deprivation of liberty safeguards david thornicroft st thomas training

Deprivation of Liberty Safeguards

David Thornicroft

St Thomas Training

www.stthomastraining.co.uk

“Double whammy” for DoLS?


House of Lords Select

Committee report, 13th

March 2014

Supreme Court ruling, 19th March 2014

Deprivation of Liberty


Remember: it’s illegal to deprive someone of their liberty without some form of external authorisation

For example:•Arresting/imprisoning someone for a criminal offence•Sectioning someone under the Mental Health Act

•DoLS authorisation from the local authority (registered homes and hospitals)•Direct authorisation from the Court of Protection (supported living, Shared Lives etc)

Deprivation of Liberty Safeguards

•Introduced in England & Wales on 1st April 2009

•An update to the Mental Capacity Act 2005

•Usually known as DoLS


“P” (the “Cheshire West” case)

•38 years old•Cerebral Palsy & Down’s •Lives in bungalow with 2 other residents•2 staff during day, 1 waking night•Supported to go to day centre, pool, pub, clubs, mum’s house


“P” (the “Cheshire West” case) continued

•Needs prompting and help with all activities of daily living, eg •Getting around, eating, personal hygiene, continence •Habit of pulling his continence pads off and putting them in his mouth•Therefore required to wear a “body suit”


“P” (the “Cheshire West” case) continued

•Court of Protection ruled this was a deprivation of P’s liberty •Court of Appeal ruled that it wasn’t •What do you think the Supreme Court said?


The UK Supreme Court (19th March 2014)


A person is deprived of his liberty if he is

“under continuous supervision and control and is not free to leave”

The UK Supreme Court (19th March 2014)


Is it still a deprivation of P’s liberty if he is compliant with the regime?

Do different standards apply to P because he is “not normal”?

Does the reasoning behind the care plan matter in determining whether it’s a deprivation of P’s liberty?

“P & Q” (the “MIG and MEG” case)

•Sisters, both with learning disabilities•Both attend same school, both have lots of activities, trips, holidays etc (with support)•MIG (18) lives with foster mother•MEG (17) lives in NHS facility


“P & Q” (the “MIG and MEG” case) continued

•Both sisters reasonably content with living arrangements•Neither showed particular desire to leave their placements•But MIG’s foster mother, and MEG’s carers, both made it clear they would restrain them if they tried to leave


“P & Q” (the “MIG and MEG” case) continued

•Court of Protection ruled that neither MIG nor MEG was being deprived of her liberty•Court of Appeal agreed•What do you think the Supreme Court said?


The Supreme Court rulingA person is deprived of his liberty if he is:

•“under continuous supervision and control and is not free to leave”

Human Rights are universal: if it would be a deprivation of my liberty, or your liberty, or anyone else’s liberty, then it would also be a deprivation of P’s liberty, or MIG’s liberty, or MEG’s liberty

•“A gilded cage is still a cage”


What does it mean for you?


What does it mean for you?


•Await guidance from the DoLS Lead at your local authority•Read the guidance that has already been published by the Department of Health (28th March) …• … and by CQC (4th April) …•… both of which are available at www.stthomastraining.co.uk

http://www.stthomastraining.co.uk/

What does it mean for you (continued)?


•Remember: deprivation of liberty should be a last resort …•… so can you possibly cater for the needs of your service user in a less restrictive way?•Are you depriving him/her of their liberty because there is definitely no alternative?•And are you acting in your service user’s best interests … or your own?

St Thomas Training

•Feel free to browse our website•Call 02380 970 914 or email [email protected] for advice•We deliver training at your venue, on a date to suit you•10% discount for HCA members!


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deprivation of liberty safeguards david thornicroft st thomas training

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