Monday 20 August 2018
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Applications to restrict freedom of people with illnesses like dementia and autism for their own safety have risen ten-fold since a landmark court ruling.

Deprivation of Liberty Safeguards (DoLS) provide protection for people with reduced mental capacity.

The Supreme Court ruling means every individual is entitled to their own assessment rather than a general one.

But social services directors say it has put major pressure on services as social workers carry out assessments.

The application for a DoLS is normally made by a hospital, care home or advocate for the person who has reduced mental capacity.

A report published on Monday by the Care and Social Services Inspectorate Wales (CSSIW) and Health Inspectorate Wales (HIW) also found hospitals and care homes were not always aware of their responsibilities under DoLS guidelines.
Increase

Figures obtained by BBC Wales show that since the Supreme Court ruling, there has been at least a ten-fold increase in applications for DoLS in most areas of Wales with some receiving significantly more.

Hywel Dda University Health Board, which covers Carmarthenshire, Ceredigion and Pembrokeshire, has seen applications rise to 251 between April and August compared with just 57 in 2013/14.

Betsi Cadwaladr University Health Board which covers north Wales has seen applications increase to 127 from 27 in the same period while Powys Teaching Health Board's figures have gone up from 30 to 140.

In council areas, Gwynedd had seven applications last year but 122 so far this year and Blaenau Gwent's figures have risen to 146 in the six months from April from just two in the previous year.

Councils and health boards are obliged to carry out a full DoLS assessment within 21 days, seven days if the request is urgent, and failure to adhere to these timescales could leave them vulnerable to legal challenges.
Imelda Richardson of the CSSIW CSSIW chief Imelda Richardson: "We're talking about very vulnerable people"

Liz Majer from the Association of Directors of Social Services Cymru said they had done a survey of local authorities which showed there had been a 30 fold increase in applications in a six month period, as compared to the previous year.

"Without additional resources you can understand that's had a major impact and pressure on service delivery", she said.
'Vulnerable people'

The report published by CSSIW and HIW said there needed to be a greater awareness and understanding in care homes and hospitals of how safeguards can be used to support people who lack mental capacity.

It also found training was fragmented and needed to be better co-ordinated.

CSSIW chief inspector Imelda Richardson said: "It's not unusual to have to go outside to relieve the pressure on the system by having additional staff on a temporary basis.

"If there is pressure on the system then there's going to be some time-lags.

"But it's important to try to keep within reasonable bandwidths on timescale because we're talking about very vulnerable people and the anxieties of their families."

Health Minister Mark Drakeford said: "Authorities need to be made more aware of their responsibilities and need to have reliable access to training and ongoing professional support which is focused on their particular role and responsibilities.

"An action plan has been agreed outlining the process for streamlining the DoLS process, to make it both proportionate and protective within the legal parameters and by embedding the Mental Capacity Act in relevant codes of practice."