Liberty Protection Safeguards - the replacement for DoLS Results of a national survey September 2018

What A national survey on the Liberty Protection Safeguards contained in the Mental Capacity (Amendment) Bill (HL) that is currently being debated by parliament. The survey was completed by 912 people. The results provide powerful evidence of the views of social and health care staff on key elements of the Liberty Protection Safeguards that could or should be amended during the parliamentary process. The survey was created by Steven Richards (steven.richards@edgetraining.org.uk) in conjunction with Community Care. Method An online survey available for one month (26 July to 28 August 2018). It had 17 questions on key parts of LPS with the option for respondents to leave comments with each question.

Findings The survey results are available in a range of formats from: http://www.edgetraining.org.uk/news/ A detailed article about the survey is available from: https://www.communitycare.co.uk/2018/09/03/majority-practitioners-opposed-key-aspects-dols-replacement-proposals/ and finally an online version of the results is available from: https://www.surveymonkey.com/results/SM-3JXFTRFXL/ All resources have open copyright and can be copied and distributed freely but they must attribute the source and authors.

Q1: Deprivation of liberty: Like DoLS, the LPS does not define what restrictions constitute a deprivation of liberty. It leaves this for case law, most notably the Cheshire West ruling by the Supreme Court. Do you agree with this?

Q2: Mental disorder: DoLS applies to people with a mental disorder whereas LPS applies to people of 'unsound mind'. This is borrowed from the European Convention on Human Rights (ECHR) but is not a term used in modern psychiatry. Do you agree with this change? Answered: 912 Skipped: 0

Q3: Best interests: Under DoLS, an assessor (BIA) has to consult the person lacking capacity as part of the best interests assessment to establish their 'wishes, beliefs and values'. Under LPS, there is no statutory requirement to consult directly with the person being deprived of their liberty. Do you agree with this? Answered: 912 Skipped: 0

Q4: Care home assessments: For care homes residents, the main assessor could now be the care home manager or another member of the care team in the home. Assessments do not have to done by qualified professionals, such as a social worker, nurse or occupational therapist. Do you agree with this? Answered: 912 Skipped: 0

Q5: BIA removal: A specially trained independent professional (BIA) must be involved in all assessments under DoLS. Under the LPS model, the majority of assessments will be carried out by care home managers. Do you agree with this? Answered: 912 Skipped: 0

Q6: Place: LPS will apply to any care setting including care homes, hospitals, supported living and domestic settings. Do you agree with this change? Answered: 912 Skipped: 0

Q7: Community-domestic settings: LPS will apply to any care settings including community and domestic settings. The procedure is the same across all settings. Do you agree with a single process for all settings? Answered: 912 Skipped: 0

Q8: Responsible body: Under LPS, NHS Trusts will be the responsible body for hospital patients, Clinical Commissioning Group (CCG) for those receiving NHS Continuing Healthcare and local authorities for other cases. The responsible body must carry out assessments (except care homes) and authorise an LPS. Do you agree with these plans? Answered: 912 Skipped: 0

Q9: AMCP intervention: A person is entitled to a professional independent assessor called an AMCP (previously called a BIA) only if they are considered to be objecting to the placement or care/treatment. Do you agree with this? Answered: 912 Skipped: 0

Q10: Consultation: Under LPS there is a legal duty to consult others as part of the assessment process. But, if a family are against the authorisation, this does not trigger any additional protection within the procedure. Do you agree with this? Answered: 912 Skipped: 0

Q11: Appeals: Under the government's LPS proposals, appeals will go to the Court of Protection like in DoLS. Do you agree appeals should remain with the court? Answered: 912 Skipped: 0

Q12: Duration and renewal: LPS can be renewed for one year after the first authorisation expires and then up to three years for the second renewal. These renewals will not require a direct assessment of the person themselves and, if the Responsible Body believes there are no significant changes in a person's case, they can authorise the renewal. Do you agree with this renewal method? Answered: 912 Skipped: 0

Q13: Appropriate Person: Under DoLS, everyone has an independent representative appointed for them. Not everyone, however gets a representative (appropriate person) under the current LPS model. Do you agree with this? Answered: 912 Skipped: 0

Q14: Advocacy: the Law Commission proposed an improved right to advocacy but this has been removed. Under LPS, if a person is in a care home and lacks capacity to ask for an advocate, the care home manager will decide whether it is in the person's best interests to one. Do you agree with this? Answered: 912 Skipped: 0

Q15: Conditions: Under DoLS, the local authority can attach conditions for care homes or hospitals to follow. Failure to meet conditions can be appealed against by the person or their representative. There are no conditions under LPS. Do you agree with this? Answered: 912 Skipped: 0

Q16: Harm to others: DoLS only authorises deprivation of liberty for 'harm to self'. LPS will authorise both harm to self and/or others. Do you agree with this change? Answered: 912 Skipped: 0

Q17: Mental Health Act: the same rules for considering the use of the Mental Health Act under DoLS remain for LPS. If a person is objecting to mental health treatment in hospital, the MHA should be used. If the person is not objecting then LPS or the MHA could be used. Do you agree with this? Answered: 912 Skipped: 0