Understanding the Six DoLS Assessments – Detailed Breakdown and Visual Guide

Six DoLS Assessments: What Care Providers Need to Know

The Deprivation of Liberty Safeguards (DoLS) remain the legal framework used in England and Wales to protect adults who lack the mental capacity to consent to care arrangements that may deprive them of their liberty.

Although the Liberty Protection Safeguards (LPS) are expected to replace DoLS in the future, the current system remains fully operational. For care providers, understanding DoLS is not optional — it is a legal and ethical responsibility that directly affects the rights, safety, and dignity of the people they support.

At the heart of DoLS are six mandatory assessments. These assessments determine whether a deprivation of liberty is lawful, necessary, and in the person’s best interests.

But to understand why these assessments matter, it’s important to first understand how a deprivation of liberty is identified and how the application process works.

complete guide to the six dols assessment

What Is a DoLS Assessment?

A DoLS (Deprivation of Liberty Safeguards) assessment is a legal process in England and Wales that protects people who lack the mental capacity to consent to their care or treatment in a hospital or care home. It ensures a person’s liberty is not unlawfully restricted by confirming that any deprivation of liberty is necessary, proportionate, and in the individual’s best interests, with proper authorisation in place.

The DoLS Application Process

When a care home or hospital identifies that a person may be deprived of their liberty, they must apply to the local authority, known as the supervisory body.

The application triggers the DoLS assessment process.

The steps typically include:

  1. Identifying restrictions that may amount to a deprivation of liberty
  2. Completing a DoLS application form and submitting it to the local authority
  3. Supporting assessors during their visits
  4. Informing the person, their family, and representatives
  5. Implementing any conditions attached to the authorisation
  6. Reviewing restrictions regularly to ensure they remain necessary and proportionate.

Once the application is received, the local authority arranges for the six assessments to be completed. Only if all six are satisfied can a Standard Authorisation be granted.

Who Requests a DoLS Assessment?

A DoLS assessment is formally requested by the care home or hospital, known as the managing authority, when they believe a person aged 18 or over who lacks capacity is being deprived of their liberty and requires authorisation from the local authority, the supervisory body. Relatives, friends, or professionals can raise concerns and prompt an application. If concerns are not addressed, they can contact the local authority directly.

The 6 DoLS Assessments Explained

Each assessment plays a distinct role in protecting the person’s rights and ensuring that any deprivation of liberty is lawful and justified.

1. Age Assessment

The first assessment confirms that the person is 18 years or older. DoLS applies only to adults. If the person is under 18, other legal frameworks — such as the Children Act or Mental Health Act — must be used instead.

Although straightforward, this assessment ensures that DoLS is not applied inappropriately to children or young people.

2. Mental Health Assessment

A specially trained section 12‑approved doctor or another qualified medical practitioner carries out this assessment. It determines whether the person is suffering from a mental disorder as defined by the Mental Health Act 1983.

This may include:

  • Dementia
  • Learning disabilities
  • Autism
  • Brain injury
  • Mental illness

The purpose is not to diagnose but to confirm that the person’s condition meets the legal threshold for DoLS. Without this assessment, a deprivation of liberty cannot be authorised.

3. Mental Capacity Assessment

This assessment determines whether the person lacks capacity to consent to the care or treatment arrangements that amount to a deprivation of liberty.

Capacity is decision‑specific and time‑specific, so the assessor must consider whether the person can:

  • Understand the relevant information.
  • Retain it long enough to decide.
  • Weigh it as part of the decision‑making process.
  • Communicate their decision.

If the person has capacity, DoLS cannot be used, even if their decision appears unwise. This reinforces the Mental Capacity Act principle that people have the right to make decisions others may disagree with.

4. Best Interests Assessment

The best interests assessment is the most detailed and person‑centred of the six.

A trained Best Interests Assessor (BIA) evaluates whether the deprivation of liberty is:

  • In the person’s best interests.
  • Necessary to prevent harm.
  • Proportionate to the likelihood and seriousness of that harm

The assessor must consult with:

  • Family members.
  • Friends
  • Carers
  • Anyone involved in the person’s life.

They must also consider the person’s past and present wishes, feelings, values, and beliefs. If a less restrictive option exists, DoLS cannot be authorised.

5. Eligibility Assessment

This assessment checks whether the person is eligible for DoLS or whether another legal framework — particularly the Mental Health Act — should be used instead.

A person may be ineligible for DoLS if:

  • They are detained under the Mental Health Act.
  • They object to being in hospital for mental health treatment.
  • They require treatment that can only be authorised under the Mental Health Act.

This prevents legal overlap and ensures the correct framework is used.

6. No Refusals Assessment

The final assessment ensures that authorising a deprivation of liberty does not conflict with:

  • A valid Advance Decision to Refuse Treatment.
  • A decision made by a Lasting Power of Attorney (LPA) for health and welfare.
  • A ruling by the Court of Protection.

If any of these apply, a DoLS authorisation cannot be granted. This protects the person’s autonomy and ensures their legally binding wishes are respected.

