Nearly 30,000 People In Need Of Care Were Wrongfully Deprived Of Their Liberty In 2015/16
According to figures taken from the 2015/16 data collection of the DoLS Mental Capacity Act 2005, 28,530 people were illegally restrained, sedated, or had their liberty deprived in English hospitals and care homes during the 2015/16 period.
The DoLs (Deprivation of Liberty Safeguards) was introduced in 2009. They are a group of legal requirements designed to ensure that individuals are only deprived of their liberty as part of their care when approved. Care homes and hospitals must submit and have their completed applications approved by their local authority
Huge Increase in Completed DoLs Applications in 2015/16 (Councils)
105,055 completed Deprivation of Liberty Safeguards (DoLS) applications were reported in 2015/16. This is an increase of 68 percent when compared to the 62,645 completed applications in 2014-15. Of the 105,055 completed applications for 2015/16, councils rejected 28,530, or almost a third.
Another potentially worrying figure, is that the North East has the highest rate of completed applications. With 665 applications per 100,000 residents. It was more than twice that of the South West at 258, which was the next highest region.
The rejected applications are a cause of major concern though, especially in regards to individuals suffering from dementia. 51 percent of the 206,010 individual DoLs applications originally filled out in 2015/16 suffered from dementia
Nearly 30,000 People Wrongfully Deprived of their Liberty
Martina Kane, from the charity Alzheimer’s Society was quoted as saying: “It is disgraceful that nearly 30,000 people were wrongfully deprived of their liberty, and in over a quarter of cases practitioners are still locking people in, sedating them, restraining them or otherwise treating them as second class citizens.
The senior policy officer for the Alzheimer’s Society continued
“Depriving someone of their liberty should always be a last resort and only ever done in someone’s best interests.”, and added:
“It is crucial that the quality of care provided to people with dementia is improved to ensure that.”
Reasons for DoLs Application Rejections
In 2015/16, English local authorities rejected 28,530 completed applications for the following reasons
- 27% failed to meet six assessment criteria.
- 30% of the individuals died before their assessment was completed.
- 43% were refused as the circumstances of the individual’s concerned had changed.
Although the law states that care providers must seek authorisation before they deprive an individual of their liberty, the Alzheimer’s Society says that reality is very different. They claim that applications are made when an individual is already being deprived of their rights. Thus, they arrive at the figure of nearly 30,000 being illegally deprived during 2015/16.
A Potential Solution to the Problem
One solution to the problem, according to a spokeswoman speaking on behalf of the Alzheimer’s Society, is to give individuals suffering with dementia much higher quality care. This would significantly reduce the total number of DoLs applications, and this would lead to a reduction in the number of people wrongfully deprived of their liberty.
Initial Reasons For The Increase In Applications
The number of DoLs applications increased in 2015/16 to record levels due to what is known as the Cheshire West ruling. This ruling made by the Supreme Court in March 2014 effectively lowered the requirements for what might constitute a deprivation of liberty. The result of this, was that between 2014-2015/16, the amount of completed applications submitted by care providers for councils to assess has increased ten times.
The ruling in the Cheshire West case (P v Cheshire West and Chester Council and P&Q v Surrey County Council) acted as clarification as to what exactly a deprivation of liberty is, and when an application should be made.
In its most basic form, a DoLs application should be made when a person does not have the ability to consent to their own care arrangements, is not free to leave their care environment, and/or requires supervision under a continuous basis. In this sense, the Alzheimer’s Society spokeswoman has a point in saying that in most cases, applications are made retroactively.
Huge Delays In Signing Off Completed Applications
There is also a time component to submitting a completed application to the local authority for assessment. Urgent applications should be assessed within seven days, and all other applications must be decided upon within 21 days.
The reality is very different though. Due to the huge increase in the number of applications, local authorities have found themselves unable to keep up. This has resulted in a significant backlog of applications, some of which have extended to over six months.
In the 2015-16 period, only 10% of urgent applications were signed off within the required seven days. 29% of urgent applications were completed within 21 days, with the rest extending further.
The effects of the backlogs are still continuing. Over 40% of the completed applications received by English councils during the 2015/16 period had not been signed off by the end of that period. Of those 40%, half of them had been waiting up to 188 days to be completed, and this number also included 21,370 delayed urgent applications.
Multiple DoLs Applications Number Over 32000
Another consequence of the backlogs caused by the DoLs scheme, is that in 2015/16 32,750 people had more than one application. Of these, 4,445 had three applications, and 1,345 had more than four. This is perhaps a problem caused by the system, but also surely adding to it.
Will the DoLs Law Be Changed?
In response to the evident problems with the system, the Law Commission has been asked by the government to find an alternative to the DoLs scheme. They acknowledge that the impact of the Cheshire West ruling has placed English councils under significant pressure, and increased their workloads.
For more information on the ‘Mental Capacity Act 2005, Deprivation of Liberty Safeguards (England), Annual Report 2015-16’ visit: http://content.digital.nhs.uk/catalogue/PUB21814/dols-eng-1516-rep.pdf