If someone is deprived of their liberty in a care home or hospital, this means that:

• they cannot decide for themselves whether to stay in the hospital or care home;
• staff in the care home or hospital have control over decisions in their life; and
• they cannot leave the care home or hospital without permission.

The person being cared for and treated in this way must have a special agreement, called a DoLS authorisation, to keep them safe.

A person is eligible for DoLS if they:

• live in England or Wales;
• are aged 18 or over;
• have a mental disorder or a learning disability;
• live in a care home, or are staying in hospital, and lack the mental capacity to agree to be there; and
• need to get treatment or care that will protect them from harm.

Who are the managing authority and what do they do?

There is a code of practice that applies to DoLS. This is a book of rules that explains what should happen and tells the people involved in someone’s care what to do.

The code of practice says that the hospital or care home that is caring for or treating the person is called the ‘managing authority’. If the managing authority thinks someone needs to be deprived of their liberty, it must make sure this is allowed under DoLS.

Who are the supervisory body and what do they do?

We are the supervisory body in West Sussex. The managing authority must write to us to tell us if someone needs a DoLS authorisation.

The code of practice says we must decide whether the person needs a DoLS authorisation. We will do this by arranging for at least two people to check how they are being treated or cared for. These people are called DoLS assessors.

One of the assessors will be a doctor. They will decide whether the person is able to decide for themselves whether to stay in the care home or hospital. They will meet with the person and then give us a report.

The second assessor is called a best interests assessor (BIA). The BIA is a professional who has carried out specialist training to do this role. The BIA must be independent, which means that someone who is already involved in the person’s care can’t be the BIA.

The BIA will discuss the person’s needs with anyone who has a valid power of attorney (is legally allowed to make specific decisions for the person and act on their behalf ). If the Court of Protection has authorised someone to act on their behalf, the BIA will also work closely with that person to make sure any decisions that are made about the person’s care and support are in their best interests.

A ‘best interests’ decision can only be made for the person if they are lacking the mental capacity to decide for themselves whether to stay in the hospital or care home.

The BIA will also meet with the person to find out their views and will speak to any family members and friends who are closely involved.

The BIA will write a report to tell us if a DoLS authorisation is needed and, if so, how long it should apply for. The BIA’s report will explain if restrictions should be in place so that the person gets the care or treatment they need.

These restrictions must be:

• in the person’s best interests;
• necessary to prevent harm; and
• in proportion to the level of harm they aim to prevent.

Sometimes the BIA’s report will include ‘conditions’, which are actions that the care home or hospital must carry out.