexistingauthorityfordecisionmakingforthatperson,suchasavalidandapplicableAdvanceDecisiontoRefuseTreatmentoradecisionbyaLastingPowerofAttorneyorDeputyforHealthandWelfare.ThisisrecordedbytheBIAonForm3.WherethisassessmentdoesnotmeettherequirementforauthorisationbecausethereisavalidrefusalfromadoneeordeputyorwhereanapplicableandvalidAdvanceDecisiontoRefuseTreatment(ADRT)isinplace,alternativearrangementsforcareortreatmentwillneedtobemadeinconjunctionwiththepersonwiththeauthoritytomakethedecision.
8.18.5EligibilityAssessment.
ThisestablisheswhethertherelevantpersonissubjecttoarequirementundertheMentalHealthAct1983thatmayconflictwithanauthorisationunderDoLSorwhetheranapplicationundertheMentalHealthAct1983shouldbemade.TheeligibilityassessmentisusuallycompletedbytheMentalHealthAssessor,butcanbecompletedbyaBIAwhoisalsoanApprovedMentalHealthProfessional(AMHP).ThisisrecordedonForm3or4.IftheoutcomeoftheassessmentisthatconsiderationshouldbegiventotheuseoftheMentalHealthAct1983insteadoftheDeprivationofLibertySafeguards, anassessmentwill need to be madeunder the MentalHealth Act1983,theMentalHealthAssessorwillcontactHerefordshireAMHPserviceviatheARTTeamonTel01432260900DetailsofarrangementsmadeshouldberecordedontheForm4and returnedtotheHerefordshireDoLSServices.
8.18.6BestInterestAssessment.
Thisassessmentestablisheswhetherthedeprivationoflibertyisoccurring,whethertheproposeddeprivationoflibertyisintherelevantperson’sbestinterests,isnecessarytopreventharmtothemselvesandthatthedeprivationoflibertyisproportionatetothelikelihoodandseriousnessoftheharmidentified.ThisassessmentmustbeconductedbytheBIAandrecordedonForm3ifthereisadeprivationoflibertyor3Aifnodeprivationoflibertyhasbeenidentified.Wherethisassessmentdoesnotmeetthe
requirementforauthorisationbecausedeprivationoflibertyisdeemednottobeintherelevantperson’sbestinterests,thecareplanwillneedtobeamendedtoavoidunlawfuldeprivationofliberty.Theresponsibleworker/team/commissionerwillbenotifiedinorderthattheycansupporttheManagingAuthoritytoworkwiththerelevantpersontoplantheiron-going care and/ortreatmentwithouttheuseofDoLS.
8.19Anequivalentassessmentisanassessmentthathasbeencarriedoutinthelast12months,whichtheSupervisoryBodyissatisfied,remainsvalidandapplicabletothepurposeunderDoLS.TheActstatesthatwhereanequivalentassessmenttoanyoftheabovesixassessmentshasalreadybeenobtained,itmayberelieduponinsteadofobtainingafreshassessment.Usualpracticeisthattheuseofequivalentassessmentsisconsideredwherethereareconsecutiveperiodsofauthorisationandthesituationisstable.Itisgoodpracticetoensurethatthebestinterests’assessmentandmentalcapacityassessmentarecompletedpriortoeachperiodofauthorisation.
8.20Extension to UrgentAuthorisations
IftheManagingAuthorityneedstorequestanextensiontoanurgentauthorisation,Form1shouldbesubmittedtotheSupervisoryBodywhomwillcompletetherestoftheform1andreturntotheManagingAuthority.Inpracticethisneed foranextensiontotheurgentauthorisationwillbediscussedwiththeManagingAuthoritybytheSupervisoryBody.Anextensionshouldonlybegrantedinexceptionalcircumstances,forexample,wherefurtherassessmentorconsultationisrequiredbytheBIA.Itisnotgoodpracticeforanextensiontoanurgentauthorisationtobegrantedinordertomanageholidayperiodsorstaffingdifficulties.TheManagingAuthorityisresponsibleforinformingtherelevantpersonandanyIMCAinstructedoftheextension,bothorallyandinwritingandinforming themoftheirrights and assistingtheirunderstanding.
