Deprivation of Liberty Safeguards (DoLS): A Complete Guide for Care Providers
If you run a care home or residential service, you have almost certainly encountered the term 'deprivation of liberty safeguards' or DoLS. Yet many care providers still find the concept confusing and the process burdensome. This comprehensive guide demystifies DoLS, explains when they apply, how the authorisation process works, and what you need to do to comply with your legal obligations.
If you have questions, contact Care Sync Experts today. Our team has extensive experience supporting care providers through DoLS authorisation and CQC compliance.
What Are Deprivation of Liberty Safeguards?
Deprivation of Liberty Safeguards (DoLS) are legal protections for people who lack capacity and are deprived of their liberty in care homes and hospitals. They exist under Schedule A1 of the Mental Capacity Act 2005, and their purpose is to ensure that deprivations of liberty are authorised, reviewed, and managed in accordance with the law.
A deprivation of liberty occurs when a person is not free to leave a place and is under continuous supervision and control. DoLS provides a legal framework within which care providers can operate when this is necessary, and they protect both the person lacking capacity and the care provider from challenges to the legality of the arrangement.
The Legal Framework: Schedule A1 of the Mental Capacity Act 2005
The Mental Capacity Act 2005 is the cornerstone of capacity law in England and Wales. Schedule A1, added by the Mental Health Act 2007, created DoLS specifically to address the gap left by the Bournewood case, which revealed that the previous legal framework did not adequately protect people who lacked capacity and were deprived of their liberty. The Bournewood case concerned a man who lacked capacity and was admitted informally to a mental health hospital. His family sought to challenge the admission, but the hospital argued that because he was willing to remain, there was no deprivation of liberty. The House of Lords agreed, leaving a significant legal gap. DoLS were introduced to fill this gap and ensure that people who lack capacity and are deprived of their liberty have legal protection, regardless of whether they are willing or compliant with their placement. For more information, see our page on the Mental Capacity Act.
The Acid Test: What Constitutes Deprivation of Liberty?
One of the most challenging aspects of DoLS is determining whether a particular situation actually constitutes a deprivation of liberty. The courts have provided guidance through the 'acid test' established in the case of Cheshire West and Chester Council v P.
The Cheshire West Acid Test
According to the Cheshire West ruling, a deprivation of liberty exists where the following two conditions are both met:
The person is under continuous supervision and control
The person is not free to leave
Both conditions must be present. If either is absent, there is no deprivation of liberty and DoLS do not apply.
Applying the Acid Test in Practice
Understanding these criteria in practice is essential because they determine whether you need to seek a DoLS authorisation. Consider these scenarios:
A person in a care home who has doors they can open, who is supported to attend activities in the community, and who is encouraged to make choices, even if staff monitor them closely. If the person is physically free to leave the building, there is likely no deprivation of liberty.
A person in a care home where doors are locked, where they are not supported to leave, where all outings are supervised, and where they attempt to leave but are prevented. This is clearly a deprivation of liberty.
A person receiving domiciliary (community) care who is supervised during the day but free to leave at any time. Domiciliary care does not typically involve deprivation of liberty, even if supervision is intensive.
The acid test requires a holistic assessment of the person's actual experience, not just their willingness or capacity. CQC and local authorities expect care providers to make careful judgements about whether the acid test is met.
Who Do Deprivation of Liberty Safeguards Apply To?
DoLS apply specifically to people who:
Lack capacity to consent to their care or residence
Are deprived of their liberty (as defined by the acid test)
Are residing in a care home or hospital
Care Homes and Hospitals
DoLS are designed for residential settings. They apply to standard care homes, nursing homes, and hospitals. They do not apply to domiciliary care settings where the person is living in their own home, even if care is intensive.
Domiciliary Care and Supported Living
If a person requires deprivation of liberty safeguards in domiciliary care or supported living accommodation, the process is different. The deprivation of liberty must be authorised through the Court of Protection rather than through the DoLS process. Additionally, the Mental Capacity (Amendment) Act 2019 introduced the streamlined 'Re X' procedure for some cases, which provides a faster route to authorisation.
If you provide domiciliary care or supported living services and suspect that a person may be deprived of their liberty, you should seek legal advice about whether a Court of Protection application is required.
