DoLS Decision Tree and Recording Requests to Leave

In light of the recent Supreme Court ruling regarding Deprivation of Liberty Safeguards (DoLS), I would suggest that a decision-tree tool is developed, based on forthcoming national guidance, to support providers in determining when a DoLS authorisation may be required.

The ruling represents a significant shift in practice. The key consideration is no longer solely whether a person has the capacity to give valid consent, but whether they are genuinely accepting of their care and living arrangements. As a result, providers will need practical tools to help them make and evidence consistent, proportionate decisions on a case-by-case basis.

I would also suggest the development of a dedicated recording tile or flag within care recording systems for situations where a person expresses a wish to leave, go elsewhere, return home, or otherwise indicates dissatisfaction with their current arrangements. Going forward, providers will need to understand and monitor these requests as part of assessing whether individuals are genuinely accepting of their arrangements. There is also a need for a symbol like the butterfly for people who lack capacity as this would help care staff recognise when additional vigilance is required and ensure that any signs of dissatisfaction with care or living arrangements are recorded appropriately.

Providers will be expected to demonstrate that they are actively gathering and considering the views of people using their services. Currently, requests to leave may be recorded across multiple care notes, making them difficult to identify and monitor. A dedicated recording mechanism would enable care staff to easily flag these requests, support management oversight, and provide evidence that individuals' views are being considered as part of DoLS decision-making.