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Operationalising the Deprivation of Liberty Safeguards (DoLS) in support of brain injury survivors – views from practice

Operationalising the Deprivation of Liberty Safeguards (DoLS) in support of brain injury... Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI).Design/methodology/approachA total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed.FindingsThree distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted.Research limitations/implicationsThe findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system.Originality/valueTo the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Journal of Adult Protection Emerald Publishing

Operationalising the Deprivation of Liberty Safeguards (DoLS) in support of brain injury survivors – views from practice

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Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
1466-8203
eISSN
1466-8203
DOI
10.1108/jap-02-2021-0006
Publisher site
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Abstract

Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI).Design/methodology/approachA total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed.FindingsThree distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted.Research limitations/implicationsThe findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system.Originality/valueTo the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.

Journal

The Journal of Adult Protection – Emerald Publishing

Published: Aug 11, 2021

Keywords: Decision-making; Grounded theory; Mental Capacity Act (MCA); Brain injury; Deprivation of Liberty Safeguards (DoLS); Liberty Protection Safeguards

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