Liberty, equality, capacity: The impact of the Deprivation of Liberty Safeguards on social care practice and human rights

Summary
Individuals who lack the mental capacity to make important decisions often have to rely on others to support their choices and protect them from harm. There is a risk, however, that this can deprive them of their liberty. The Mental Capacity Act Deprivation of Liberty Safeguards (DoLS), which came into force in 2009, provide a framework to protect individuals' rights and to ensure that they are only deprived of their liberty when this is in their best interests.

This research will look at what impact these safeguards are having on human rights and social care practice. It will also look at how the well-being of disempowered individuals can be safeguarded and how they can be provided with greater autonomy by adult social care practitioners in circumstances that may deprive them of their liberty. The findings will be made widely available to the social care sector, including voluntary sector organisations acting for individuals who may lack capacity, such as people with dementia, learning difficulties or mental health difficulties. An illustrated, easy-to-read version will also be produced.

Aims
To examine the implementation of Deprivation of Liberty Safeguards (DOLS) and whether they protect the human rights of people lacking mental capacity through an examination of:

• factors that lead to applications for a DOLS being considered worthy of authorisation or not
• the rationale for the infringements to individuals’ liberty and autonomy permitted by DOLS
• the impact of DOLS on practitioners’ practice and awareness of human rights principles
• the use of ethical reasoning in decision-making amongst those involved in applying for or authorising a DOLS
• key elements of good practice.

The study will generate knowledge concerning how the well-being of disempowered individuals can be safeguarded by adult social care practitioners and their autonomy promoted, in circumstances that may deprive them of their liberty.

After gathering general information about DOLS processes and procedures, a sample of 16 people subject to a DOLS application will be drawn. Through qualitative interviews the views and experiences of relatives, care home/ward managers, other relevant practitioners and DOLS personnel will be explored, along with the individuals themselves, wherever possible. A national online survey of DOLS assessors in England will also be undertaken to examine the factors they consider significant in determining what constitutes deprivation of liberty and in what circumstances such a deprivation is viewed as justifiable and/or proportionate, Their views of practice will also be elicited.

Findings will support improved practice in adult social care for people with compromised decision-making capacity at risk of deprivation of liberty, through dissemination across practitioner, service user, carer, policy, social care provider and DOLS networks.