There has been a sharp increase in the number of applications to use deprivation of liberty safeguards for people over the age of 75, it has emerged.
The Care Quality Commission’s annual report on DoLS found overall applications increased in 2012-13, although the increase was smaller than for each of the previous three years.
DoLSs were introduced in 2009 as part of the Mental Capacity Act 2005. They are intended to ensure a care home or hospital only deprives someone lacking mental capacity of their liberty when it is in their best interests, and in a safe and correct way.
The majority of applications and authorisations granted to use DoLSs relate to older people with dementia living in care homes – in 2011-12 dementia accounted for 53 per cent of applications to use the power.
While applications to use DoLS increased by 4 per cent in 2012-13, for those aged 75 to 84, there was a 9 per cent increase in the number of applications, and among those aged over 85, a 7 per cent increase.
Since DoLS were introduced the number of applications for those aged 75 to 84 has increased by 81 per cent, and among those aged over 85, by 69 per cent.
The CQC’s report also found that the Mental Capacity Act “is still not understood and implemented consistently across health and social care services”, and that sometimes those subject to DoLS restrictions “cannot properly exercise their legal rights and cannot challenge their detention”.
In addition, two thirds of care homes and hospitals are not complying with the legal requirement to notify the CQC of the outcome of DoLS applications, according to the care regulator.
The Alzheimer’s Society said the findings indicated “a worrying lack of awareness and understanding of the use of DoLS”, and that it was “unacceptable” that a majority of providers were not following procedures.
To try to improve the safeguards’ application, the CQC has recommended that effective use of DoLS should be added to NHS England’s standard contract for providers. The regulator has also committed to strengthening its focus on DoLS as a key priority of its refreshed post-Francis inspection regime.
Paul Farmer, chief executive of the mental health charity Mind, said the variation in DoLS use was “of great concern”. However, he welcomed the CQC’s “emphasis on listening to the experiences of people who have been deprived of their liberty as a key part of their monitoring”.