5.3 Describe own responsibilities in relation to restrictive practices and deprivations of liberty

This guide will help you answer 5.3 Describe own responsibilities in relation to restrictive practices and deprivations of liberty.

People receiving adult care support have the right to live as independently as possible. Sometimes, restrictions are put in place to keep individuals safe, but these must be balanced against their rights and freedoms. As a manager or leader in adult care, you play a key part in recognising, monitoring and justifying any restrictive practice or deprivation of liberty.

What are Restrictive Practices?

A restrictive practice is any action that limits a person’s freedom of movement or choice. Examples can include locking doors, using bed rails, or physically holding someone to prevent harm.

Types of restrictive practice:

• Physical (manual restraint or use of barriers)
• Mechanical (using equipment, such as lap belts)
• Chemical (using medication to control behaviour)
• Environmental (restricting access to certain areas)
• Psychological (using threats, intimidation or coercion)

Sometimes minor restrictions are used to reduce risk, but every restriction must have a clear, legal, and ethical reason. The aim is always to keep restrictions to the lowest possible level and for the shortest possible time.

What is Deprivation of Liberty?

Deprivation of liberty means that someone is kept under continuous supervision and is not free to leave the care setting. In English law, the Mental Capacity Act 2005 and its Deprivation of Liberty Safeguards (DoLS) set out how and when this can happen.

Key features of deprivation of liberty:

• The person is under continuous supervision or control.
• The person is not free to leave.
• The care arrangement is set up by someone other than the person.
• The person lacks capacity to consent to these arrangements.

As a leader or manager, it is your job to know when your service might be depriving someone of their liberty, even if it is for their own safety.

Legal and Ethical Responsibilities

Legal responsibilities include:

• Following the Human Rights Act 1998. Article 5 states every person has the right to liberty and security.
• Respecting the Mental Capacity Act 2005. This gives people the right to make their own decisions where possible. If someone lacks capacity, decisions must be made in their best interests.
• Complying with Deprivation of Liberty Safeguards where they apply, for people in hospitals or care homes.

Ethical responsibilities mean putting the person first, respecting their dignity, and using the least restrictive measures. Always challenge and reduce unnecessary restrictions. Any restrictions used must be proportionate, necessary and in the person’s best interests.

Duties in Daily Practice

You have clear duties in your management or leadership role.

Key duties include:

• Recognise restrictive practices: Know what counts as a restriction. Train your staff and look critically at care plans.
• Review restrictions regularly: Keep restrictions to a minimum, review them often and remove them when possible.
• Record why and how restrictions are used: Document every restrictive measure and the reasons for it.
• Involve people: Include the person, their family or advocates in all decisions about restrictions.
• Promote independence: Support people to do as much for themselves as possible. Use positive risk-taking so people can try new things.
• Monitor staff practice: Supervise and mentor your team to avoid unnecessary restrictions.
• Report and respond: If a restriction is used for the wrong reasons, take action. Report improper restrictions using your whistleblowing or safeguarding process.

Safeguarding and Promoting Rights

Your responsibilities include protecting people from harm but also promoting their rights.

This means:

• Balancing safety with freedom
• Giving clear information about any restrictions
• Supporting people to challenge restrictions they feel are unfair
• Using advocacy where appropriate

If a person’s liberty is being restricted significantly, you have a duty to check that the right legal process is being followed. For people in care homes or hospitals, request or review a DoLS authorisation if needed.

Example scenarios:

• A person is locked in their room at night – is this necessary, and is there a less restrictive option?
• Medication is given to calm a person’s behaviour – is this really required, or are there other ways to support them?

Always question the practice and look for ways to empower the person.

Mental Capacity Act and Best Interests

Under the Mental Capacity Act, always presume a person can make their own decisions unless shown otherwise. If a restriction is being considered:

• Check whether the person can consent.
• If not, carry out a mental capacity assessment.
• Make a best interests decision involving everyone relevant – family, professionals and the person themselves wherever possible.

Best interests decisions consider:

• The person’s beliefs, values and wishes
• The least restrictive option
• What is most likely to benefit the person

For every restriction, record the decision-making steps and show clearly why it is justified.

