At HMT Hospitals the needs of our patients lie at the heart of everything we do.  We pride ourselves on offering the highest levels of healthcare. Our staff are trained to provide the highest level of care with a specialist focus on dementia support.

In cases where resident’s vulnerability is increased to a point where they cannot make safe and sound judgement, our staff will take additional steps to help maintain a safe and comfortable environment for them. We adopt nationally recognised best practice to ensure the health and safety of every resident in each of our homes.

Governance around healthcare states that someone who lacks mental capacity cannot do one or more of the following four things:

•    understand information given to them
•    retain that information long enough to be able to make a decision
•    weigh up the information available and understand the consequences of the decision
•    communicate their decision – this could be by any possible means, such as talking, using sign language or even simple muscle movements like blinking an eye or squeezing a hand.

What steps do we take towards additional safeguarding?
In cases where patients lack the ability to make sound judgement, we follow a controlled process to ensure they continue to receive the care they need in a safe environment and always strive to provide care in a way that does not deprive them of their liberties. In some cases, we have a duty under the Deprivation of Liberties Act to enforce certain levels of care. This is tailored to the individual needs of the resident, examples of this may include adding a lap belt to a wheelchair, adding side rails to a bed or not allowing a resident to leave the hospital unsupervised.

Clearly this is an important decision to make and there are strict measures that we follow to ensure the process is followed correctly. Our hospital management team would apply to our local authorities for a ‘Deprivation of Liberty Safeguarding’ or DoLS, after which follows an independent assessment to ensure that the application was valid.

In an emergency, we may need to apply for an urgent DoLS whilst a formal assessment is conducted.

Who do I speak to about concerns relating to DoLS?
The best interest of residents lies at the heart of every decision we make as we strive to care and support residents in the safest environment possible. Our Hospital Directors and Matrons are always happy to speak to patients and their family about the care we provide.

Who can speak on behalf of patient with DoLS?
Any patient who is subject to DoLS must has a ‘relevant person’s representative’. This person is appointed by the local authority and will usually be a family member or friend, or it may be another carer who has been involved in the assessment.

The representative would have access to documents relating to the DoLS, have the option to ask for a review of the decision and be informed if anything changes. The representative must stay in contact with the resident who is subject to DoLS to fulfil their role and protect the rights of that person.

How is ongoing care managed?
A DoLS may be a temporary measure and all cases are reviewed on an annual basis. Regular checks will be made on the resident to ensure the authorisation is still needed and where no longer necessary, DoLS will be removed. The review is a formal process and would also be carried out should there be any change in circumstances.

The following links will provide further reading around the topic of DoLS;