In February 2014 the Care and Social Services Inspectorate Wales (“CSSIW”) and Healthcare Inspectorate Wales (“HIW”) published its fourth annual monitoring report on “Deprivation of Liberty Safeguards: Health and Social Care” in Wales. The report analyses the key findings for the year 2012-13 and sets out the observed trends as well as areas of concern and achievements.

There were 526 applications made to supervisory bodies in Wales in 2012/2013 (compared to 545 in 2011/12). These applications were concerned with 417 individuals (compared to 428 in 2011/12). Overall the figures have been very similar in the four years that the reviews have been carried out. A total of 254 standard authorisations were granted, 182 (72%) of which were granted by local authority supervisory bodies, and 182 (28%) of which were granted by health board supervisory bodies. In care homes, 55% of the authorisations sought were granted, whereas in hospitals 43% of the authorisations sought were granted. The number of cases where the relevant person and relevant persons’ representatives received help from IMCAs fell to 70 in 2012/13 (from 75 in 2011/12).

Echoing the theme of regional variation in  the Department of Health’s report on the IMCA Service 2012/2013 (summarised above), the CSSIW and HIW report expressed concern over significant variation in the proportion of DOLS applications made and the proportion of applications that were authorised in different local areas. Some local authority areas were identified as receiving five times as many DOLS applications as others, per 100,000 population, and while some local authorities authorised most of the applications they received, others did not approve any. As these variations cannot be fully explained by demography and the geographical distribution of care services, the CSSIW and HIW have announced their intention to undertake a national review to examine the application and effectiveness of the DOLS safeguards  in Wales. This will include inspections of a sample of local authorities and health boards and further interrogation of performance information. Routine inspections of care homes will also follow up previously reported notifications of applications to use the DOLS safeguards and will look at the experience of people who have been, or should have been, subject to the safeguards. The national overview report following the review is due to be published in summer 2014.