Deprivation of Liberty Safeguards (DoLS)

If a person lacking capacity is under continuous supervision and not free to leave, apply for DoLS authorisation.

Your own responsibilities include:

• Recognising a potential deprivation of liberty situation
• Telling your senior manager or nominated individual straight away
• Completing the necessary paperwork for DoLS authorisation
• Cooperating with assessors and inspectors
• Making sure that the care team understands the DoLS authorisation and any conditions included
• Monitoring practice to ensure the authorisation is followed correctly
• Reviewing the arrangements to see if deprivation of liberty is still needed

Failure to follow DoLS can lead to legal action against your service, as well as poor outcomes for the person.

Documentation and Record Keeping

Good records are essential. They protect the person and the staff, and show that you are following the law.

Records should include:

• Details of the restriction (what, when, why, who was involved)
• Risk assessments and mental capacity assessments
• Best interests decisions
• Input from the person, their family or advocate
• Reviews and outcomes
• Any DoLS authorisation and documentation
• Evidence of efforts to reduce or end restrictions

Good documentation can protect you, your staff and your organisation if there is an audit or inspection.

Supervision, Training, and Support

Your team must understand which practices are restrictive and why they should be avoided when possible. Organising training for staff on the Mental Capacity Act, DoLS and human rights is your responsibility.

Support staff by:

• Providing updated training sessions
• Offering regular supervision to discuss issues with restrictions
• Encouraging staff to report bad practice or unsafe restrictions
• Supporting a culture where people’s rights come first
• Giving clear guidance on when and how to use restrictions in exceptional cases

Challenging and Reporting Inappropriate Practice

If you see or are told about restrictions being used in the wrong way, you must take it seriously.

Steps to take:

• Listen to concerns or reports from staff, people using the service, or their families.
• Look at the care records and talk to the people involved.
• If the restriction cannot be justified, act. This could mean retraining staff, changing practice or starting safeguarding processes.
• Use your whistleblowing policy if there are risks of harm or abuse.
• Report to CQC or the local authority if needed.

You are responsible for setting a safe, fair and accountable culture in your service.

Involving People in Decisions

People have the right to make or influence decisions about their care. You must involve them by:

• Explaining why a restriction might be needed
• Seeking their views and wishes
• Involving family, friends or advocates if the person has difficulty speaking for themselves
• Reviewing restrictions with the person
• Helping people challenge restrictions they do not agree with

This not only meets legal duties but improves well-being and trust.

Policy Development and Implementation

You are required to write, review and update policies on restrictive practices and deprivation of liberty.

A clear policy should:

• Explain what counts as a restriction
• Set out when restrictions may be used (last resort, least restrictive, best interests)
• Clarify the process for approvals and reviews
• Outline training needs for staff
• Give a reporting procedure for concerns
• State the process for DoLS applications and renewals

Communicate these policies to all staff and monitor compliance.

Promoting a Positive and Enabling Culture

As a leader or manager, you set the tone for your service. Promote a culture where people’s rights come first and where restrictions are not automatically used.

Ways to do this include:

• Modelling positive behaviour and language
• Encouraging independence, choice and participation
• Praising staff who use creative, less restrictive solutions
• Using audits to spot patterns and reduce unnecessary restrictions
• Regularly reviewing risk assessments as people’s needs change

Set clear expectations and lead by example.

Working with External Professionals

Sometimes, you will work with social workers, medical staff or legal professionals about restrictions or deprivation of liberty. You need to:

• Respond promptly to requests and share relevant information
• Participate in best interests meetings
• Follow through on recommendations and agreed actions
• Work in partnership to keep the person safe and respected

Your input is vital as you know the person and their daily routines best.

Continuous Improvement

Review incidents, complaints and audits to spot trends in the use of restrictive practices. Put improvement plans in place where needed, such as extra training or policy updates.

Ask people using your service and their families for feedback. Use their views to shape better practice.

Keep up to date with legal changes and new best practice guidance, and share what you learn with your team.

Final Thoughts

You play a pivotal part in balancing the duty to keep people safe against each person’s right to freedom and independence.

In summary, stay vigilant, act ethically, and always put the person first when considering restrictive practices or deprivation of liberty. This approach strengthens dignity, promotes well-being and meets both legal and moral duties in adult care management.