Monitoring and Reviewing Restrictions

A review must be requested when any of the following 3 ground for review apply:

1. One or more of the qualifying requirements is no longer met;
2. The reason that any qualifying requirement is met has changed;
3. The conditions on the standard authorisation need amending.

The qualifying requirements

Note: A review must not be requested when the criteria for a suspension of a standard DoLS authorisation is met (see Section 4, Suspension of a standard authorisation below).

Note: A review must also not be requested if a standard authorisation is due to end and a request has been made (or is going to be made) for a further standard authorisation.

A review should be requested when any of the following apply:

1. The person no longer lacks the mental capacity to consent to the care or treatment being provided;
2. The deprivation of liberty is no longer necessary or a proportionate measure to reduce the likelihood and seriousness of harm. This could be because the level of risk has been reduced, or an alternative way of supporting the person has been identified;
3. The person has become subject to detention under the Mental Health Act 1983.

Less restrictive care or treatment

Opportunities to provide less restrictive care or treatment should always be properly explored. This includes opportunities identified by the service, but also those recommended by a professional involved with the person (for example a Psychologist or Physiotherapist).

If the opportunity appears to be viable, contact the authorising body. They will confirm whether the proposed changes can be implemented straight away or whether a review or any further action is required. Restrictions should not be in place for any longer than they are needed.

More restrictive care or treatment

The service should never increase the level of restrictions without first seeking a review. The review will determine whether the increased restrictions are in the person’s best interests and, if so, vary the authorisation accordingly.

Form 10: Review Request

Please note, before downloading the form from the government website, check whether your local authority has its own version and process that they require you to use. Some local authorities have created a specific form for requesting a standard authorisation review.

If using the government form, the sections relating to requesting a standard authorisation review must be completed. This is page 1 and 2.

There is guidance to support you to understand and complete the form:

The Mental Capacity Act Deprivation of Liberty Safeguards: Guidance to the Forms

The form must be submitted to the supervisory body in line with local processes.

The supervisory body should confirm receipt of the review request. If no such confirmation is received within 24 hours, the managing authority should contact them to make sure the request has been received.

The supervisory body is responsible for deciding whether review eligibility is met, completing the relevant review process and deciding whether the standard authorisation should remain in place or be terminated. They will record this information on pages 3 and 4 of the same form submitted to them by the managing authority.

A copy of the completed Form 10 must be provided to the managing authority and kept on the relevant person’s file.

If the standard authorisation remains in place, the supervisory body may decide to vary it to reflect any changes in circumstances. Any variations will be set out on page 4 of the form. The managing authority must make sure that individual care or support plans are updated accordingly to reflect the variations, and that staff are also made aware of the changes.

If the standard authorisation is terminated, the supervisory body must provide confirmation of this to the managing authority using an additional form - a ‘Standard Authorisation Ceased’ form. This should also be kept on the relevant person’s file.

If the supervisory body terminates the standard authorisation, the restrictions depriving the person of their liberty must end with immediate effect. The supervisory body should explain why they have terminated the standard authorisation, and offer advice about steps the service should take to provide less restrictive support.

The supervisory body will provide a copy of the completed Form 10 and the ‘Standard Authorisation Ceased’ form to the relevant person.

The managing authority (registered manager) must take reasonable steps to ensure that the person understands that the standard authorisation has been reviewed and what the effect of the variation/termination is.

The managing authority (registered manager) must complete a Suspension of Standard Authorisation Form if the relevant person becomes subject to restrictions under the Mental Health Act 1983, for example, if they are detained in hospital for assessment or treatment or if restrictions are imposed through a Guardianship or Community Treatment Order (CTO).

Form 7: Suspension of Authorisation

Please note, before downloading the form from the government website, check whether your local authority has its own version and process that they require you to use. Some local authorities have created a specific form for suspension of a standard authorisation.

If using the government form, the section relating to suspension of a standard authorisation must be completed. This is page 1.

There is guidance to support you to understand and complete the form:

The Mental Capacity Act Deprivation of Liberty Safeguards: Guidance to the Forms

The form must be submitted to the supervisory body in line with local processes.

The suspension comes into force as soon as the relevant section of the form is completed and signed by the managing authority.

No confirmation or authority is needed from the supervisory body.

A copy of the suspension must be kept on the relevant person’s file.

If, at any point in the 28 days after suspending the standard authorisation the relevant person is no longer subject to restrictions under the Mental Health Act 1983, the authorisation can be reinstated.

To reinstate the standard authorisation, the same form should be used. Page 2 should be completed with the first of the 2 available options selected.

As soon as the form has been completed and signed by the managing authority, the reinstated standard authorisation comes back into force. No confirmation or authority is needed from the supervisory body. A copy of the reinstatement must be kept on the relevant person’s file.

If, after 28 days, the relevant person is still subject to restrictions under the Mental Health Act 1983, the managing authority must advise the supervisory body of this and request that the standard authorisation be terminated.

To terminate the standard authorisation, the same form should be used. Page 2 should be completed with the second of the 2 available options selected.

As soon as the form has been completed and signed by the managing authority, the standard authorisation is permanently terminated. No confirmation or authority is needed from the supervisory body. A copy of the termination must be kept on the relevant person’s file.

Should the restrictions under the Mental Health Act 1983 be removed at any point after that, if the care or treatment can still not be provided without depriving the person of their liberty, a new standard authorisation request form must be completed.

See: The DoLS Process

Under Regulation 18 of the Care Quality Commission (Registration) Regulations 2009, the registered person must ensure that the CQC is notified whenever a person using the service dies.

See: Death of a person using the service – notification form.