CQC publishes first Deprivation of Liberty Safeguards report

The Care Quality Commission (CQC) has delivered its first progress report into the Deprivation of Liberty Safeguards (DoLS). While it found examples of good practice, it also highlighted that some managers are unaware of the safeguards. The DoLS are designed to protect the rights of people in care homes and hospitals who lack the mental capacity to consent to care or treatment. They are applicable to people with learning disabilities if they are unable to consent. The safeguards became law in April 2009 as part of the Mental Capacity Act 2005. A care home or hospital must apply for authorisation if they propose to deprive someone of their liberty by, for instance:

• Keeping them locked in
• Physically restraining them
• Placing them under high-levels of supervision
• Forcibly giving them medication
• Preventing them from seeing relatives and friends.

The CQC’s report The Operation of the Deprivation of Liberty Safeguards in England, 2009/10, provides an update on how the safeguards have been implemented, what is working well and what needs to be improved. Its key findings include:

• Examples of good practice in some hospitals and care homes, where safeguards are being used effectively to protect people’s rights and staff have been made aware of their duty under the safeguards
• Many PCTs have made good progress in implementing the mechanisms set out in the safeguards
• The establishment of joint teams and effective partnership working.

But the report also warns that there is a clear variation in understanding, practice and training, and even some managers who were unaware of the safeguards. It also warns that restraint was still being used without due consideration that could deprive someone of their liberties. As a result, the CQC has called clearer guidance on what should be considered as a deprivation of liberty. Cynthia Bower, CQC’s chief executive, said: “The Deprivation of Liberty Safeguards are an important piece of legislation designed to protect the human rights of this particular group of vulnerable people. “Care homes and hospitals should always seek to use the least restrictive ways of caring for people. If they believe there is no alternative to depriving someone of their liberty, and it is in the person’s best interests, it is their responsibility to seek authorisation though the safeguards process. “This was the first year of implementation of the safeguards, and all the organisations involved were feeling their way to an extent. But it is essential for those who need this protection that we all learn very quickly and make sure the safeguards are implemented fully throughout the country.”