Supreme Court ruling triggers 16-fold rise in deprivation of liberty cases in Wales

Welsh care regulator questions whether services have sufficient staff to cope with surge

A landmark Supreme Court ruling triggered a 16-fold increase in Deprivation of Liberty Safeguards (Dols) caseloads in Wales last year, new figures show.

Welsh councils and health boards received 10,679 applications to authorise care placements under the safeguards in 2014-15, up from 631 applications the year before.

The surge was triggered by the Supreme Court’s ‘Cheshire West’ ruling in March 2014, which effectively lowered the threshold for cases requiring Dols assessments.

The Dols are used to authorise deprivations of liberty in care homes and hospitals.

The figures were released by the Care and Social Services Inspectorate for Wales. The regulator said the “unprecedented” level of Dols activity raised questions over whether services had enough staff to cope and whether delays processing cases were impacting patients.

The report adds to a growing body of evidence on the ruling’s dramatic impact on services. Official figures compiled from English councils showed those services saw a tenfold increase in Dols caseloads in the year after the judgment – with applications rising from 13,700 in 2013-14 to 137,540 in 2014-15.

The Welsh figures also highlight the backlogs built up by services handling Dols cases. Councils are required by law to complete Dols applications within either seven days or 21 days. Most applications (56%) handled by Welsh services were not completed within 21 days of referral, compared to 44% in England.

The length of time Dols authorisations were in place for in Wales increased. More than half (55%) were made for the maximum 12-month period in 2014-15, up from 1% in 2013-14. Reviews were completed for 1% of Dols authorisations in 2014-15, down from 8% the previous year.

When care placements are outside of care homes and hospitals, for example supported living, any deprivation of liberty must be authorised by the Court of Protection. The Welsh inspectorate figures show these cases rose from 2 in 2013-14 to 10 in 2014-15.

In response to the pressure on deprivation of liberty teams, and the Court of Protection, the government asked the Law Commission to review the legal frameworks for authorising deprivation of liberty in care.

Last year the commission published a draft set of proposals for a scheme to replace the Dols. The government issued a critical response to the draft proposals, urging the commission to make them less complex and costly to implement. Final recommendations will be made to ministers by the end of 2016.

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