When it comes to safeguarding the rights of individuals under the Mental Capacity Act (MCA) 2005, one crucial element is the Deprivation of Liberty Safeguards (DoLS). These safeguards ensure that any deprivation of liberty is in a person’s best interests and that they receive proper care and treatment. This overview outlines the six key assessments for DoLS.
1. Age Assessment
The first of the six key assessments for DoLS is the age assessment. This assessment confirms that the person is aged 18 or over. Why is age important? The DoLS safeguards only apply to adults, so children and young people under the age of 18 fall outside their remit. Instead, different legal frameworks, such as the Children Act 1989, apply to them.
- Simple but crucial: While this may seem like a straightforward step, it is critical to ensure the protections are applied correctly.
- Who conducts it?: Usually, the assessor will review identification documents, such as a birth certificate or passport, to verify age.
2. Mental Health Assessment
The second key assessment determines whether the person has a “mental disorder” as defined by the Mental Health Act 1983. This does not just refer to mental illness but includes a wider range of mental health conditions like dementia, learning disabilities, and personality disorders.
- Broad criteria: A qualified psychiatrist or a doctor with specialist training in mental disorders usually conducts this assessment.
- Purpose: It’s vital to establish whether the mental disorder impacts the person’s ability to make decisions about their care and treatment.
3. Mental Capacity Assessment
This assessment examines whether the individual lacks the capacity to make decisions about their care or treatment. Mental capacity refers to the ability to understand, retain, and use information necessary to make an informed decision.
- Two-Stage Test: The assessor must first identify if there is an impairment or disturbance in the functioning of the person’s mind or brain. If yes, then they need to determine if this impairment prevents the person from making a specific decision.
- Nuances in capacity: Remember, people might have the capacity for some decisions but lack it for others. For instance, someone might understand what meals they prefer but not comprehend the medical implications of a treatment.
4. Best Interests Assessment
The best interests assessment ensures that any deprivation of liberty is in the best interests of the person concerned. It considers whether the proposed care plan is the least restrictive option and genuinely benefits the individual.
- Holistic approach: The assessor takes into account the person’s past and present wishes, feelings, beliefs, and values. They also consult with family members, carers, and anyone else genuinely interested in the person’s welfare.
- Checklist: The best interests checklist, as stated in the MCA, provides guidance on various factors that should be considered.
5. Eligibility Assessment
The eligibility assessment involves determining whether the person is already, or should be, detained under the Mental Health Act 1983 instead of being subject to DoLS.
- Overlap with Mental Health Act: This assessment helps to avoid conflicts between legal frameworks. If someone meets the criteria for detention under the Mental Health Act, they will not be covered by DoLS.
- Independent assessment: A doctor or approved mental health professional (AMHP) usually performs this assessment. They ensure that the correct legal pathway is chosen for each person’s situation.
6. No Refusals Assessment
Lastly, the no refusals assessment ensures there are no valid advance decisions, Lasting Powers of Attorney (LPA), or court-appointed deputies that would object to the deprivation of liberty.
- Respecting wishes: If an advance decision to refuse treatment is in place, it must be respected. Likewise, if someone holds LPA for health and welfare decisions for the person, their views need to be considered.
- Legal scrutiny: This assessment also checks for any existing court orders that might counter the proposed course of action.
Why These Assessments Matter
Each of these six assessments plays a pivotal role in safeguarding a person’s liberty while ensuring they receive necessary care. Let’s dig into why they matter:
- Protection from inappropriate deprivation: Ensuring someone is only deprived of their liberty when absolutely necessary protects their basic human rights.
- Clear framework: The six key assessments provide a structured, transparent process that all professionals involved in health and social care must follow.
- Ongoing review: These assessments are not a one-time event. Regular reviews ensure that the care plan remains in the person’s best interests and adapts to any changes in their condition or circumstances.
Key Points to Remember
- Clarity and specificity: Each assessment focuses on a specific aspect of the person’s care and legal status, making sure no area is overlooked.
- Trained professionals: Different assessments may require input from various professionals, such as psychiatrists, social workers, and GPs, ensuring comprehensive evaluation.
- Legal compliance: Following the guidelines for these assessments ensures compliance with the MCA, protecting both the individual and the care providers legally and ethically.
Conclusion
The six key assessments for DoLS form an essential part of the Mental Capacity Act 2005’s framework to protect individuals who lack the capacity to make decisions regarding their care. Each assessment serves a distinct purpose, collectively ensuring that any deprivation of liberty is justified, necessary, and in the person’s best interests.
Staying informed about these assessments not only helps professionals fulfil their legal obligations but also ensures that the rights and dignity of vulnerable individuals are upheld. By adequately applying these safeguards, we can offer compassionate, respectful, and legally sound care to those who need it most.