8.21Third PartyRequests
8.21.1Ifanyonebelievesthattheyoranotherpersonmaybebeingdeprivedoftheirlibertywithoutauthorisation, they needtoalerttheManagingAuthority andsuggesttheyapplyforanauthorisation.Thisalertcanbemadeverballyorinwriting.TheManagingAuthoritymustnormallyrespondtothisrequestwithin24hours.RefertoChapter9ofthe DoLSCodeofPracticeforfurtherdetails onThirdPartyrequests.
8.21.2WheretheManagingAuthorityhas beenunabletoresolvetheThirdpartyrequest,i.e.wheretheyhavenotbeenabletosatisfythethirdpartythatnodeprivationoflibertyisoccurring,theymustsubmitarequestforanauthorisationtotheHerefordshireDoLSService.
8.21.3TheThirdPartycanraisetheirconcernsdirectlywiththeHerefordshireDoLSService,whowillconsidertheissuewiththeManagingAuthorityanddecidewhetherto
pursuetherequestfurther,appointingaBIAtoassesswhetherthereisanunauthoriseddeprivationofliberty.IfaBIAisinstructedtheyshouldcompleteanunauthorisedDoLSassessmentwithinsevendays.
8.21.4TheSupervisoryBodyrecordsitsdecisionusingForm18.TheHerefordshireDoLSServicewillgivecopiesofthisdecisiontothethirdparty,therelevantperson,theManaging Authorityand anyIMCAinvolved.
8.22Access to Records
8.22.1TheManagingAuthoritymustprovidetheBIAconductingassessmentswithanyrelevantassessmentsorcareplansandenableaccesstoandcopiesofanyrecordsheld thatassessors orIMCA mayconsiderrelevant.
8.23Assessment
8.23.1TheBIAshouldmaintaincontactwiththeIMCAthroughouttheassessmentstageandidentifyandattempttoresolveanypotentialdisagreementsthatmayemergewiththeIMCA.TheBIAmusttakeintoaccountandreferencetheIMCA’sviewswithintheassessment.
8.23.2TheBIAshouldattempt,whereverpossible,todiscusswiththeManagingAuthorityanypossiblerecommendationstheyintendtomakeintheirreporttoensureearlyremedialaction intheeventof anauthorisationnotbeing granted.
8.23.3ShouldAssessorshaveconcernsthatdeprivationoflibertyisaffectinganumberofpeoplewithinahomeorahospitalward,theyneedtoadvisethemanagingauthorityofthisandrequesttheycompleteanurgentauthorisationandputinapplicationstotheDoLSTeam.TheniftheManagingAuthoritydoesnotcomplywiththis,areferraltoAdultSafeguardingwillneedtobemade.
8.23.4ShouldeitherassessorbeawarethattheyaregoingtobeunabletocompletetheassessmentswithinthestatutorytimescalestheyneedtoinformtheHerefordshireDoLSService.Ifthereareexceptionalcircumstances,anextensiontotheurgentauthorisationmaybe granted.
8.24The Decision onAuthorisation
8.24.1IfanyoftheassessmentsconcludethatoneoftherequirementsisNOTmet,thentheassessmentprocessshouldstopimmediatelyandauthorisationmaynotbegiven.Form6shouldbecompletedbytheHerefordshireDoLSServiceandsignedbytheauthorisedsignatoryfromtheSupervisoryBody.AcopyoftheformandanexplanatoryletterwillbesenttotheManagingAuthoritywhowillbeaskedtodiscusstheoutcomewiththerelevantpersonandtheirfamilymembers.Adjustmentsmayneed
tobemadetothecareplan.Ifappropriateadjustmentsarenotpossibleandthepersonisunlawfullydeprivedoftheirliberty,thenasafeguardingalertshouldbemadeandareferral madetothe Court ofProtection.
