Deprivation of Liberty Safeguards – A time of change

1. Deprivation of Liberty Safeguards – A time of change Sam Cox Knowledge Officer (Legal and Welfare Rights)

2. Introduction • What are DOLS? • Is change needed - problems with the current system • The Law Commission consultation

3. What are DOLS? • An independent check to ensure that where a person’s care results in them being deprived of their liberty it is the right thing to do • It is a process of making this check • They only apply to care homes and hospitals

4. What safeguards do theyprovide? • The independent assessment by 2 professionals • If authorised will be appointed a RPR • Enable appeals • Renewal date set • Coroner’s inquest

5. A time for change?

6. THE SUN SHINE CELEBRITY NEWS AND GOSSIP WORLD EXCLUSIVES Human rights system will cripple social care

7. THE DAILY NEWS THE WORLD’S FAVOURITE NEWSPAPER www.dailynews.com - Since 1879 Human rights gone mad as used to ban family from seeing relative

8. THE SUN SHINE CELEBRITY NEWS AND GOSSIP WORLD EXCLUSIVES Families left distraught after being told they must wait months to bury loved ones

9. Law now impossible to follow leaving many people without rights

10. THE DAILY NEWS THE WORLD’S FAVOURITE NEWSPAPER www.dailynews.com - Since 1879 House of Lords say DOLS are ‘not fit for purpose’

11. Problems • System went from 12,400 applications in 2013-14 to over 113,000 in 2014-15 • Over 50% are breaching legal time scales • Funding and resources • Involvement of family • Still being misused, and are still misunderstood • Coroner’s inquests

12. The Consultation

13. Law Commission • Commissioned by government to conduct a review and propose new DOLS legislation • Consultation this summer on draft new DOLS system • End of 2016 will publish a report and draft new bill (this has changed from 2017) • This will then go back to parliament to (maybe) be enacted

14. The new system: ‘Protective care scheme’ • Supportive care • Restrictive care and treatment • Separate system for hospitals and palliative care

15. Supportive care: Criteria • Those moving into (or already living in) – care home, supported living or shared lives accommodation • Vulnerable people but not deprived of their liberty • Lack capacity to decide where they will live

16. Supportive Care – Safeguards • Confirmation that all legal safeguards have been followed (e.g. MCA, CA) • Oversight of tenancy arrangements – confirmation in care plan • Care planning safeguards must be in place • Ongoing monitoring and review • Right to advocacy and an appropriate person under the CA must be appointed

17. Restrictive care and treatment This is the direct replacement for DOLS – it aims to cover slightly more cases then just deprivation of liberty cases

18. Restrictive care and treatment: Criteria • The person is moving into (or already living in) a care home, supported living or shared lives accommodation • Restrictive care and treatment is being proposed • Person lacks capacity to consent to the care and treatment

19. Restrictive care and treatment: Safeguards • An assessment takes place which is overseen by an independent professional • Power to recommend conditions and make recommendations • Care planning safeguards • Ongoing monitoring and review • Right to appeal and tribunal • Rights to CA advocacy and an ‘appropriate person’ and RPR

20. The ‘Approved Mental Capacity Professional’ (AMCP) • Builds on BIA • All assessments referred to AMCP – note though can delegate assessments • AMCP is responsible for ongoing oversight of the restrictive care and treatment • Acting as an independent decision-maker on behalf of the local authority • Regulated by the Health and Care Professional Council and the Care Council for Wales

21. Deprivations of Liberty • The care plan is the authority for the care provider to detain the person • AMCP will need to ensure the objective medical expertise

22. Right to appeal Proposals: • A tribunal system similar to the MHA • First tier tribunal – right of access • Then right of access to upper tribunal or CoP (consultation question) • Automatic reviews for restrictive care and practice cases when no referral has been made – time limits discussed in the consultation

23. Hospitals and Palliative care Proposal of a bespoke system • May deprive someone of liberty for up to 28 days in a hospital based on the report of a registered medical practitioner • A responsible clinician must be appointed and a care plan produced • Further authorisations for a DOL would require agreement from a AMCP

24. Effect on advocacy Proposals includes: • Replacing IMCAs with CA advocates and appropriate persons • Scrapping paid RPRs – still keeping unpaid ones Will this work?

25. Other key issues: • Legal supportive decision making scheme • Reforms of the BI checklist – prioritising the person’s wishes and feelings • Deprivation of liberty at home

26. Reform of coroner’s legislation – enabling more coroner’s discretion • MHA interface • Advance decision-making and DOLS – ability to consent to a future DOL • Governance and oversight by CQC, CSSIW and HIW

27. Conclusions • Are problems with the current system • BUT – does the proposed new system solve these? • Consultation closes 2 November