The CQC has produced a third annual DOLS report relating to the 2011-12 period.2 It offers fascinating insights into the real life operation of the safeguards, with numerous examples and case studies. We cannot do justice to it in this brief summary but here are the main findings:

  • Use of DOLS increased by 27% on the previous year and over half of the requests led to an authorisation;
  • Significant regional variation continued;
  • There is still a lack of understanding of the MCA among some staff in hospitals and care homes;
  • The implications of DOLS in practice are not easy to understand, and staff in some mental health hospital wards did not understand the difference between powers under the Mental Health Act 1983 and DOLS;
  • Use of restraint is not always recognised or recorded so it is not easy to monitor;
  • Local authorities widely vary in how they carry out their supervisory body responsibilities;
  • There was very little evidence in CQC’s inspections of the involvement of people who use services and their relatives or friends in the processes of DOLS themselves, which was a significant omission.