8.24.2Iftheoutcomeoftheassessmentsisthatthequalifyingrequirementsaremet,theSupervisoryBodygrantstheauthorisation.TheSupervisoryBodywillscrutinisetheassessmentstoensuretherelevantlegalcriteriaandguidancefromtheCodeofPracticehavebeenconsidered.Anyissueswillbediscussedwiththeassessorduringthisprocess.Form5shouldbecompletedbytheHerefordshireDoLSService.TheForm5willthenbesignedbytheauthorisedsignatoryoftheSupervisoryBody.Furtherscrutinyanddiscussionmaytakeplace.Thesignatorymustdeterminetheperiodofauthorisation(whichcannotnotbelongerthantheperiodrecommendedbytheBIA)andsetconditionsfortheManagingAuthority(beingmindfuloftherecommendationsmade bytheBIA).
8.24.3TheHerefordshireDoLSServicewillphonetheManagingAuthoritytoadvisethemoftheoutcomeandconditionsassoonasadecisionhasbeenmade.AcopyofthedecisionformplusanexplanatoryletterandtheassessmentreportsaresenttotheManagingAuthority,theRelevantPerson’sRepresentativeandthe39AIMCA(ifrequired).Copiesoftheformandexplanatorylettercanalsobe senttoanybodythattheBIAhaslistedthattheyhaveconsultedduringtheassessment.Copiesarealsosenttotheresponsibleworker/team/commissioner.TheinformationandlegalstatusisalsorecordedonFrameworki.TheManagingAuthoritymustplacethecopiesontheperson’s carerecords.
8.25Relevant Person’sRepresentative
8.25.1TheBIAneedstoinitiateidentifyingaRelevantPerson’sRepresentativeintheearlystagesoftheassessment,althoughthispersonwillnotactuallybeappointeduntilanauthorisationisgranted.TheroleoftheRelevantPerson’sRepresentativeistomaintaincontactwiththerelevantpersonandtoprovideindependentrepresentationandsupporttotherelevantpersoninallmattersrelatingtothedeprivationoflibertysafeguards,includingtriggeringareviewandmakingapproachtotheCourtofProtectionasnecessary.Chapter7ofTheCodeofPracticeprovideseligibilitycriteriaforwhocanbetherelevantperson’srepresentative.TheBIAneeds togivetheirrecommendationontheForm3oriftherelevantpersondoesnothaveanyonewhocouldactastheirrepresentative,theBIAshouldinformtheSupervisoryBodyandtheywill need toappoint apaidrepresentative,usuallyanIMCAfromtheadvocacyservice.
8.25.2Whenauthorisationisgranted,aRelevantPerson’sRepresentativeshouldbeappointedbasedontheBIA’srecommendationsandtheirappointmentshouldbeconfirmed in writing by completing Form 5 which should be signed by the
representative.Acopyneedstobesenttothefollowing;theManagingAuthority;therelevantperson;therelevantperson’srepresentative;anyIMCAinvolved;anydoneeordeputy;andinterestedpersonslistedasconsultedbytheBIA.TherepresentativemustbegiveninformationandsupporttoassistthemintheirroleandbeprovidedwiththemeanstocontactanIMCA.TheSupervisoryBodyneedstodecidewhetheritwouldbebeneficialfortherelevantperson’srepresentativeand/ortherelevantpersontohavethesupportofa39DIMCAandtoappointthemiftheybelieveitwouldbeintheperson’sbestinterests.Thiswouldusually bebasedonarecommendationmadeby theBIA.
8.25.3Ifthereisanydelayinappointingarepresentative,orthereisaperiodbetweentheterminationofonerepresentativeandtheappointmentofanother,theSupervisoryBodyshouldappointa39CIMCAtosupporttherelevantpersonuntilarepresentativehas beenappointed.
8.25.4TheManagingAuthoritymustaccommodatevisitsbytheRelevantPerson’sRepresentativeanddetailsofvisitsaretoberecordedintherelevantperson’srecords.TheManagingAuthoritymustinformtheSupervisoryBodyiftherepresentativeisnotmaintainingappropriate contact.
8.25.5TheSupervisoryBodycanterminatetheappointmentoftheRelevantPerson’sRepresentative.
8.26CQC StatutoryNotifications
8.26.1TheManagingAuthoritymustinformCQCthatrequestforastandardauthorisationhasbeenmadeandofoutcomeoftherequest.Forfurtherinformationforhospital trustsandhospices:
For further informationfor carehomes:
services/notifications/notifications-non-nhs-trust-providers
8.27Complaints
8.27.1TheManagingAuthorityshouldraiseanyconcernsabouttheassessmentprocess via thecomplaintsproceduresoftheSupervisoryBody.
