Inspectorates call for less bureaucratic approach to DoLS in Wales

The deprivation of liberty safeguards process in Wales must become less bureaucratic, a report commissioned by the Welsh Government has found.

In their joint report the Care and Social Services Inspectorate Wales (CSSIW) and Healthcare Inspectorate Wales (HIW) said the ‘Cheshire West’ Supreme Court judgement had significantly expanded the definition of those receiving state care who should be considered as having been deprived of their liberty.

The judgement had led to a significant increase in applications for deprivation of liberty safeguards authorisations and orders in Wales, placing increased pressure on statutory bodies, the report found.

It said all relevant staff should be aware of and understand the principles and expectations of the Mental Capacity Act.

Health and social services minister Mark Drakeford said: “Being able to make choices, whenever possible, is an essential part of being human. If, however, the capacity to make and communicate decisions begins to be lost it is essential the legal frameworks designed to protect our dignity and human rights are fully employed.”

He said the report had highlighted good practice but also found that processes were “overly-complex and excessively bureaucratic”

Among its findings, the report said training and skills development for staff involved in the delivery of the Act and of deprivation of liberty safeguards “was very fragmented”, that the use of conditions attached to the safeguards “was very variable and some areas rarely used them” and that information for the public was not always clear.

The two organisations called on local authorities and health boards to audit authorisations to ensure they were used when needed, focus on improving outcomes, and to develop robust quality assurance and reporting mechanisms

HIW chief inspector Kate Chamberlain said: “The safeguards provide a framework for medical and care professionals when deciding if depriving a person of their liberty is the safest and most appropriate way to care for them.

“It is therefore vital that the safeguards are used appropriately, are well understood and embedded in every day practice.”

Mark Smulian