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Mental Capacity Act and DoLS

The Mental Capacity Act 2005 came into force in April 2007 to empower and protect people who do not have the ability to make their own decisions, especially about things like finance, social care, medical treatment and living arrangements.

Deprivation of Liberty Safeguards (DoLS) are intended to protect people who lack mental capacity from being detained when it is not in their best interests.

Having mental capacity means being able to understand and retain information and to make a decision based on that information. Someone might not have capacity because they have: A learning disability; Dementia; A mental health problem; A brain injury or a stroke; Are under the influence of substances such as alcohol.

Mental capacity can be temporary or permanent. Each decision must be considered separately and are specific to the time that the decision needs to be made.

The law aims to ensure that people who lack capacity to make decisions by themselves get the support they need to be as involved as possible in decisions about their lives. It also outlines how an assessment of mental capacity should be made, in which situations other people can make decisions for someone who cannot act on their own and how people can plan ahead in case they become unable to make decisions in the future.

There are five principles at the heart of MCA which should be used to underpin all actions and decisions taken in relation to those who lack capacity:

Principle 1: A presumption of capacity. Every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise. Do not assume that someone cannot make a decision for themselves just because they have a particular medical condition or disability.

Principle 2: Individuals being supported to make their own decisions. Make every effort to encourage and support people to make the decision for themselves. If lack of capacity is established, it is still important to involve the person as far as possible in making decisions.

Principle 3: Unwise decisions. People have the right to make what others might regard as an unwise or eccentric decision.

Principle 4: Best interests. If a person has been assessed as lacking capacity then any action taken, or any decision made for, or on behalf of that person, must be made in his or her best interests.

Principle 5: Less restrictive option. Someone making a decision or acting on behalf of a person who lacks capacity must consider whether it is possible to decide or act in a way that would interfere less with the person’s rights and freedoms of action, or whether there is a need to decide or act at all.

The Deprivation of Liberty Safeguards (DoLS) is the procedure prescribed in law when it is necessary to deprive of their liberty a resident or patient who lacks capacity to consent to their care and treatment in order to keep them safe from harm and ensure that the least restrictions are placed on them.

The Deprivation of Liberty Safeguards are intended to:

  • Protect people who lack mental capacity from being detained when this is not in their best interests;
  • To prevent arbitrary detention;
  • To give people the right to challenge a decision.
  • Ensure that the least restrictions are placed upon the person.

The legislation sets out a procedure for care homes and hospitals to obtain authorisation to deprive someone of their liberty. Without that authorisation the deprivation of liberty will be unlawful. These safeguards are intended to protect people from being deprived of their liberty unless it is in their best interests to protect them from harm and there is no other less restrictive alternative.

If you think someone is being deprived of their liberty without authorisation, contact the DoLS Coordinator in the relevant area:

In April 2023 in response to our current priority to: Embed a good understanding of the Mental Capacity Act within the practice of our partners.  We ran a Mental Capacity Act survey with the aim being for the board to better understand the current support available and challenges within the partnerships for those supporting vulnerable adults in identifying and managing and supporting people with issues around mental capacity.

There were an amazing 199 responses to this survey and the results were considered by the Board in June 2023, this link provides a copy of the presentation.

Key learning from the survey was that there is a lack of confidence in practice in the:

  • Assessment of executive function when assessing capacity
  • Understanding the criteria for referring to advocacy services
  • Assessing capacity when the individual has or may have fluctuating capacity.

The key word when responding to the following question: What would help the wider safeguarding system to improve understanding and practice in relation to mental capacity? Was training, particularly scenario-based training.

In follow up to this survey the Learning and Development Subgroup will consider the partnerships training offer for mental capacity and provide recommendations to the Board.

