When someone who lacks mental capacity is in a hospital or care home there may be some restrictions on their liberty such as keypad door locks, cot sides or certain medications such as those causing drowsiness.
In order for the principles of Best Interests and Least Restrictive Option to be applied, there are additional protections for people under the DoLS rules, which were added as an amendment to the Mental Capacity Act.
This is how DoLS protects people in a residential setting who lack mental capacity to object to a restriction.
- The hospital or care home must apply to the supervisory body (usually the local adult social care authority) for “standard authorisation” if they intend to put a restriction in place
- The supervisory body must scrutinise the planned restriction of liberty to ensure that it is in the best interests of the person and is the least restrictive option
- Urgent authorisation can be applied for 7 days if there is an immediate need for a restriction to be in place before standard authorisation has been obtained
- A relevant person’s representative (RPR) is appointed. This is usually a family member whose role is to represent and support the person, which might include making a complaint on their behalf or making an application to the Court of Protection
- Both the person and their RPR are entitled to advocacy support from an Independent Mental Capacity Advocate (IMCA) when making an application to the Court of Protection
You can see that the role of RPR is important and if you are appointed as one you should receive a booklet to help you understand your responsibilities and rights.
DoLS were due to be replaced by Liberty Protection Safeguards (LPS) in 2020 but we understand this will not now come into force until Autumn 2024. Deprivations of liberty will have to be authorised in advance by “the responsible body” who will be the hospital manager for NHS hospitals. For care homes and other settings the responsible body will be the local authority.