8.28Reviews
8.28.1Astandardauthorisationcanbereviewedatanytimeduringtheauthorisation–seeChapter9oftheCodeofPractice.ReviewswillbeconductedwhereanyofthestatutorygroundsforreviewaremetorwheretheManagingAuthority,therelevantpersonortheirrepresentativerequestsareview.TheSupervisory Body canalsodecidetocarryoutareview.TheprocessisnowcapturedononeformsharedbetweentheManagingAuthorityandtheSupervisoryBody–Form10.TheManagingAuthoritycanrequestareviewbycompletingForm10.Therelevantpersonortheirrepresentativecan requestareviewby making awritten orverbalrequest.
8.28.2TheHerefordshireDoLSServicemustcarryoutareviewifthestatutorygroundsaremet.TheymustalsoconductareviewwhereithasbeenrequestedbytheManaging Authority, the relevantperson or therelevantperson’srepresentative.
8.28.3DeprivationofLibertycanendbeforeaformalreview.Anauthorisationonlypermitsdeprivationofliberty;itdoesnotmeanthatthepersonmustbedeprivedwherea changeofcircumstancenolongernecessitates it.
8.28.4Duringtheperiodofauthorisation,theManagingAuthoritymustinformtheHerefordshireDoLSService of anyofthefollowingevents:
•Wherethedeprivationoflibertyisnolongeroccurringandtheauthorisationwillbeneed tobeended.
•Where anycircumstances havechangedthatmayrequire areview.
•Whereanycircumstanceshavechangedthatmayrequirereviewoftheeligibilityassessmentandshorttermsuspensionoftheauthorisation(suchasadmissiontohospitalundertheMentalHealthAct1983).UnderthesecircumstancestheSupervisoryBodycansuspendtheAuthorisationforupto28days.Form7shouldbeusedtoinformthe SupervisoryBodythatanauthorisationneedstobesuspended.
•After28daystheManagingAuthorityshouldinformtheSupervisoryBodywhetherthepersonhasreturnedwithinthetimeperiodandsotheAuthorisationisonceagaininforce.Ifthepersonhasnotreturnedwithinthistimeperiod,theAuthorisationwillceasetobe inforce attheendof the28dayperiod
•WheretheManagingAuthorityidentifiesthattherelevantpersonhasregainedcapacityona long-termbasisandtheauthorisationwill need tobeterminated.
8.28.5Oncearequestforareviewhasbeenreceived,theHerefordshireDoLSServiceshouldacknowledgeitandmakeplansforconductingthereviewwithin24hoursoftherequestbeingreceived.Form10shouldbeusedtoinformtherelevantperson,theirrepresentativeandtheManaging Authorityof the intentiontoconduct a review.
8.28.6TheHerefordshireDoLSServicewillneedtodeterminewhichoftherequirementsneedstobe reviewed and whether anyfurtheractionisrequired.
8.28.7Ingeneral,thereviewsshouldfollowthesameprocessasthestandardauthorisationforeachofthequalifyingrequirementsthatneedtobereviewed.ABestInterestAssessorand/oraMentalHealthAssessorwillneedtobeappointed,asrequired,andtheyneedtoensurereportsarecompletedandsentbacktotheHerefordshireDoLSServiceinatimelymannerastheoutcomeofthereviewhastobeachievedandcommunicatedwithin21days.
8.28.8Form5needstobecompleted,andthensignedanauthorisedsignatoryoftheSupervisoryBody,detailingtheoutcomeofthereview(andanynecessaryactions)such as:
•Thereviewhasdeterminedthattherequirementscontinuetobemetandtheauthorisationremainsintheirindividual’s bestinterest.
•The conditionsneedto bevaried as aresultofthereview
•Theauthorisationterminatesifthereviewestablishesthatadeprivationoflibertyisnolongeroccurringorifanyrequirementisnolongermet.Forms8and9needtobecompletedtoterminatetheauthorisationandtheappointmentoftherelevantperson’srepresentative
8.28.9AcopyoftheForm10andallre-assessedreportswillneedtobesenttotheManagingAuthority,therelevantperson,theirrepresentative,anyIMCAinstructedandanyotherpersonsconsultedduringthereview.
