title: Deprivation of liberty safeguards: how prepared are we?
abstract: The Mental Health Act 2007 introduced Deprivation of Liberty safeguards into the Mental Capacity Act 2005 with potentially far reaching resource implications. There appears to be no scientific data regarding the prevalence of deprivation of liberty in clinical settings such as hospitals and nursing homes. We examined how many patients across a whole Trust area in Wales were subject to some lack of capacity, how well documented this was and how many were potentially deprived of their liberty. We found that no patient was deprived of their liberty, but 8% lacked capacity to make either basic or complex decisions; another 5% lacked capacity to make complex decisions. Documentation was good in mental health and community directorates, but there were gaps in documentation (not practice) in the medical and surgical directorates. Routine collection of data improved documentation regarding deprivation of liberty criteria. There is a high likelihood that senior nursing staff underestimate the number of patients who lack capacity.
authors.affiliation: Betsi Cadwaladr University Local Health Board, North Wales and University of Wales Bangor, Wrexham Academic Unit, Technology Park, Croesnewydd Road, Wrexham LL11 7TY, UK. peter.lepping@wales.nhs.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Lepping
authors.forename: Rajvinder Singh
authors.initials: RS
authors.lastname: Sambhi
authors.forename: Karen
authors.initials: K
authors.lastname: Williams-Jones
mesh_terms: D001291:Attitude of Health Personnel; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D004739:England; D005610:Freedom; D017408:Guidelines as Topic; D006801:Humans; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D028701:Patient Rights / Q000331:legislation & jurisprudence; D026684:Personal Autonomy; D019989:Persons with Intellectual Disabilities / Q000331:legislation & jurisprudence*; D012946:Social Welfare / Q000331:legislation & jurisprudence; D014852:Wales