In August 2024, the nursing home asked for my consent to apply for a Deprivation of Liberty Safeguards (DoLS) assessment for my husband. His physical, cognitive, and mental condition was deteriorating, and he was increasingly putting himself at risk at home. We made the decision that he needed to go into a residential care home as I could no longer meet his needs at home.
My Initial Concerns
At first, I was deeply unsettled by the idea and it sounded so harsh. Did this mean my husband was no longer just a resident but a prisoner with no release date? I worried that I was signing away his freedom and that this process would add unnecessary stress to an already difficult and stressful situation.
The nursing home explained that they had a legal duty of care to my husband. Without a DoLS in place, they would have fewer legal rights especially if he became uncooperative. What this meant in reality is he was in a closed unit which prevented him from walking off to protect him from harm.
Understanding DoLS: My Research and Reassurance
I needed answers before making a decision. Could the assessment be done without my husband present to spare him stress? (No, it must be done with him.) What did it really mean for him? (It was more about protecting his rights than restricting them.)
I found the Age UK factsheet helpful and also spoke with Good Company, who reassured me that this wasn’t about taking away his liberty but more about protecting it.
With that in mind - and because I feared the nursing home might ask my husband to leave if I didn’t consent - I agreed to the assessment.
Lessons Learnt
DoLS is not about locking people away - it’s a legal safeguard to ensure that any restrictions in place are truly necessary for their safety and does not inappropriately restrict their freedom.
Even if family members don’t agree, the DoLS process will still go ahead. However, it can be challenged in the Court of Protection.
The Best Interests Assessor (BIA) makes the final decision, considering input from family, the nursing home, and medical professionals.
If a family member or friend does have an LPA for Health and Welfare, their role is to nominate a representative. If no one has the LPA then the BIA also makes this decision.
Tips for a Smoother Process
Having lived through this experience, I now realise how important preparation is. Here are my key takeaways for anyone going through the same situation:
1. Meet with the Care Home Early
Request a face-to-face meeting with the care home staff to discuss DoLS and what it means in practical terms for the person in care. This will help you ensure that any decisions you make are truly in their best interests.
📌 Note: Care home staff may only know the basics about DoLS, as their role is primarily to trigger the application and provide information to the Best Interests Assessor (BIA).
2. Ask for the List of Questions in Advance
If possible, prepare the person in care before the assessment. When my husband was asked unexpected questions, it triggered anxiety.
📌 Note: Assessors don’t always contact family members in advance. If you want to be involved, make sure the care home notes this in the application.
3. Confirm the Assessment Date Directly
In my case, the local authority informed the care home, not me. I had to chase them to rearrange the appointment.
📌 Tip: If you want to be there, ask for direct communication from the local authority, not just second-hand updates from the care home.
4. Specify That You Want to Be Present
A psychiatrist and a social worker usually conduct the assessment. In my husband’s case, a psychiatrist arrived unannounced and began the process without me. No one challenged this, even though it should not have happened.
📌 Tip: While the Best Interests Assessor (BIA) usually arranges a suitable time, the psychiatrist assessing mental capacity may turn up unannounced. Unfortunately, families don’t get much control over this.
5. Talk to the Assessors Beforehand
Let them know if the person in care might need breaks or if certain topics could cause distress.
In my husband's case, the assessor kept mentioning locked doors, which he had not previously noticed. This caused unnecessary distress. While I understand the legal requirement to check whether a person is “under constant supervision and control and not free to leave,” how questions are asked matters.
📌 Tip: If you’re present, you can guide the assessor on how to phrase things sensitively.
6. Manage Your ‘What If’ Thoughts
I spent a lot of time worrying about worst-case scenarios:
What if my limited knowledge of DoLS led to negative consequences for my husband?
What if he was moved to a home that didn’t follow best practices?
What if I became unwell and couldn’t advocate for him?
These thoughts are natural, but I wish I had recognised them earlier and found a way to manage them more effectively.
📌 Key Reassurance: The DoLS team cannot force someone to move homes—that would require a separate social work assessment. If you feel unable to check in on how DoLS is being implemented, you can request an Independent Mental Capacity Advocate (IMCA) to visit every three months.
My Final Thoughts
The Deprivation of Liberty Safeguards (DoLS) process is often misunderstood. It’s not about restricting freedom but about ensuring that any restrictions are justified, appropriate, and in the person’s best interests. There has been an ongoing discussion to make the process less cumbersome and change the name to Liberty Protection Safeguards (LPS) which sounds much nicer. I hope this is something the Government does tick off their to-do list soon.
For anyone going through this process, my biggest advice is: ask questions, request involvement, and prepare in advance. With the right approach, DoLS can be a positive safeguard rather than a cause for distress.
If you’re facing this process and need support, reach out to Good Company - they were a huge help to me.
📞 07472 564519
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