8.28.10Wherethedeprivationofliberty mayneedtocontinueafterexpiryoftheauthorisationtheManagingAuthorityneedstoapplyforanewstandardauthorisationusingForm1beforethecurrentauthorisationexpires,ensuringthereisgoodtimeallowed for comprehensive assessments tobecompleted.
8.28.11OnreceiptoftheForm1,theHerefordshireDoLSServicewillneedtore-instigatetheassessmentprocess asoutlinedabove.
8.28.12TheHerefordshireDoLSServicewillcontacttheManagingAuthoritytowardstheendoftheperiodofauthorisation.IftheManagingAuthorityadvisesthattheywillnotberequestingafurtherperiodofauthorisation,areviewwillbearrangedtoensurethatthequalifying requirements areno longermet.
9.OUTOFAREAASSESSMENTSORDINARYRESIDENCEWITHREGARDTOCAREHOMES
9.1WhendecidingwhichLocalAuthorityisresponsibleforassessinganindividualinacare home or hospitalthe rulesof ordinaryresidenceapply.
9.2Whereapersonneedstobedeprivedoftheirlibertyinacarehome,theSupervisoryBodyisalwaysthelocalauthorityinwhichthepersonisordinarilyresident.Thisremainsthecaseregardlessofwhetherthepersonhasbeenplacedinthehomebyalocal authorityorCCG.
9.3Ifapersonisself-fundingtheircareunderprivatearrangements,theymayacquireanordinaryresidenceintheareainwhichtheircarehomeislocatediftheyhadcapacityto choose tomove tothatareawhentheyoriginallymoved.
9.4Whereapersonisnotordinarilyresidentinanylocalauthority(forexampleapersonofnosettledresidence),itisthelocalauthorityinwhichthecarehomeissituatedthatbecomesthe SupervisoryBody.
9.5Whereapersonisplacedinacarehomeinanotherlocalauthority areabecomesinneedofadeprivationoflibertyauthorisation,theyremainordinarilyresidentintheirplacinglocal authority.Therefore,theplacing authoritywould betheSupervisoryBody.
9.6Whereapersonisdeprivedoflibertyinhospital,theyremainordinarilyresidentinthe area in which they were ordinarily residentimmediatelybefore theywere admitted tohospital.Ifthatpersonneedstobedeprivedoflibertyinacarehomeupontheirdischargefromhospital,andthecarehomeappliesforthestandardauthorisationinadvance,whilstthepersonisstillinhospital(aswouldbegoodpracticeinthissituation),itisthelocalauthorityinwhichthepersonwasordinarilyresidentbeforetheiradmissiontohospitalwhichisresponsibleforundertakingtheroleofSupervisoryBody.Thisremainsthecaseevenwhereitisplannedthatthepersonwillbedischargedfromhospital toa carehomelocated inanotherlocalauthorityarea.
9.7Ifthepersondoesnotrequirethelocalauthoritytomakearrangementsontheirbehalfandentersthathomeasaself-funder(usuallyadeputywouldenterintoacontractwiththecarehomeontheirbehalf),theywouldgenerallyacquireanordinaryresidenceintheareainwhichtheircarehomeislocated.However,ifthepersonhasnotenteredthecarehomeatthepointwhentheDoLSapplicationismade,theycannotbeordinarilyresidentinthatlocalauthority,despiteanyimminentplanstomovethere.Whilstthepersonremainsinhospital,theyareordinarilyresidentintheirpreviouslocalauthorityuntiltheyaredischargedfromhospital.Itislikelythattheself-funderwouldbecomeordinarilyresidentinthelocalauthorityinwhichtheircarehomeislocatedassoonastheirmovetakesplacebuttheirsupervisorybodyunderDoLSwouldbetheirprevious local authority.
