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The Care Quality Commission today (15 March) publishes its first monitoring report on the implementation of the Deprivation of Liberty Safeguards, which protect the rights of people in care homes and hospitals who lack the mental capacity to consent to their care or treatment. They include people with dementia or a learning disability.

An application must be made for authorisation to impose restrictions on someone that may amount to a deprivation of their liberty. Authorisation is granted only if the proposed course of action is considered to be in their best interests and there is no other way to care for them or safely provide treatment.

The safeguards became law in April 2009 as part of the Mental Capacity Act 2005. A care home or hospital must apply for authorisation if they propose to deprive someone of their liberty by, for instance:

• keeping them locked in;
• physically restraining them;
• placing them under high-levels of supervision;
• forcibly giving them medication;
• preventing them from seeing relatives and friends.

Applications by care homes must be made to the council with responsibility for social services in their area, and hospitals must apply to their primary care trust (PCT). The council or PCT must carry out assessments of the person involved before deciding whether to authorise the proposed action.

The role of the Care Quality Commission (CQC) is to monitor, and report to the Secretary of State for Health, on how the safeguards are being implemented.

In its report on the first year of the safeguards, to the end of March 2010, CQC says there were variations in their implementation across England. In some care homes and hospitals a lack of awareness and training among managers and staff was evident. Some councils and PCTs had not progressed as well as others in setting up the mechanisms needed to deal properly with applications.

Cynthia Bower, CQC’s chief executive, said: “The Deprivation of Liberty Safeguards are an important piece of legislation designed to protect the human rights of this particular group of vulnerable people.

“Care homes and hospitals should always seek to use the least restrictive ways of caring for people. If they believe there is no alternative to depriving someone of their liberty, and it is in the person’s best interests, it is their responsibility to seek authorisation though the safeguards process.

“This was the first year of implementation of the safeguards, and all the organisations involved were feeling their way to an extent. But it is essential for those who need this protection that we all learn very quickly and make sure the safeguards are implemented fully throughout the country.” 

Notes to editor

CQC’s report, The operation of the Deprivation of Liberty Safeguards in England, 2009/10, can be found on our website here.

From April 2012, councils with social services responsibilities will take on the duty to determine Deprivation of Liberty Safeguards applications from hospitals, as well as those from care homes.

For further information please contact the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England. Our aim is to make sure that better care is provided for everyone, whether it is in hospital, in care homes, in people’s own homes, or anywhere else that care is provided. We also seek to protect the interests of people whose rights are restricted under the Mental Health Act. We promote the rights and interests of people who use services and we have a wide range of enforcement powers to take action on their behalf if services are unacceptably poor.

We are introducing a new regulatory system that brings the NHS, independent healthcare and adult social care under a single set of essential standards of quality and safety for the first time. We register health and adult social care services if they meet essential standards, we monitor them to make sure that they continue to do so and we respond quickly if there are concerns that standards are not being maintained.  We rely on people who use services and those who care for and treat them to tell us about the quality and safety of services. This feedback is a vital part of our dynamic system of regulation which places the views, experiences, health and wellbeing of people who use services at its centre.