Mental Capacity Act (MCA), Deprivation of Liberty Safeguards (DoLS) and you

The Mental Capacity Act is legislation designed to ensure that everyone over the age of 16 has the right to make choices about their own health and welfare if they are able to. It also provides a framework for what to do if you are unable to make decisions for yourself and how we can best support you.

What is 'mental capacity'?

Mental capacity is simply your ability to make a specific decision. Some people have impairments of the mind that cause them to not be able to make a decisions even with a lot of help and support. These can be temporary impairments affecting the ability to make decisions for only a short period of time, or the condition can be lifelong.

How do we assess mental capacity?

If the staff have reasonable belief that you may lack capacity, they will complete a mental capacity assessment where they will establish if you are able to make a specific decision. These are likely to be if you can decide if you want to stay in hospital for treatment or if you can decide what you want to do when you leave hospital.

What happens if you are deemed to lack mental capacity to consent to a certain decision?

If the staff discover you lack capacity to consent to a specific decision, there is a framework to establish what is in your best interests. This means that the staff, with support from others, will need to make decisions on your behalf. Your family and friends may well be included in this decision so we can ask what your views and beliefs would have been if you were able to decide for yourself. No one individual can consent on behalf of someone lacks capacity unless they have Lasting Power of Attorney or are a court appointed deputy.

Deprivation of Liberty Safeguards (DoLS)

The Deprivation of Liberty Safeguards are a part of the Mental Capacity Act and are used to protect patients over the age of 18 who lack capacity to consent to their care arrangements if these arrangements deprive them of their liberty or freedom.

In situations when you are unable to understand why you need to remain in hospital but need to stay for treatment it may be very difficult for you and your friends and family.

The Deprivation of Liberty Safeguards provide a legal framework to ensure we are abiding by the law in keeping you in hospital and that your rights are being considered.

What does this mean?

DoLS ensure that if you are confused and do not understand why you need to remain in hospital, we can keep you in the hospital safely to ensure that you get the essential treatment that you need.

It also ensures that we are abiding by the law and pay close attention to you so if you regain the capacity to decide to remain in hospital that we give you the choice, and to check that what we are doing to keep you in hospital is the least restrictive way possible, whilst keeping you safe.

What does it look like?

If the staff feel that the treatment they are giving you amounts to a deprivation of liberty they will first assess your capacity to decide if you want to stay in hospital for treatment. If you have capacity to make this decision, it is your decision to make; in such a case DoLS would not be appropriate. If you are found to not have capacity to understand why you need to stay in hospital, staff complete a form explaining the following things about you:

• why the care you are receiving is depriving you of your liberty
• why it is essential for you to remain in hospital for treatment
• what less restrictive options have been tried/ why this is the least restrictive option whilst keeping you safe

This form is sent to our Adult Safeguarding team, who decide if it is appropriate and ensure that all the above areas have been considered and it is sent to the local authority where you live.

Whilst under DoLS, you will have regular reviews by our Adult Safeguarding team to update the local authority with any changes or to ensure the restrictions are not in place any longer than they need to be.

If you or your family or friends have any questions, please speak to the nurse in charge or the Adult Safeguarding team.