9.8ThisappliestoallNHSaccommodationandnotjusthospitals.Thismeansthatwhereapersonisplacedinacarehome“outofarea”byaCCGunderNHSCHCarrangementstheyremainordinarilyresidentintheareainwhichtheywereordinarilyresidentbeforebeingprovidedwithNHSCHC.Therefore,ifthepersoninreceiptof
NHSCHCsubsequentlyneedstobedeprivedoftheirliberty,itisthelocalauthorityinwhichtheywereordinarilyresidentimmediatelybeforebeingprovidedwithNHSCHCthat is responsibleforperformingthe supervisorybodyrole.
9.9ManagingAuthoritieswillneedtoknowwhichLocalAuthorityisresponsibleforcommissioningthecareoftheirresidents.Ifmanagingauthoritiesareindoubt,theyshoulddiscuss withtheHerefordshireDoLSService.
9.10Whenthereisadisputeaboutwheretherelevantpersonisordinarilyresident,theSupervisoryBodywillbetheLocalAuthorityfortheareainwhichthecarehomeissituated,untilthematterisresolved.HerefordshireCouncilwillco-operatewithotherSupervisoryBodiestoensurethebestinterestsofanypotentialrelevantpersonaremet.
10.APPEALSAND COURTOF PROTECTION
10.1OnceanauthorisationhasbeengrantedorrefusedbytheSupervisoryBody,theManagingAuthorityitselfcannotappealagainstthedecision.However,theManagingAuthoritycanappealagainsttheassessmentprocessifitbelievestherewasafaultinthe assessmentprocessornegligenceonthepart ofthe assessor,orwhetherachangeintheconditionofthepersonrequiresare-assessment.ThedisputewillneedtobeinvestigatedthroughtherelevantSupervisoryBody’scomplaintsprocedures.
10.2TheCourt ofProtection,established bythe Mental CapacityAct 2005 (seeChapter8oftheMentalCapacityActCodeofPractice),allowsanybodydeprivedoftheirlibertytherighttospeedyaccesstoareviewofthelawfulnessoftheirdeprivationofliberty.ItistheresponsibilityoftheManagingAuthoritytoensurethattherelevantpersonandtheirrepresentativeisawareoftheirrightstoapplytothecourtbothbeforetheauthorisationisgrantedandafterwardsandthattheyhavetheinformationrequiredinordertomakeareferraltotheCourt.Therelevantpersonandtheirrepresentativeshouldbemadeawareofthetypesofquestions/issuestheycantaketotheCourtasstated in theCodeofPractice Chapter 10.
10.3TheSupervisoryBodyshouldappointasupportingIMCAfortherepresentativeand/ or theirrepresentative iftheybelievethiswill be ofbenefittothem.
10.4TheManagingAuthorityandtheSupervisoryBodyshouldendeavourtoresolveanyconcerns throughmediation, or theirown complaints procedures before therelevantpersonor theirrepresentative refer thematterto theCourt.
10.5TheManagingAuthorityandSupervisoryBodyarerequiredtocomplywithanyconditionsimposed bythe Court.
10.6WherethedirectionoftheCourtisrequiredonamatterrelatingtoanauthorisation,forexamplewherethereison-goingrestrictiononcontactwithfamily,proceedingsshouldbeinitiated bytheSupervisoryBody.
11.REPORTINGTHEDEATHOFAPERSONWHOISSUBJECTTODEPRIVATIONOF LIBERTYSAFEGUARDS
11.1Shouldaperson diewhilstbeingthesubjectofaDeprivationofLiberty Safeguardsauthorisation,theManaging AuthorityshouldinformthecoronerofthisusingForm12.
12.COMPLAINTS
12.1ComplaintsshouldbedealtwiththroughtherelevantManagingAuthorityorSupervisoryBodycomplaintsprocedure.Whereverpossible,concernsaboutthedeprivationoflibertyshouldbe resolvedinformally.
13.TRAINING
13.1HerefordshireSafeguardingAdultBoardhasimplementedamulti-agencytrainingstrategywhichincludesMCAandDoLStosupporttraininganddevelopmentofstaffwithinHerefordshire’sstatutory,independentandthirdsectorHealthandSocialCareworkforce.TheaimistoprovideknowledgeandunderstandingtoenablestafftocarryouttheirdutiesandresponsibilitiesundertheMCA.Withinthisstrategypartnerorganisationswillhavetheirowntrainingstrategiestomeetthespecialistneedsofindividualorganisationsteamsandservice.
