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Before deciding if an individual should be deprived of liberty we must complete an application for standard authorisation. The managing authority such as the registered manager of a care home, the NHS trust or the authority that manages the hospital has overall responsibility for applying for an authorisation of deprivation of liberty.

The authorisation should be completed when someone is about to be admitted or is already in a hospital or a care home. It is unlawful to deprive someone of their liberty without an authorisation in place. If an application hasn’t been completed and you feel that deprivation is occurring, then as the first point of call you will need to speak to the care or hospital manager, to see if you are able to agree on changes that can be made to reduce restrictive practices.

Before applying for a standard authorisation, we must always consider whether it is possible to provide care or treatment in such a way that they will not be deprived of their liberty.

The application for a standard authorisation must be made in writing to a supervisory body, this will be the local authority in the case of care homes and/or hospitals. The supervisory body has up to 21 calendar days to make a decision on the application.

The application itself contains information such as names, address and contact details and the date from which the authorisation is required. In also includes any relevant medical information, care plans and needs assessments, whether the person has specific communication needs and details of what restrictions on liberty are proposed.

If the supervisory body thinks that the application is appropriate, they will commission an assessment to determine whether the qualifying criteria are met and once completed they will either grant or refuse an authorisation.

This is all well and good in theory, but as we know sometimes urgent decisions are needed. In the event of an emergency, the management of the hospital and/or care home may grant itself an urgent authorisation. However, this is only possible when a standard authorisation has also been requested. The urgent authorisation is usually valid for seven days, although the supervisory body may extend this for up to another seven days in some circumstances.

If you are dealing with an emergency you must ensure that all decisions are taken in a structured way and record all reasons for decisions. You must; follow established good practice for care planning, make a proper assessment of whether the person lacks the capacity to decide whether or not to accept the care of treatment proposed, take proper steps to help the relevant person retain contact with family, friends and carers, review the care plan on an ongoing basis.

It is normal for the assessment to be completed when it is required however, it is possible for a person to make an advanced decision, if you are 18 years or over you can whilst you have the capacity. You are required to state in writing that you refuse medical treatment if you lose the capacity to make a decision. If this happens the Health Professionals need to validate the advanced decision.