When Is a DoLS Assessment Required?

A Deprivation of Liberty Safeguards (DoLS) assessment request is made by a care home or hospital when a person aged 18 or over lacks the mental capacity to consent to their care or treatment, is under continuous supervision and control, and is not free to leave. In these circumstances, formal authorisation from the local authority is required, and an urgent authorisation may be issued immediately where restrictions must be applied without delay.

What Happens After the Six DoLS Assessments Are Completed?

After the six DoLS assessments are completed, the Supervisory Body reviews the outcomes to decide whether to grant a Standard Authorisation (Form 5) or refuse it (Form 6), ensuring all legal criteria for depriving someone of liberty are met.

If authorised, the person is appointed a Relevant Person’s Representative (RPR), usually a family member or friend, and may also receive support from an IMCA.

They retain ongoing rights to request reviews, challenge the authorisation in the Court of Protection, and remain fully involved in decisions about their care.

If Authorisation Is Granted (Form 5)

  • Decision by the Supervisory Body: The Supervisory Body confirms that the person meets all legal criteria for a deprivation of liberty.
  • Appointment of RPR and IMCA: A Relevant Person’s Representative (usually a family member or friend) is appointed. If no suitable person is available, an IMCA is allocated to support the individual and safeguard their rights.
  • Information and Explanation: The person, their RPR, and the IMCA receive copies of the authorisation, along with a clear explanation of their rights.
  • Conditions and Review: Conditions may be added to ensure care remains as least restrictive as possible. The authorisation is time‑limited and must be reviewed regularly.

If Authorisation Is Denied (Form 6)

  • Process Stops: The proposed deprivation of liberty cannot go ahead.
  • Reasons Provided: The Supervisory Body explains why the criteria were not met, which may include identifying less restrictive alternatives or confirming that the person has capacity to decide.
  • Focus on Alternatives: The care plan should be adjusted to prioritise less restrictive approaches.

Ongoing Safeguards and Rights

  • Right to Challenge: The person and their RPR can challenge the authorisation in the Court of Protection.
  • Right to Review: They may request a review if circumstances change or if they disagree with the decision.
  • Advocacy and Support: The RPR and IMCA ensure the person’s wishes are represented and that they fully understand their rights throughout the process.

When Should a DoLS Assessment Be Requested?

A DoLS assessment request is made when a person in a hospital or care home lacks capacity, is under continuous supervision and control, and is not free to leave. Care providers must apply to the local authority, or the Welsh health board in Wales, to ensure any deprivation of liberty is lawful, proportionate, and in the person’s best interests.

Key Guidance from the DoLS Code of Practice

The DoLS Code of Practice provides essential guidance for professionals. Key areas include:

The Acid Test

Clear guidance on identifying a deprivation of liberty using continuous supervision and control and not being free to leave.

  • Assessment Process
    • Detailed expectations for completing the six assessments lawfully and thoroughly.
  • Best Interests
    • A strong emphasis on necessity, proportionality, and the least restrictive option.
  • Rights and Representation
    • The Code outlines the roles of:
    • Relevant Person’s Representative (RPR)
    • Independent Mental Capacity Advocate (IMCA)

Both ensure the person has support, representation, and the right to challenge authorisations in the Court of Protection.

Understanding the “Acid Test”

The Supreme Court’s landmark Cheshire West ruling introduced the “acid test” — a simple but powerful way to identify whether someone is deprived of their liberty.

According to the test, a deprivation of liberty occurs when a person:

  • Is under continuous supervision and control, and
  • Is not free to leave,
  • And lacks the mental capacity to consent to these arrangements.

This test applies regardless of the person’s compliance, comfort, or the quality of care they receive.

A person may appear content, settled, or happy — but if the acid test is met, a deprivation of liberty exists and must be authorised.

For care providers, recognising this is crucial. Many everyday care arrangements — locked doors, 1:1 supervision, restrictions on movement, or preventing someone from leaving — can meet the acid test. When they do, a DoLS application must be made.

Why These Safeguards Matter

The six assessments — supported by the Code of Practice and the wider DoLS framework — ensure that:

  • People are not deprived of their liberty unnecessarily.
  • Decisions are transparent and accountable.
  • Families and representatives are involved.
  • The person’s rights remain central.
  • Restrictions are regularly reviewed.
  • Care remains person‑centred and least restrictive.

DoLS is not just a legal process. It is a human rights safeguard that protects some of the most vulnerable people in society.

Final Thoughts

Understanding the six DoLS assessments and the wider legal framework around them is essential for every care provider.

These safeguards ensure that restrictions are used only when absolutely necessary and always in a way that respects the person’s dignity, rights, and individuality.

Ongoing learning is crucial, and care staff benefit greatly from structured training courses that deepen their confidence and competence in applying the Mental Capacity Act and DoLS correctly.

As the sector prepares for the eventual transition to LPS, strong DoLS practice remains vital.

High‑quality, rights‑focused care today lays the foundation for a smoother, more confident transition tomorrow, especially when supported by accessible, well‑designed training that helps teams stay informed and empowered.

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