13.2Organisationalspecifictrainingandimplementationneedswillbeaddressedwithinindividualagencieswithinthecontextoftheoverallstrategy.AlltrainingshouldbelinkedtotheMCACompetenciesdetailedinthe safeguardingtrainingstrategy.
14.INFORMATIONGOVERNANCE
14.1Thereisaneedtotransferconfidential,sensitiveinformationbetweenmanagingauthorities,SupervisoryBodies,BestInterestAssessors, MentalHealthAssessors,healthandsocialcareprofessionals,IndependentMentalCapacity Advocates,therelevantperson,theirCarers,familymembersandrepresentativesthroughtheassessmentandauthorisationprocedureswithregardtotheDeprivationofLiberty
Safeguards.Informationgovernancemustbeconsideredbyallorganisationsinvolvedinthisprocess.ManagingAuthoritiesshouldcontacttheHerefordshireDoLSServicetodiscuss thesafetransferofinformation.
14.2Sometimes,thirdpartiesmayrequestinformationaboutsomeonewholackscapacity.Chapter 16oftheMCACodeofPractice offers generalguidance.Practitionersmusthaveregardtothe Data ProtectionActand relevantorganisationalpolicy.
14.3Thefollowing is asummaryofkeypoints:
•Itshouldalwaysbeconsideredfirstwhetherthepersonwholackscapacityinrelationtoaspecificdecisionmayneverthelesshavethecapacitytoagreetothatinformationbeingdisclosed.Ifso,theperson’sconsenttodisclosetheinformationshouldbesought;
•Itshouldalwaysbeconsideredwhetherthepersonmakingtherequestforconfidentialinformationhas lawfulauthorityto askfor it;
•StaffmustbesatisfiedthatthepersonmakingtherequestforinformationisactingintheBestInterestsofthepersonwholackscapacityandneedstheinformationtoactproperly;
•Staffmustalsobesatisfiedthatthepersonmakingtherequestwillrespectconfidentialityandwillkeeptheinformationfor nolongerthanis necessary;
•Ifstaffdecide,basedupontheBestInterestsandneedsofthepersonwholackscapacity,thatinformationshouldnotberevealedtotheperson’sCarer,Chapter15ofthe MCACodeofPracticeprovidesoptionstoconsider;
•Ifstaffrevealconfidentialinformationlawfully,theyshouldasktherecipienttoconfirmthattheywillkeepthatinformationsafe,confidentialandfornolongerthanisreasonablynecessaryfor thepurposerequested;
•Staffshouldensuretheyrecordallincidentsofinformationsharingandtheirjustificationfor sharingat thatpointintime.
14.4 Individuals or their relatives may make requests to see their records, and the proper processes for such “subject access requests” must be followed within the organisation receiving the request to ensure that it is answered lawfully. Other data protection rights such as the right to correct inaccurate data must also be respected and the correct organisational procedures followed when these rights are invoked.”
14.5 A privacy notice will be in place to inform individuals how their personal data will be processed, and that a data sharing agreement will document the process for sharing information
15.RELATED POLICIES, PROCEDURESAND FORMS
HSAB Mental CapacityAct Policy
AdultSafeguarding:Multi-agencypolicyproceduresfortheprotectionofadultswithcare &supportneedsintheWestMidlands.
HSAB GuidanceonPositiveApproaches toBehaviourthatChallenges
Guidance onOrdinaryResidenceComplaintsProcedure
Recording PolicyConsentPolicyMedicinesPolicyEndofLifePolicyRiskManagementInformationSharing
16.MONITORINGAND REVIEW
16.1This policywill bemonitored onanannual basisand reviewed in 3years
17.IMPLEMENTATION
17.1Partneragenciesexisting related policies andprocedureswill needtobe reviewedtoensureconsistencywith this updatedDoLSpolicy,procedureandguidelines.
OverviewofDeprivation of LibertySafeguardsprocessAppendix1
APPENDIX2
Whatshould a managing authorityconsiderbeforemakinganapplication for Deprivation ofLibertySafeguards