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DoLs focuses on restrictions, in this video, we will explore what is meant by this word and how it affects you.

The restriction means looking at whether the restriction imposed is great enough to amount to a deprivation of liberty. This will vary depending on individual circumstances.

There are many examples that could be classed as restriction such as; Where a patient or service user is being restrained in order to admit them to hospital, where medication is being given against a person’s will, or where staff are having complete control over a patient’s or service users care or movements for a long period.

The difference between restriction and deprivation of liberties is merely one of degree and intensity, staff need to consider exactly what these restrictions are and the frequency and intensity of these actions. These factors must be considered when deciding if an application of restriction is necessary.

The important thing to remember about restriction is that this should always be completed in the least restrictive way possible, and those planning care should always consider other options. If alternative options have been explored and the hospital or care home believes it is necessary to deprive a person of their liberty in order to care for them safely, then strict processes must be followed.

This is known as the Deprivation of Liberty Safeguards and is designed to ensure that a person’s loss of liberty is lawful and that they are protected.

The use of restraint would need to be appropriate, for example, this would be used to prevent harm. If restrictions and/or the use of restraint were frequent, cumulative and ongoing or if there were other factors present, it may amount to a deprivation of liberty and authorisation should be applied for.

The European Court of Human rights and UK courts have determined the number of cases of deprivation of liberty. Their judgements indicate that the following factors can be relevant to identifying whether steps taken involve more than restraint and amount to a deprivation of liberty. A list has been compiled by them but it is important to remember that this list is not exclusive; other factors may arise in future in particular cases.

We must consider;
• Use of physical restraint, including sedation. This covers where restraint is used, including sedation, to admit a person to an institution where that person is resisting admission.
• Where staff exercise complete and effective control over care and movement for a significant period
• Where staff exercise control over assessments treatments contacts and residence
• Where it is decided that a person will be prevented from leaving if they make a meaningful attempt to do so. This decision has been made by the institution that the person will not be released into the care of others, or permitted to live elsewhere unless the staff in the institution consider it appropriate.
• Where requests by carers for the person to be discharged are refused
• Where the person is unable to maintain social contacts because of restriction placed on access to other people.
• Where the person has no autonomy because they are under continuous supervision and control

Considering the points mentioned we must remember that there are no absolute definitions of restriction and deprivation of liberty, however, the code of practice says that moving from a restriction to a deprivation is a matter of degree. Each situation must be considered individually.