The deprivation of liberty safeguards must be "drastically revised" or replaced according to the findings of a Mental Health Alliance draft report, which has concluded that they are "not fit for purpose", writes Helen Mooney.
It warns that too many vulnerable hospital and care home residents are being left without any protection and says that the government should replace the current system.
The Dols were introduced in April 2009, under the Mental Capacity Act 2005, to protect the interests of people detained in care for their own protection. Care homes and hospitals must apply to councils and primary care trusts for authorisation. Councils and primary care trusts. must then carry out a series of assessments to determine whether a deprivation is legal.
The report shows there has been no change since its July 2010 report, which showed that Dols applications were running at only a third of the government's predicted rate and varied widely across the country.
Author and Mental Health Alliance Dols lead Roger Hargreaves said some PCTs and local authorities have claimed that the low rates of applications for Dols shows their success in persuading care providers to adopt less restrictive care practices.
However, he said it was "inconceivable" that some PCTs and local authorities could have been 50 times more successful than others in reducing levels of deprivation of liberty.
Hargreaves also warned that the safeguards did not cover many very vulnerable people who were under the "total control" of their carers because they had not been defined as having had their liberty deprived.
"[Court of Protection judgements] show that a swathe of situations that were previously assumed to fall within Dols actually fall outside of them," he added.
Care services minister Paul Burstow said the government would look carefully at the MHA report to see what lessons could be learned.
BBC Radio 4 features Dols in The Report on 24 November at 8pm.
Helping care home managers navigate the deprivation of liberty process
Safeguards to prevent wrongful detentions in care 'need review'