The Deprivation of Liberty Safeguards (DoLS) have been in the news a lot over the last year because of a court ruling that has redefined the test of whether a service user’s freedom is being restricted or not. To help you to understand the implications of restraining someone, or restricting their movements, the Social Care Institute for Excellence (SCIE) has produced two new Social Care TV programmes. These will help you to think about the issues around restraint; to make sure that you protect your service users' human rights and to ensure that any best interest decisions made to restrain the person use the least restrictive option available. Read on to find out how you can use this new material in your service to ensure that you and your staff can protect and respect your service users' rights.
The court ruling, in P v Cheshire West and Chester Council (2014), found that there were two tests to decide whether a person’s freedom was being restricted. These were:
- Whether the person concerned is under continuous supervision and control?
- Is the person free to leave?
In both these cases, it doesn’t matter whether the person objects to this or not, complies or not, or the purpose behind the placement. For example, if the service user doesn’t object to you locking the door but you still lock it, you would be restricting the person’s liberty and the DoLS safeguards would apply.
What Does this Mean for Your Practice?
SCIE suggests you need to be aware of what restraint is and to talk about the subject openly and freely with your staff so that you can ensure that they protect and respect the service user’s rights. They suggest that restraint is not necessarily wrong but that discussions take place to look at the situation objectively, assess the risk to the person and mitigate against this risk, then use the least restrictive option open to you. In fact, in some cases, it might be neglectful to not restrict someone’s liberty. For example, taking the above service user, if they lived by a river and, due to their Alzheimer’s disease, had left the house and fallen in it and had to be rescued from drowning three times, then not locking their door might be considered neglectful.
What You Should Do Next
- Use the videos to help you to start talking to your staff about restraint and the problems associated with this, so they know and understand the implications of their actions.
- Go to the SCIE Social Care TV channel and view the two new videos so that you can identify the issues surrounding restraint. The videos include: ‘Restraint: A human rights issue’ and ‘Practical approaches to minimising restraint’.
- In addition, SCIE has also produced some other materials that can help you and your staff to discuss issues with restraint:
- Minimising the use of ‘restraint’ in care homes: Challenges, dilemmas and positive approaches.
- Managing risk, minimising restraint.
Make sure you are meeting all your DoLS responsibilities to affected service users: read Care Quality Matters for the latest in advice, guidance, best practice and everything else you need to pass your CQC inspections.