The number of deprivation of liberty safeguard applications for people lacking capacity varies widely between local authorities, two reports show.
Figures for England and Wales show that, between April 2009 and the end of March 2010, the number ranged between five and 60 in different local authorities.
The applications are made under the deprivation of liberty safeguards (DoLS), which were introduced in April 2009 as a result of the Mental Capacity Act 2005. They ensure that a person who lacks capacity is not deprived of their freedom in a care home or hospital unnecessarily and that their best interests are served.
Applications must be authorised by local authorities for care homes, or primary care trusts or health boards for hospitals. If successful, checks are put in place to ensure decisions are taken in the person’s best interests.
The rate of applications in the East Midlands was double that in the South West, according to the reports from the Care Quality Commission (CQC), which monitors care standards in England, and the Care and Social Services Inspectorate Wales (CSSIW). Three local authorities received no applications.
Campaigners fear that the low number in some areas may mean that people are being deprived of their liberty without access to the safeguards.
However, both reports attributed this to a lack of training and guidance.
“We discovered that professionals needed to understand the Mental Capacity Act better so that they were aware of what exactly constituted a deprivation of liberty,” said CSSIW chief inspector Imelda Richardson.
The CQC said the government should develop clearer guidance that can be applied by frontline social workers.
“This was the first year of implementation of the safeguards, and all the organisations involved were feeling their way,” said CQC chief executive Cynthia Bower. “But it is essential for those who need this protection that we all learn quickly and make sure the safeguards are implemented fully throughout the country.”
The CSSIW report found that a greater-than-expected percentage of authorisations were acquired through emergency applications. Previous guidance predicted that only exceptional cases would need an urgent authorisation and yet these types accounted for 61% of all applications in 2009-2010.
The CQC found that primary care trusts rejected a larger proportion of applications than did local authorities.
Both organisations praised many councils and health bodies for establishing joint teams to handle authorisations of DoLS applications.
The findings of the CQC and CSSIW reflect those of a report by the Mental Health Alliance in July 2010 which called for a review of the safeguards.
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