Deprivation of Liberty Safeguards (DoLS) Audit - Care Homes
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- Q1: Is there a current DoLS policy in place that reflects MCA principles and CQC regulatory requirements?
- Q2: Are all staff trained in the Mental Capacity Act (MCA) and DoLS, with refresher training completed regularly?
- Q3: Are residents regularly assessed for capacity to consent to care and accommodation using a clear, documented process?
- Q4: Is a Best Interest decision made and recorded if a resident lacks capacity, involving the appropriate parties?
- Q5: Is there a centralised and up-to-date log of all DoLS applications, authorisations, expiry dates, and conditions?
- Q6: Are urgent DoLS authorisations completed correctly when immediate restrictions are necessary?
- Q7: Are standard DoLS applications submitted in a timely manner where restrictions are ongoing or planned?
- Q8: Are all DoLS authorisations visibly documented in the care plan and communicated to staff involved in the resident’s care?
- Q9: Are any conditions attached to the DoLS authorisation clearly noted, with a named person responsible for compliance?
- Q10: Are DoLS renewals tracked and re-applied for in advance of expiry, with no unlawful gaps in authorisation?
- Q11: Are relatives, advocates, or IMCAs involved where appropriate, and is their input documented in the decision-making process?
- Q12: Are restrictions (e.g., locked doors, 1:1 supervision, bedrails, sensor mats) clearly justified and least-restrictive in nature?
- Q13: Are daily care practices consistent with the authorised DoLS and the least-restrictive principle?
- Q14: Is there evidence of regular review of restrictions to assess if they are still necessary or can be reduced?
- Q15: Are staff aware of which residents are subject to a DoLS and what that means for their care approach?
- Q16: Is there clear documentation of efforts made to involve the resident in decisions to the fullest extent possible?
- Q17: Are residents supported to maintain freedom of movement, privacy, and autonomy wherever safe and appropriate?
- Q18: Is the person’s right to challenge the DoLS (e.g., through the Court of Protection) explained and recorded?
- Q19: Is advocacy support (e.g., IMCA) sought and documented where the resident has no family or friends involved?
- Q20: Is there evidence that families are informed about the DoLS process and their rights to appeal or discuss the decision?
- Q21: Are incident reports reviewed to identify any unauthorised or disproportionate restrictions that may require a DoLS application?
- Q22: Are DoLS-related decisions reviewed at every care plan review or following a significant change in needs?
- Q23: Is the use of restraint, physical or chemical, recorded and evaluated in the context of MCA and DoLS compliance?
- Q24: Are mental health needs, dementia, or acquired brain injuries considered when assessing for deprivation of liberty?
- Q25: Are residents supported in making decisions where they have fluctuating capacity, with evidence of time and support given?
- Q26: Are DoLS audits conducted internally or through governance to ensure ongoing compliance and CQC readiness?
- Q27: Is there a named lead or designated person responsible for coordinating DoLS compliance in the home?
- Q28: Is MCA/DoLS discussed regularly in team meetings, supervision, and clinical governance forums?
- Q29: Are staff able to describe what constitutes a deprivation of liberty and when to escalate a concern?
- Q30: Is there evidence of legal advice being sought when there is uncertainty about restrictions or capacity decisions?
- Q31: Are digital records secure, and is access to DoLS documentation appropriately restricted and monitored?
- Q32: Are transitions (e.g., hospital discharge, readmission, or move to another home) reviewed for DoLS continuity?
- Q33: Is the home prepared for the upcoming Liberty Protection Safeguards (LPS) implementation with awareness-raising in place?
- Q34: Are actions taken when a resident’s needs change significantly, potentially requiring an amended or new DoLS?