What does DoLS stand for?

DoLS is an acronym you may have encountered in care settings or legal discussions relating to the rights of people who lack the capacity to make certain decisions for themselves. It stands for Deprivation of Liberty Safeguards. These safeguards exist to ensure that when someone lacking mental capacity is deprived of their freedom in hospital or a care home, this is done lawfully and with respect for their human rights. Understanding what DoLS means, when it applies and how it works is vital for families, care professionals and anyone concerned with protecting the autonomy and welfare of vulnerable adults.

What does DoLS stand for?
DoLS refers to a specific set of legal processes introduced under the Mental Capacity Act 2005 in England and Wales. The full title is Deprivation of Liberty Safeguards. The safeguards create a framework for authorising and reviewing arrangements that amount to a deprivation of liberty for people over eighteen who lack the capacity to consent to their care or treatment. The aim is to provide a protective procedure that balances the need for care and supervision with respect for individual rights and freedoms.

Origins and legal framework
The concept of DoLS arose after a key judgment by the Supreme Court in 2014 clarified what constitutes a deprivation of liberty in hospitals and care homes. Parliament responded by adding the safeguards to the Mental Capacity Act through the Mental Health Act 2007 (Amendment) Regulations 2009. These regulations set out who can be deprived of liberty, when authorisation is required and how authorisation is granted and reviewed. The safeguards work alongside the Human Rights Act 1998 to ensure that any deprivation of liberty is in accordance with the law, necessary and proportionate.

When do DoLS apply?
A DoLS authorisation is needed when a person:

1. Is aged eighteen or over.
2. Lacks capacity to consent to arrangements for their care or treatment.
3. Is subject to continuous supervision and control.
4. Is not free to leave the hospital or care home.
5. Is accommodated in a hospital or care home setting.

If all these conditions are met, the care provider must arrange for an authorised person, known as the supervisory body, to consider whether a deprivation of liberty can be lawfully authorised under DoLS.

Key assessments under DoLS
Before authorising a deprivation of liberty, five assessments must be carried out:

Age assessment
Confirms the individual is eighteen or over.

Mental capacity assessment
Establishes the person lacks capacity to consent to the care arrangements.

Necessary and proportionate assessment
Determines whether the proposed deprivation of liberty is necessary to prevent harm and is the least restrictive option.

Mental health assessment
Checks whether the person requires detention under the Mental Health Act instead.

Eligibility assessment
Ensures the person does not have a primary psychiatric disorder that requires a different legal framework.

Each assessment must be conducted by a trained Best Interests Assessor or a qualified health professional appointed by the supervisory body.

The role of the Best Interests Assessor
The Best Interests Assessor is central to the DoLS process. This person is independent of the hospital or care home and has specialist training. They interview the individual, their carers and anyone with an interest in the person’s welfare. They review records and observe care arrangements. Their task is to decide whether the deprivation of liberty is in the person’s best interests, whether it is necessary to prevent harm and whether it is proportionate to the likelihood and seriousness of that harm.

Authorisation and duration
If the supervisory body agrees with the assessors’ recommendations, it grants a standard authorisation, which can last up to twelve months. In urgent situations where delaying care would place the person at risk, the care provider can apply for a temporary authorisation that lasts up to seven days. Both standard and temporary authorisations must be recorded in writing, setting out the reasons for authorisation and any conditions to be met.

Review and renewal
A DoLS authorisation must be reviewed at regular intervals to ensure that the deprivation of liberty remains necessary and proportionate. The first review must take place before the initial authorisation expires. If the person continues to meet the DoLS criteria, the supervisory body can renew the authorisation for a further twelve months. If at any point the person regains capacity, or if less restrictive measures become possible, the authorisation must be terminated.

Rights of the person and advocacy
Every person subject to a DoLS authorisation has the right to be informed in a way they can understand about what is happening and why. They also have the right to challenge the authorisation. An Independent Mental Capacity Advocate (IMCA) or a paid representative can support them in making their views known to the supervisory body and, if necessary, in appealing to the Court of Protection. This ensures that the person’s voice remains central to decisions about their freedom.

When to seek legal advice
If you believe a DoLS authorisation has been wrongly applied, or that your loved one’s rights have not been upheld, you can ask the Court of Protection to review the authorisation. Grounds for appeal include failure to follow the correct procedure, flawed assessments or a lack of proper consideration for the person’s wishes and feelings. Legal advice from a specialist in mental capacity law can guide you through the process and help safeguard the person’s rights.

Challenges and reforms
DoLS have faced criticism for complex procedures and long waiting lists, which delay authorisations and reviews. In response, the government has proposed replacing DoLS with Liberty Protection Safeguards (LPS) under the Mental Capacity (Amendment) Act 2019. LPS aim to extend safeguards to settings beyond hospitals and care homes, simplify procedures and reduce delays. Until LPS come into force, DoLS remain the law and care providers must follow the current safeguards to protect individual rights.

Supporting families and carers
Caring for a loved one who lacks capacity can be emotionally taxing. Understanding the DoLS process helps families feel more in control. Local authorities and NHS trusts often provide information sessions and support groups. Carers can also access counselling, respite services and training in dementia care to manage stress. Clear communication between care providers and families reduces uncertainty and builds trust.

Emotional and psychological impact
Being deprived of liberty, even when lawful, can cause anxiety, confusion and frustration for the person affected. Care teams must offer reassurance, keep routines as consistent as possible and involve the person in daily choices. Familiar objects, family visits and personalised activities can help maintain a sense of self and dignity. Advocacy services and emotional support for staff also contribute to a more compassionate environment.

Summary
DoLS stands for Deprivation of Liberty Safeguards. These safeguards provide a legal framework to protect adults who lack capacity from unlawful detention in hospitals and care homes. The process involves detailed assessments, independent oversight by Best Interests Assessors and regular reviews. Individuals have rights to information, advocacy and appeal. While DoLS procedures can be complex, they play a vital role in balancing safety with respect for autonomy. Understanding DoLS empowers families and care providers to navigate the system with confidence, ensuring that every deprivation of liberty is lawful, necessary and in the person’s best interests.