Where such care amounts to a deprivation of liberty, it has to be shown to be in an individual's best interests. A care home or hospital must apply for a DoLS authorisation from a supervisory body which is always the local authority in England.
In 2021-22, the number of DoLS applications has increased by 5.5% from the previous year. The graph below shows the total applications received and the total applications completed by local authorities across England from 2013-14 to 2021-22.
There has been a huge increase of applications from 2014 which is a result of the Supreme Court judgment in the case of Cheshire West which widened the number of individuals who may be considered to be deprived of their liberty, and therefore the need for DoLS applications rose significantly.
The increase of cases in 2021-22 may be explained by the impact of the pandemic. Due to COVID-19, some aspects of the DoLS process changed in 2021-22, with the implementation of new government guidance. During the pandemic, DoLS authorisation was not required in most cases. This guidance was withdrawn on 10 August 2021 and the DoLS framework should be followed, however some practitioners may have become unfamiliar with processes.
While the last year showed a record number of applications made, the average growth rate per year is slowing down. The five-year average growth rate from 2016-17 to 2021-22 was 4.5% per year for applications made, compared to the five-year average growth rate from 2014-15 to 2019-20 which was 14%.
The total number of applications reported by local authorities as completed was 254,215 which is an increase of three per cent from the previous year. This left 124,125 applications uncompleted which if four per cent more than the end of the previous year. Interestingly, as with the previous year, 56% of completed applications in 2021-22 were not granted, with the predominant reason being there was a change in circumstance.
Other key findings
- More urgency - the proportion of DoLS applications which have an urgent authorisation attached has increased from 54% in 2020-21 to 56% in 2021-22.
- 5.8 months is the average time required to complete outstanding applications in England.
- Targets missed - only 20% of standard applications were completed within the statutory timeframe of 21 days. This has fallen from 24% the previous year.
- Turnaround time - the average length of time for all completed applications was 153 days, compared to 148 days in the previous year.
What should you do?
Local authorities may find this data useful to benchmark against other organisations in terms of the amount of applications being made and the results with previous years.
All local authorities must remember to notify the Care Quality Commission about the outcome of an application to deprive a person of their liberty.
The DoLS framework is will soon be replaced with a new scheme known as Liberty Protection Safeguards (LPS). LPS will provide protection for people aged 16 or above who are, or who need to be, deprived of their liberty in order to enable their care or treatment and lack the mental capacity to consent to their arrangements. They were due to come into force in April 2022, however this was postponsed due to pandemic-related pressures. So, local authorities should continue to focus on training practitioners on the current DoLS framework and make applications when required. This is to avoid the risk of depriving people of their liberty without proper authorisation while we await the introduction of the LPS.