How to Start a Supported Living Service
Planning a supported living service? Learn what CQC expects, how to structure your service, and the steps to get registered and operational.
The Deprivation of Liberty Safeguards Process
The DoLS process consists of several stages. Understanding each stage is crucial to ensuring you comply with the law and protect both the person and your organisation.
Step 1: Standard Authorisation Request
If you identify that a person meets the acid test for deprivation of liberty, you must request a standard authorisation from the supervisory body. The supervisory body is typically the local authority for the area in which the care home is located.
Before requesting authorisation, you should seek informal agreement from the relevant person (or their family or representative if they lack capacity). Whilst DoLS can be authorised against the person's wishes, seeking buy-in at the outset helps establish a collaborative approach.
Step 3: Age Assessment
This assessment establishes that the person is 18 or over. It is straightforward and is completed by reviewing the person's date of birth.
Step 5: Best Interests Assessment
This is the most complex assessment. It determines whether it is in the person's best interests to be deprived of their liberty and accommodated in the care setting. The best interests assessor must consider whether less restrictive alternatives are available and whether the deprivation of liberty is proportionate to the risk being managed.
Step 7: No Refusals Assessment
This assessment establishes that there are no valid advance decisions or court orders that would prevent the deprivation of liberty. For example, if the person has left a valid advance decision refusing to live in a care home, an authorisation cannot be granted.
Step 2: The Six Assessments
Once you request a standard authorisation, the supervisory body must arrange for six specific assessments to be completed. These assessments determine whether a DoLS authorisation can be granted and, if so, under what conditions.
Step 4: Mental Health Assessment
This assessment determines whether the person is suffering from a mental disorder within the meaning of the Mental Health Act 1983. The assessment is carried out by a doctor approved under the Mental Health Act (usually a consultant psychiatrist or experienced mental health doctor).
Step 6: Eligibility Assessment
This assessment determines whether the person is eligible for a DoLS authorisation. Eligibility can be complex because a person may not be eligible if, for example, they are currently detained under the Mental Health Act.
The Six Assessments Explained: Who Conducts Each and What They Involve
Each of the six assessments is conducted by different professionals, and each requires specific expertise and knowledge.
Age Assessment and Mental Health Assessment
These are typically conducted quickly. Age assessment simply requires confirmation of the person's date of birth. Mental health assessment is more involved and requires a doctor's clinical judgement about whether the person has a diagnosable mental disorder.
Mental Capacity Assessment
The mental capacity assessor must apply the test for capacity set out in the Mental Capacity Act. Capacity is issue-specific, so the assessor must determine whether the person lacks capacity specifically in relation to residing in the care home for the purpose of receiving care.
Best Interests Assessment
This is the most critical assessment. The best interests assessor must investigate whether the person's wishes and feelings are known, consider their values and beliefs, involve family members and carers, and explore whether less restrictive alternatives could meet the person's needs.
Eligibility and No Refusals Assessment
These assessments are technical but essential. The eligibility assessor must determine whether the person meets all the eligibility criteria. The no refusals assessor must check whether there are any advance decisions, valid statements under a lasting power of attorney, or court orders that would prevent the authorisation.
Who Grants Deprivation of Liberty Safeguards Authorisation?
The supervisory body is responsible for granting DoLS authorisations. The supervisory body is the local authority for the area in which the care home is located. The supervisory body appoints the assessors, receives their reports, and makes the final decision about whether to grant authorisation.
The Supervisory Body Role
The supervisory body must ensure that all six assessments are completed within prescribed timescales. If the supervisory body is satisfied that the person meets all criteria and that a DoLS authorisation is appropriate, it will grant an authorisation. An authorisation typically lasts for 12 months, after which it must be reviewed and renewed if necessary.
The Managing Authority Role
Your care home is the 'managing authority'. This means you are responsible for identifying when DoLS may be required, for requesting authorisation from the supervisory body, and for implementing the terms of any authorisation granted.
Urgent Authorisation
If you believe that a person should be placed immediately and there is not time to complete the standard authorisation process (which typically takes several months), you can request an urgent authorisation. An urgent authorisation can last up to seven days (or longer in certain circumstances) and gives you a legal basis to place the person whilst the standard authorisation is being processed..
