The Care Quality Commission (CQC) has published its 4th annual report into Deprivation of Liberty Safeguards (DOLS) showing a sharp rise in the number of applications for people aged over 75, with dementia accounting for more than half of all applications. The CQC Chief Executive, David Behan, spoke on BBC Radio 4’s You and Yours programme on 16 January 2014 to highlight this. His view was that it demonstrated that health and social care staff were applying the relevant legislation to safeguard vulnerable patients who lack capacity to make decisions for themselves.
However, the CQC has also called for more focus on reducing the restraint and restriction on such patients, as it suggests that there are too many examples of restraint being used where it might be avoided.
The report further criticises the procedures for challenging DOLS as being ineffective. This report mirrors our own experience. There is a confusing and sometimes conflicting range of options available to deal with people who lack capacity to keep themselves safe. Some are subject to guardianship under the Mental Health Act where we can make applications to the independent Mental Health Tribunal. Some are subjected to the Deprivation of Liberty Safeguards under the Mental Capacity Act. Unfortunately these involve proceedings in the Court of Protection which, unlike the tribunal is neither quick nor cheap and lacks adequate provision for regular review. Others are simply unlawfully detained, with their freedoms controlled by care staff without any lawful authorisation or periodic review. People detained without a legal framework can be abused as we know only too well. We are regularly called on to advise on tribunal and Court of Protection cases by social workers, advocates and families. However, it is of concern that many vulnerable people are left without help because they have no support to alert us to abuse. Some have family relations who positively concur with deprivation of liberty as it gets rid of ‘the problem’.
We campaign against abuse wherever we find it and encourage anyone visiting friends or relations in care homes to be vigilant to enquire about residents who seem lonely, unloved or abused and speak out.