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Care in the home: carer helping elderly lady down the stairs

DoLS in focus: The role of the Managing Authority (MA)

Under DoLS, the Managing Authority (MA) is the nursing/care home or hospital providing (or going to provide) care and treatment for the relevant person. The responsibilities of the MA are outlined within the Code of Practice for DoLS (2008) and expanded on through Court of Protection (CoP) case law.

These documents require that the Managing Authority carry out its responsibilities with due care and diligence, with appropriate consultation. All decisions and actions taken should be fully documented as part of professional best practice.

UK Parliament

New official statistics for DoLS cases, 2022-23

NHS Digital has published national statistics for DoLS cases for the period April 2022 to March 2023. The report reveals that:

  • There were an estimated 300,765 requests for authorisations during 2022-23, up 11% on the previous year
  • There were 289,150 authorisations completed in 2022-23, while 126,100 remain uncompleted as of the end of the year
  • Of all DoLS applications, 56% of applications were not granted, mostly due to either change of circumstances, misapplication (requiring a community DoLS or Inherent Jurisdiction) or not meeting the assessment criteria
  • The statutory 21-day timeframe for authorisations was only met in 19% of cases
Contact meeting between relevant person and their representative

The rule 1.2 representative process explained

In Mental Capacity law, a rule 1.2 representative (or ‘1.2 rep’) performs a similar role to a Relevant Person’s Representative (RPR), but in a community setting.

The process for assigning a 1.2 rep is slightly different to that of an RPR. This is because community DoLS authorisations are authorised through the Court of Protection, and not by the Local Authority DoLS office, as is the case in hospital and care home settings.  And so a 1.2 rep will be identified and allocated through this process by those applying and agreed by the Court.

Insight and understanding: Elderly woman smiling as she looks into the distance

DoLS restrictions and the right to object

In simple terms a deprivation can be described as a restriction, while a deprivation of liberty is a restriction on everyday living. The Mental Capacity Act enacts vital safeguards and protections an individual who can not consent to their care and treatment is is deprived of said liberties. It protects the individual through upholding their rights, monitoring any form of restriction in place and striving to ensure these are proportionate, justifiable and the least restrictive option. In today’s blog, we consider what these restrictions may include, and the importance of keeping the individual’s voice at the heart of any Best Interest decision.

Retaining information: man looking out of window

DoLS placements, best interest and the ‘least restrictive option’

There have been a number of high-profile Court of Protection (CoP) cases this year on the subject of DoLS placement and provisions. These cases each raise questions around the least restrictive option for the individual, what classes as ‘best interest’, and what do we mean by proportionate, reasonable and justifiable care.