For every person in a hospital or care home who lacks capacity, the following questions should be asked:
- Does the care or treatment being provided take away the person’s freedom to do what they want to do to such an extent that it amounts to a deprivation of their liberty?
- Do you believe that the care or treatment being provided is in the person’s best interests?
If the answer to these questions is ‘yes’, you need to ask yourself whether the care or treatment could be given in a way which does not deprive the person of their liberty.
If the answer to this question is ‘no’, and the person cannot be cared for or treated any other way, you must apply to the supervisory body for authorisation to continue with the care programme and deprive the person of their liberty. The supervisory body will then carry out a series of assessments to decide if it is right to deprive the person of their liberty.
The Mental Capacity Act 2005 Code of Practice [PDF 952KB] and the Deprivation of Liberty Safeguards Code of Practice [PDF 470] give guidance and information about how the act works in practice and should always be referred to.
In addition to the codes of practice there is a joint Nottingham & Nottinghamshire Deprivation of Liberty Multi Agency Policy & Procedure [PDF 464KB], which provides local guidance for everyone involved in deprivation of liberty across Nottinghamshire and should be used in conjunction with the codes of practice.
This policy and the Template DOL policy for Managing Authorities [Word 139KB], should be used to implement deprivation of liberty safeguards throughout your organisation.
If a person need to be deprived of their liberty immediately a Form 1 should be completed, this grants urgent authorisation which last for 7 days.
At the same time you must also apply for a standard authorisation using a Form 4.
If a person will need to be deprived of their liberty in the next 28 days, you must apply for a standard authorisation using Form 4.
In addition to the forms mentioned above you must also provide any other relevant information e.g. relevant care plans.
In exceptional circumstances you can use a Form 2 to apply for an extension (up to 7 days) to an urgent authorisation.
A standard authorisation can be reviewed at any time and is made by completing a Form 19.
You must make regular checks to see if the deprivation of liberty is still needed, and a request for a review must be made if there has been a change in the person’s situation that requires the authorisation to be altered, temporarily suspended or terminated altogether. This includes when the relevant person changes residence or dies.
Blank forms to download and complete:
Form 1 - Urgent authorisation [PDF 155KB]
Form 2 - Request for an extension [PDF 90KB]
Form 4 - Request for a standard authorisation [PDF 232KB]
Form 19 - Request for a review of a standard authorisation [PDF 114KB]
Completed forms for guidance:
Form 1 - example of an urgent authorisation [PDF 183KB]
Form 2 - example of a request for an extension [PDF 113KB]
Form 4 - example of a request for a standard authorisation [PDF 462KB]
Form 19 - example of a request for a review of a standard authorisation [PDF 122KB]
All completed forms should be sent to the supervisory body for where the person is ordinarily resident; for Nottinghamshire forms should be sent via fax or email wherever possible to the deprivation of liberty team:
Forms should not be posted unless in exceptional circumstances, in which case recorded mail should be used.
Each time an application is made to deprive someone of their liberty you must notify the CQC of the application and of the outcome.
This can be done by using standard forms which can be downloaded from the CQC website.