Prevalence of deprivation of liberty: a survey of in-patient services

Selmes, Thomas; Robinson, Julie Ann; Mills, Elizabeth; Branton, Tim; Barlow, Jeff

doi:10.1192/pb.bp.109.025684

Cited by 6 publications

(4 citation statements)

References 4 publications

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“…Managers' understanding of the complexity of the issue was limited; the authors quoted one respondent baldly asserting, 'Deprivation of liberty speaks for itself ' (p. 290). Selmes, Roninson, Mills, Branton, and Barlow (2010) reviewed the circumstances of 55 informal mental health and learning disability patients in one health trust. Defining a DoL in terms of the presence of at least one significant safeguarding factor, 46 of these patients were being deprived of their liberty, mainly because the staff would prevent the person from taking their own discharge.…”

Section: Previous Researchmentioning

confidence: 99%

Deprivation of Liberty Safeguards: What determines the judgements of Best Interests Assessors? A factorial survey

Carpenter

Langan

Patsios

et al. 2013

Journal of Social Work

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The Deprivation of Liberty Safeguards were introduced in England and Wales to protect the interests of people with learning disabilities, dementia and neurological conditions resident in hospitals and care homes. The Safeguards apply when residents lack capacity to make decisions about their care and treatment in circumstances that may amount to a deprivation of their liberty. Best Interests Assessors must establish whether a deprivation of liberty has occurred. However, there is no definition in statute; instead, the identification of factors which define a deprivation of liberty is evolving through case law. A factorial survey was used to identify the factors which influenced the professional judgements of 93 Best Interests Assessors (three-quarters social workers) who generated 798 responses to randomly generated vignettes.Findings: Coercive staff behaviour was the strongest statistical predictor of a deprivation of liberty judgement, followed by the resident's response. Other indicators of staff control, including the use of medication to reduce agitation, restriction of movement and family unhappiness with care were also significant. The resident's condition, gender/ age and the setting were not significant predictors. Best Interests Assessors were generally confident in their decision making; there were no differences in confidence associated with Best Interests Assessors' professions.Applications: Reviews of the operation of the Safeguards stress significant complexity in defining a deprivation of liberty. Nevertheless, this study suggests that the factors which Best Interests Assessors take into account are rooted in the fundamental principles of the Safeguards and an informed appreciation of case law. Best Interests Assessors and local authorities, in their role as supervisory bodies, must keep up to date with developments.

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Section: Previous Researchmentioning

confidence: 99%

Deprivation of Liberty Safeguards: What determines the judgements of Best Interests Assessors? A factorial survey

Carpenter

Langan

Patsios

et al. 2013

Journal of Social Work

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“…Shah and Heginbotham (2010) argue that this absence of an agreed legal definition of deprivation of liberty -and potential confusion with the less coercive "restriction" of liberty -creates difficulties for practitioners in determining what constitutes the threshold for deprivation of liberty. While the DoLS Code of Practice (Ministry of Justice, 2008) states "there is no simple definition of deprivation of liberty", Selmes et al (2010) assert that this raises questions about how to decide who will require a DoLS assessment.…”

Section: No Legal Definition Of Deprivation Of Libertymentioning

confidence: 99%

“…The lawyers' expert views were based on current available case law, but they represented a divergence from Code of Practice guidance on DoLS. Selmes et al (2010) state that clinicians are anxious about being asked to apply a legal concept that has emerged from ad hoc case law into real-life clinical situations. Their study demonstrated the difficulty of clearly defining deprivation of liberty, and claimed further case law could lead to a dramatic change in deprivation of liberty prevalence.…”

Section: No Legal Definition Of Deprivation Of Libertymentioning

confidence: 99%

Deprivation of Liberty Safeguards: complexity, confusion and case law – a commentary

Lennard¹

2014

Social Care and Neurodisability

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Purpose -As a healthcare professional caring for people who lack capacity, the author has noted a wide variation in knowledge and awareness by staff of the Deprivation of Liberty Safeguards (DoLS). The purpose of this paper is to examine the DoLS and the background to their coming into being, describes their operation and qualifying requirements, and the continuing problems with their application nationwide. Design/methodology/approach -Utilising a literature search of government papers, official reports of statutory bodies, and critical studies, it examines the central criticisms of DoLS, particularly the lack of a clear statutory definition of deprivation of liberty, and reports on the wide variation in knowledge of the legislation by staff in health and social care, and uneven application of the safeguards nationwide. Findings -It cites evidence from studies showing that even professionals with high levels of expertise in the field find the legislation confusing, and presents testimony from legal experts that case law has failed to clarify the issues for professionals. Originality/value -Finally, it argues that the legislation is now too complex to successfully amend, and tentatively suggests that, pending a government review to make the process more understandable, health care professionals make 'precautionary' applications for DoLS. The author argues that, notwithstanding its faults, the process is a worthwhile exercise in care planning and ensuring that people's care is in their best interests and the least restrictive available.

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“…Thus a person's personal conviction system is part of their personal history and identity. When George Kelly 3 developed the personal construct theory he demonstrated that everyone has a personal template by which they evaluate life. If we seek to understand and respect this, we discover that we will need also to look at our own understanding because we in turn evaluate others on the basis of our own templates.…”

mentioning

confidence: 99%

When to use DoLS? A further complication

Zigmond¹

2010

Psychiatrist

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Prevalence of deprivation of liberty: a survey of in-patient services

Cited by 6 publications

References 4 publications

Deprivation of Liberty Safeguards: What determines the judgements of Best Interests Assessors? A factorial survey

Deprivation of Liberty Safeguards: What determines the judgements of Best Interests Assessors? A factorial survey

Deprivation of Liberty Safeguards: complexity, confusion and case law – a commentary

When to use DoLS? A further complication

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