Mental Capacity Act 2005, Deprivation of Liberty Safeguards (England), Annual Report 2015-16
This official statistics report provides the findings from the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) data collection for the period 1 April 2015 to 31 March 2016. It includes any application that was active during the reporting year. The Deprivation of Liberty Safeguards (DoLS) are a legal framework that exist to ensure that individuals who lack the mental capacity to consent to the arrangements for their care, where such care may (because of restrictions imposed on an individual’s freedom of choice or movement) amount to a “deprivation of liberty”, have the arrangements independently assessed to ensure they are in the best interests of the individual concerned .A key element of the safeguards is that health and care providers must formally apply to their local Council with Adult Social Services Responsibilities (CASSR, council or local authority) and satisfy six different assessment criteria.
The Supreme Court’s judgment of March 2014 in the case of “Cheshire West” clarified an “acid test” for what constitutes a deprivation of liberty. The acid test states that an individual who lacks the capacity to consent to the arrangements for their care and is subject to continuous supervision and control and is not free to leave their care setting, is deprived of their liberty and should be the subject of a DoLS application (where they are in a care home or hospital setting). The Supreme Court also ruled that the individual’s objection to the arrangements that amount to a deprivation of liberty is not a relevant consideration (even if the individual is not objecting, a DoLS application is required).The judgment marked a significant change to established practice.
The data used to generate this report are collated by the NHS Digital from a mandatory data collection of all councils, for all DoLS applications that were received, processed or considered to be “active” in any way between 1 April 2015 and 31 March 2016.
The data tables published alongside the report present further analyses and breakdowns of the data, including breakdowns by council and care provider (i.e. a care home, nursing home, hospital etc.).
195,840 DoLS applications were reported as having been received by councils during 2015-16. This is the most since the DoLS were introduced in 2009 and represents 454 DoLS applications received per 100,000 adults in England.
Variation is apparent between regions however, with the North East having almost three times as many received applications (900 per 100,000) compared to London (319). The remaining regions received between 400 and 500 applications per 100,000 adults in 2015-16.
Following a period of relative stability during 2013-14 (prior to the 2014 Supreme Court judgment and where the total number of applications received was 13,715), a period of month-on-month growth occurred during 2014-15. This peaked with 14,930 applications received in March 2015, before monthly figures look to have re-stabilised at just above this level throughout 2015-16.
105,055 completed applications were reported in 2015-16, compared to 62,645 in 2014-15. This represents an increase of 68 per cent and follows a 380 per cent increase in completed applications between 2013-14 and 2014-15 (from 13,040 in 2013-14).
Of the 105,055 completed applications in 2015-16, 76,530 (73 per cent) were granted and 28,530 (27 per cent) were not granted. Whilst the proportion of completed applications that have been authorised has generally shown an upward trend since DoLS were introduced in 2009, the proportion of applications that were granted in 2015-16 (73 per cent) represents a reduction compared to the proportion observed in 2014-15 of 83 per cent (52,125 of 62,645).
The North East has the highest rate of applications completed, with 665 applications per 100,000 residents. This is more than two and a half times the next highest region, the South West (258). The other eight regions display some variation, with the South East having the lowest rate of completed applications (179 per 100,000 residents).
Although the proportion of applications granted was relatively consistent across most regions, only 44 per cent were granted in the South West, whereas 86 per cent were granted in the North East and London.
Please note (07/10/16): The main publication document has been replaced to correct five figures and to make some specific changes to improve the accuracy of the wording. These are as follows:
Corrections to figures
• Page 13: The narrative content associated with Figure 1.5 has been amended to state that the South East (rather than London) received the lowest proportion of applications accompanied by an urgent authorisation (34 per cent of 32,310 applications, or 11,090 urgent applications). This text originally stated that this was London, with the following figures referenced in the text: 36 per cent, 21,420 applications and 7,680 urgent applications. The figures included within the table were correctly stated.
• Page 25: The narrative content associated with Figure 3.1 (the number of DoLS authorisations that occurred during 2015-16) incorrectly included a figure of 67,555. The correct figure was 54,765 and this has now been included in the text. This figure was also used to determine the ratio between granted and authorised applications. This was originally stated as 88% and this has now been corrected to 72%. The figure included within the chart was correctly stated as 54,765.
Amendments to wording
• Page 14: the chapter description has been amended – this previously referred to applications that were completed and signed-off and should have referred to applications that were completed and received during 2015-16.
• Page 16: two instances of the term “residents” have been changed to “adults” and a footnote has been included.
• Page 36: the definition of an active application has been brought in line with that outlined on page 5.
• Page 38: the term “people” has been changed to “adults”.
• Page 41: the narrative content associated with Figure 3.3 has been updated to reflect that the figures quoted refer to authorisations lasting for six month or less, rather than for less than six months.
NHS Digital apologise for any inconvenience caused.
Furthermore, an additional document has been added to the output set below to provide council level data around the volumes of applications completed during 2015-16, and for those not yet signed off as at the end of 2015-16, analysed by seven and twenty-one day time-scales. This file is now provided below as annex E and should support stakeholders in understanding variations in turnaround times across the country.
Please note (06/01/17): An additional comparator report which contains council level data for a number of different measures has now been published. The report allows users to compare figures for a specific council with other councils within their peer group.
This additional report can also be found on NHS Digital’s supplementary information files web page: http://content.digital.nhs.uk/suppinfofiles