DoLS reviews, suspension and ending

How often should a DoLS be reviewed?

There's no fixed interval. A standard authorisation can be reviewed at any time, and it lasts no longer than the period set, up to 12 months. After that, a further authorisation needs the same assessments again (DoLS Code 8.1, 8.28).

Between times, the managing authority must keep the case under review. The care plan should say who monitors it and when a review is needed. If the person's condition changes often, review it more often (DoLS Code chapter 8).

Who can ask for a Part 8 review?

• The person, their RPR or the managing authority. The council must then carry out a review (Sch A1 para 102).
• The managing authority must ask if a qualifying requirement appears no longer met, or may not be (para 103(2); DoLS Code 8.5).
• An IMCA. A s39C IMCA can ask in the RPR's place, and a s39D IMCA can help the person or RPR to ask (para 159; s39D(8)).
• The council itself, at any time, at its discretion (para 102(1)).

Anyone else, such as a relative who isn't the RPR, can raise concerns with the council, which can choose to review. The managing authority uses Form 10, which the council completes with the outcome. The person or RPR can simply write.

The grounds for a DoLS review

No other ground counts (para 104(2)). Losing eligibility for other reasons, such as detention under the MHA, leads to suspension under Part 6 instead (para 91).

How a DoLS review works: step by step

1. The council tells the person, the RPR and the managing authority that it's reviewing, before it starts or as soon as practicable after (para 108).
2. It decides which requirements, if any, are reviewable. If none are, it needn't do anything more (paras 109-110).
3. It arranges a separate review assessment for each reviewable requirement (para 111). If only the conditions need changing and the change isn't significant, it can vary them without a full best interests assessment (paras 111(3)-(5), 114).
4. If any review assessment is negative, it must end the authorisation immediately (para 117).
5. If they're all positive, it updates the reasons where they've changed, and varies the conditions where appropriate (paras 115-116). Variations must be in writing (para 119).
6. It tells the managing authority, the person, the RPR and any s39D IMCA the outcome (para 120).

Ending the deprivation of liberty early

An authorisation permits a deprivation of liberty. It doesn't require one. If the hospital or home decides it's no longer necessary, it must end it immediately by changing the care. Then it should ask the council to review and end the authorisation (DoLS Code 8.8).

Fluctuating capacity needs judgement. If someone regains capacity consistently over the longer term, lift the deprivation of liberty and seek a review. If the improvement is likely to be temporary, keep the authorisation and keep it under review (DoLS Code 8.22-8.24).

Suspension when the person becomes ineligible

If the managing authority is satisfied the person no longer meets the eligibility requirement, it must tell the council, on Form 7. The commonest reason is detention under the MHA. The authorisation is suspended from when the notice is given, and stops authorising anything (Sch A1 paras 91-93, 97).

If they become eligible again within 28 days, the managing authority tells the council and the authorisation revives (paras 94-95). If not, it ceases at the end of the 28 days, counting from the day it was suspended (para 96). No review can be requested while it's suspended (para 122).

Suspension doesn't apply if they become ineligible because they now object to being in hospital for treatment of mental disorder (Sch 1A para 5). That needs an immediate review, and usually an MHA assessment (para 91(4); DoLS Code 8.21). See MHA or MCA.

When does a DoLS end?

• Its period runs out (para 64(1)).
• A review finds a requirement isn't met (para 117).
• A new authorisation for a new place comes into force (para 62(2)).
• It's been suspended for 28 days without reviving (para 96).
• The Court of Protection ends it under s21A. See section 21A.
• The person dies.

Whatever the reason, the council must tell the managing authority, the person, the RPR and everyone the BIA consulted (para 65), and records it on Form 9. The RPR's appointment ends too, unless a further authorisation follows (DoLS Code 7.29).

What happens when a DoLS expires?

The authority to deprive the person of liberty ends with it. If the deprivation of liberty carries on, it's unauthorised (DoLS Code 8.25). ADASS's view is that an authorisation shouldn't just run out: either it's renewed, or a review ends it because things have changed.

After AGNI, many people under DoLS may no longer be deprived of liberty under the new test. DHSC says councils can let those authorisations lapse, recording clear reasons. Leaving one in place while you review it isn't unlawful, and you can reduce restrictions without a review or a new authorisation.

Renewing a DoLS: further authorisations

If the person still needs to be deprived of liberty, the managing authority requests a further standard authorisation on Form 2. It should start as soon as the current one ends (DoLS Code 8.26). There's no statutory limit on how early, but not so early that the assessment can't be accurate (DoLS Code 8.27, 3.19).

The same six assessments apply, though some may be equivalent assessments. ADASS recommends identifying renewals at least 28 days ahead, and making sure there's never a gap where Court of Protection proceedings are running. See standard authorisations.

Deaths under DoLS: Form 12 and the coroner

When someone dies under DoLS, tell the council, which records the end of the authorisation on Form 9.

The 2015 Form 12 says the managing authority must notify the coroner before the death certificate is signed, so the coroner can investigate a death in state detention. That's out of date. Since 3 April 2017, someone deprived of liberty under DoLS, a Court of Protection order or s4B isn't in state detention. That's s48(2A) of the Coroners and Justice Act 2009, added by s178 of the Policing and Crime Act 2017.

So being under DoLS doesn't, on its own, mean the death goes to the coroner. Report it on the usual grounds, such as a violent or unnatural death or an unknown cause (CJA 2009 s1(2)). Check your trust's or council's policy, which may predate the change.