Joanie Callaghan, Best Interests Assessor, Isle of Wight Council Deprivation of Liberty Safeguards – Update for Residential Homes Forum October 2017 Joanie Callaghan, Best Interests Assessor, Isle of Wight Council

INTRODUCTION DoLS introduced April 2009 – low numbers affected: Isle of Wight 20-30 per year 2014 Supreme Court ruling in Cheshire West: the acid test widened the scope: 500+ per year Big backlog of outstanding requests: 750+ Law Commission review: Liberty Protection Safeguards – no dates set.

When do we need to request DoLS Authorisation? Acid Test: A person is deprived of his/her liberty if s/he is under continuous supervision and control and not free to leave. ‘Under continuous supervision and control’ describes the day-to-day management of the resident, in particular restrictive actions taken without his/her consent. ’Not free to leave’ is about longer term decisions about residence. This applies if the person is unable to give consent to the placement, due to lacking mental capacity, rather than that s/he is attempting to leave.

High Priority: 1:1 care, sedating medication, regular use of physical restraint, restriction on contacts, any objections by resident, family, friends or advocate, regular attempts / requests to leave; Medium Priority: occasional attempts / requests to leave, unsettled at times, infrequent use of medication / physical restraint; Low Priority: meets acid test, but no specific restrictive actions and no objections; Further requests will be accorded the same priority as the original request.

Information to be sent to the Supervisory Body An initial request DoLS Form 1: basic information (name, date of birth, care home etc.), standard demographic data and detailed information on the individual resident (the ‘relevant person’). Purpose of the Authorisation: a description of the care and / or treatment the person is receiving, including personal care, mobility, medication, support with behavioural issues, types of choice the person has and any medical treatment they receive; The restrictions the person is subject to: a description of the restrictions put in place which are necessary to ensure the person receives care and treatment, their frequency and why they are necessary; Further requests for authorisation Form 2: when an authorisation is due to expire a further request should be made, 4-6 weeks before expiry.

Notifying Changes Once a request has been made this will remain valid until fully assessed and there is no need to re-submit further requests at periodic intervals. The Supervisory Body must be notified of any of the following changes dolsoffice@iow.nhs.uk: any significant changes to the care plan that increase or reduce the level of restrictions; any significant changes in medication, in particular the use of sedating medication or covert administration of medication; changes in behaviour, in particularly requiring an increase in the level or frequency of physical interventions; any objections to the placement; any change that may increase the priority of the request; a resident being discharged or dying.