Urgent authorisation can only be requested if placement is necessary because there is a risk of serious harm. This is a high threshold and is not used routinely.
Liberty Protection Safeguards (LPS): The Planned Replacement
The Mental Capacity (Amendment) Act 2019 introduced Liberty Protection Safeguards (LPS), which are intended to replace DoLS. However, as of early 2026, LPS has not yet been implemented. The implementation has been delayed several times, and no confirmed date has been announced.
Key Differences Between DoLS and LPS
When LPS is implemented, there will be significant changes:
LPS will apply to both residential and non-residential settings, including domiciliary care and supported living
The authorisation process will be streamlined
The concept of the 'deprivation of liberty' will be refined
Assessments will focus on whether restrictions or conditions are necessary and proportionate
What Care Providers Should Do Now
Whilst LPS has not yet been implemented, care providers should:
Continue to comply with DoLS requirements as they currently stand
Monitor government updates on LPS implementation
Ensure that their governance and record-keeping systems are robust enough to adapt to the new regime when it is introduced
Seek training and guidance on LPS when it is eventually implemented
CQC and Deprivation of Liberty Safeguards
The Care Quality Commission (CQC) has clear expectations about how care providers should manage DoLS. During inspection, CQC will examine whether you have identified DoLS appropriately and whether authorisations are in place where required.
During inspection, CQC inspectors will:
Ask whether you have identified people who may be deprived of their liberty
Review your DoLS applications and authorisations
Check whether authorisations are renewed before they expire
Examine whether conditions imposed in authorisations are being met
Speak with people who are subject to DoLS to understand their experience
Check whether there is evidence of involvement with relevant person's representatives and IMCAs
Regulation 11 and Regulation 13
DoLS compliance relates directly to your obligations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 11 requires you to ensure that people are protected from abuse and harm, and Regulation 13 requires you to ensure that people's rights and freedoms are respected. Failure to manage DoLS appropriately can constitute a breach of these fundamental standards.
Notification Requirements
You must notify CQC of any DoLS authorisations that are granted. This notification should be made when the authorisation is first granted and when any significant changes occur. For more information on CQC notifications, see our page on CQC notifications.
Common Mistakes Care Providers Make with DoLS
Understanding where other providers have stumbled can help you avoid the same pitfalls.
Failing to Apply the Acid Test Correctly
Many care providers do not properly apply the acid test. They either over-identify deprivation of liberty (applying for authorisation when it is not legally required) or under-identify it (failing to seek authorisation when they should). The acid test requires careful, individualized assessment of whether the person is under continuous supervision and control AND is not free to leave.
Applying DoLS to the Wrong Settings
DoLS apply to care homes and hospitals, not to domiciliary care. Some care providers running community services have incorrectly applied for DoLS when a Court of Protection application would be required.
Failing to Renew Authorisations
DoLS authorisations expire, usually after 12 months. Many care providers fail to renew them in time, leaving the person without a legal basis for the deprivation of liberty. This is a serious breach of Regulation 11 and can result in safeguarding concerns being raised.
Not Involving the Person or Their Family
DoLS is a legal process, but it should not be purely bureaucratic. The person subject to the authorisation and their family should be involved in the process, kept informed of progress, and supported to understand what the authorisation means. Failure to involve people can lead to safeguarding concerns and poor inspection ratings.
Inadequate Record-Keeping
CQC expects to see clear evidence of your DoLS applications, the decisions made, and how conditions are being met. Inadequate record-keeping makes it difficult to demonstrate compliance.
How Care Sync Experts Can Help
Care Sync Experts specialises in helping care providers understand and implement DoLS correctly. Our services include:
Mental Capacity Act training for all staff on the principles of the Act and DoLS requirements
Safeguarding adults support including DoLS policy development and implementation
Audit of your current DoLS applications and authorisations to identify any lapses or errors
Support in preparing evidence for CQC inspection relating to DoLS compliance
Advice on capacity assessment and best interests decision-making
Support with domiciliary care and supported living services on Court of Protection applications
CareSync Expert
If you need support with DoLS or any other aspect of mental capacity law, contact Care Sync Experts today. Our team can provide training, audit, and practical support to ensure you are meeting all your DoLS obligations.
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