DoLS APP –  Added February 2024

Edge have launched a DoLS App, which is available in App Stores (search DoLS App) or Google Play (search DoLS). The app contains an overview of the Deprivation of Liberty Safeguards (DoLS). Content includes: the key legal criteria such as the ‘acid test’, time limits, forms, process, and rights. It also includes numerous resources to aid learning such as short, animated videos, tables, and a quiz. Plus, links to additional free resources and one click access to the statutory Codes of Practice and our popular DoLS case law summary sheet. The App is written by the authors, Steven Richards and Aasya F Mughal.  Click here for more information: NEW DoLS APP (

Mental Capacity Act Guidance

Produced by Wokingham Borough Council and published by the SAB in February 2024, practitioners are encouraged to use the following documents to support in their application of the Mental Capacity Act. Please note that there is reference to agencies specific to Wokingham Borough Council so please ensure you refer or contact other agencies that they cover the area you are working in.

Wokingham Borough Council MCA Guidance

Wokingham Borough Council MCA Que Cards

Mental Capacity training

A 12-month rolling schedule was launched in January 2024 which provides details of Mental Capacity training open to all.

MCA training

Mental Capacity in Maternity

A practitioners experience, reflection and shared learning. Click to view a recorded webinar delivered by NHS England South East in 2023: Maternity & MCA Case study – East Safe Guarding Learning Platform

Executive Function 

This short animation has been produced for Worcestershire Safeguarding Adults Board. Professor Keith Brown, who is the  helps us to; understand what the term Executive Function means, recognise signs of decreased Executive Function and offers advice and tips about how to support someone showing signs of decline in executive function in relation to the journey of dementia.

Mental Capacity Act Guides – Added October 2022

With Bournemouth University, The National Centre for Post-Qualifying Social Work and Professional Practice, our partnerships independent chair Professor Keith Brown has produced the following guides on the application of the Mental Capacity Act:

Mental Capacity Toolkit – Added August 2022

In March 2022 Bournemouth University published a Mental Capacity Toolkit to support health and social care professionals working with individuals whose decision-making process is impaired.

The Mental Capacity Toolkit is a free resource for health and social care professionals and for friends or family who may have to make decisions on behalf of another person.

As part of a wider research project funded by the Burdett Trust for Nurses, BU developed the toolkit to enable ethical, legal, and informed professional practice and ensure professionals are confident in their understanding of the Mental Capacity Act 2005.

The toolkit contains sections of the Mental Capacity Act 2005:

  • Reflecting on values and bias within mental capacity decision making
  • The history and current context of mental capacity legislation and policy
  • The concept of mental capacity
  • Best interests
  • Supporting decision making
  • Deprivation of liberty: human rights
  • MCA in clinical decisions for care and treatment
  • MCA and the Office of the Public Guardian (OPG) role

These sections are underpinned by interactive user experiences such as videos and quizzes.

To access the Toolkit please visit:

Community DoLs (Deprivation of Liberty Safeguards)

The  Hampshire and Isle of Wight Integrated Care Board have created the following fact sheets to support individuals and their families in their understanding of the Community DoLs process.

Mental Capacity Act Code of Practice 2005

NHS Choices

39 Essex Chambers

Case Study: a practical analysis of a mental capacity assessment

When mental capacity assessments must delve beneath what people say to what they do – Community Care

Mental Capacity and Executive Functioning when there is self-neglect and or alcohol use – June 2024

This webinar was delivered by Kathy Kelly ICB Berkshire West Designate for Safeguarding Adults and Prof Keith Brown Chair of the Berkshire West Safeguarding Adults Board and Edd Bartlett MCA Lead Professional on 11th June 2024. It was created and credit to Wokingham LA Rebecca Berry and Suzanne Rhodes Adult Safeguarding Quality and Development Manager and Suzanne Rhodes DOLS Manager. The session was delivered in response a Tina SAR Recommendation:  The safeguarding adult board to request assurances that all partner agencies are trained in applying the Mental Capacity Act 2005 and completing formal Mental Capacity Assessments, specifically regarding decisional and executive capacity when working with self-neglect and alcohol use. Ensuring that local guidance and training is in place so that mental capacity assessments and reassessments are undertaken where appropriate and, in a manner consistent with the guidance set out in the Mental Capacity Act Code of Practice.

Click for: Webinar and copy of Presentation


See also the Workforce Development page of this website.