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Publication, Part of

Mental Capacity Act 2005, Deprivation of Liberty Safeguards England, 2019-20

Official statistics

Introduction

A note regarding these statistics

This publication provides statistics from the Mental Capacity Act 2005, Deprivation of Liberty Safeguards data collection for the most recent financial year. DoLS are a legal framework that exist to ensure that individuals who lack the mental capacity to consent to the arrangements for their care, where such care may amount to a "deprivation of liberty", have the arrangements independently assessed to ensure they are in the best interests of the individual concerned, and to give those subject to a deprivation of liberty the means to challenge this.

This publication covers DoLS applications made to local authorities by care homes and hospitals. Data were provided by all 151 Councils with Adult Social Services Responsibility (CASSRs) - for ease of reading and consistency ‘local authority’ will be used subsequently to refer to CASSRs. Statistics on challenges to DoLS authorisations are published by the Ministry of Justice.

This publication provides analysis of all DoLS applications that were active at any stage during the period, and concentrates on six main areas of DoLS activity:

  • the demographic profile of people for whom a DoLS application was submitted, analysing data on the applications received for individuals during the period rather than the total number of applications received
  • applications received during the year, regardless of the status of the application at the end of the period
  • applications completed (i.e. signed off) during the year, regardless of when the application was received
  • applications not completed as at year end
  • analysis of the length of the application process, including compliance with the 21 day standard outlined in the Code of Practice
  • analysis of the duration (proposed and actual) of granted authorisations and the proportion of authorisations that ended early

The publication consists of:

  • tables providing data at local authority level
  • machine readable open data (csv files)
  • a data quality assessment, including data completeness and integrity measures
  • supporting information
  • the Adult Social Care Analytical Hub, an interactive business intelligence tool

In order to prevent the disclosure of individuals, figures 0, 1, 2, 3 and 4 are displayed as a "*" (star symbol) in the data tables. All other figures have been rounded to the nearest multiple of 5. Proportions (percentages) are calculated on the unrounded figures.

These statistics have not been materially impacted by the coronavirus (COVID-19) pandemic as the data period ended before the pandemic really took hold. However, due to reduced capacity at local authorities to collate the data, the data quality assessment also includes a summary of the checks taken to review the impact the pandemic period has had on data quality. 


How can the data be used?

Do use this data:

  • for monitoring trends in DoLS applications and authorisations for care homes and hospitals
  • for comparing local authorities in England
  • for comparing larger areas e.g. regions

Do not use this data:

  • for monitoring deprivations of liberty in other settings or for children
  • for inferring efficiency of local authorities
  • to make judgments about appropriateness or effectiveness of practice
  • for understanding outcomes for people who are deprived of their liberty

Background

DoLS data are collated and processed by NHS Digital from an annual mandatory data collection from all local authorities in England. The collection requires one record per DoLS application with information on; the dates that applications were received and processed, details of the key decisions made and demographic information about the individuals involved. No person identifiable data is collected.

Between April 2009 and March 2013, DoLS applications were processed by both local authorities and Primary Care Trusts (PCTs). Local authorities processed applications from care homes and PCTs processed those from hospitals. During this time, NHS Digital collected data on a quarterly basis from both local authorities and PCTs in an aggregated form. Following the abolishment of PCTs in 2013, all applications from both health and care settings have been processed by local authorities and the returns are submitted at a case level on a yearly basis. The DoLS collection has remained mandatory for all local authorities.

The collection methodology changed for the 2013-14 DoLS collection onward, following a “zero-based review” of adult social care data collections. The review considered changes in the delivery of social care and looked into what information should be provided to monitor the most important current and future priorities. The key changes introduced were to move to collecting the data annually and at a case level, rather than quarterly and in aggregate. The 2013-14 DoLS collection was developed following consideration of this feedback and was approved by the Department of Health and Social Care (DHSC), the Department of Communities and Local Government (DCLG) and other key stakeholder organisations including the Association of the Directors of Adult Social Services (ADASS).

The data collection has evolved since then in fairly minor ways, with any changes being signed-off by the appropriate governance boards, which involves a process of approval consisting of the DoLS Working Group (comprising a cohort of local authority DoLS leads and performance leads to advise on the data collection), the Adult Social Care Data Delivery Action Group (a national group overseeing adult social care data collections, publications and the working groups, and which consists of NHS Digital, ADASS, Local Government Association, Care Quality Commission and DHSC) and the Adult Social Care Data Outcomes Board (a strategic national group setting the priorities for adult social care national data collections, publications and associated developments).

Any changes to the collection are communicated to local authorities via aData Provision Notice and are also detailed in the annual ‘September Letter’ and the associated social care collection materials.

For 2019-20 three data items were removed from the DoLS data collection. These were Third Party Request Date, ‘Number of Previous DoLS Authorisations’ and ‘Duration of Entire DoLS Period’. The change was been made in accordance with the governance process of adult social care statistics, namely via the DoLS Working Group, the Data Delivery Action Group, and the Data and Outcomes Board.

In previous years there were 152 local authorities. However, on the 1st April 2019 Bournemouth and Poole merged to form the new Bournemouth, Christchurch and Poole (BCP) local authority. The inclusion of Christchurch has also reduced the size of the Dorset local authority. Therefore, care should be taken when making comparisons over time for Dorset due to such changes.

Also for this year the Adult Social Care Analytical Hub has been developed to also include historical data so that a timeseries can be seen for each local authority and each measure.


Who this publication is aimed at

This publication may be of interest to members of the public, policy officials and other stakeholders to make local and national comparisons and to monitor the quality and effectiveness of services.

In particular, local authorities may find this data helpful in shaping services and making improvements, especially in terms of benchmarking their services and comparing them with previous years or to share best practice with colleagues in other authorities.

DoLS teams across England are working to bring improvements to the DoLS processes and to service users’ quality of life and may use the data presented here to focus their efforts.

Officials in DHSC can use the data contained within this DoLS publication to make decisions about national policy and practice.

Members of the public and other stakeholders, such as charity organisations, can also use this DoLS publication to help satisfy themselves that processes are followed and that officials are acting in service users’ best interests.


Additional analysis

In previous years, prior to the publication of 2018-19 data, an annual report has formed part of this publication. This provided a broad range of in-depth analysis and commentary around the data. This is again not included this year - the publication follows the same format as last year and the data released remains the same.

Instead of providing analysis upfront, NHS Digital encourages any users wanting bespoke additional analysis to request this directly and we can work with you to understand your requirements and provide the data. We hope this will provide a more responsive and valuable service to meet your needs. Please send any such requests to enquiries@nhsdigital.nhs.uk. Where this happened last year the resulting analysis was released alongside the publication.

Please note that although the data released remains the same, the data tables were reformatted last year. The table below shows previous years’ annex tables and where they map to in the publication from 2018-19 onwards.

2018-19 onwards Up to and including 2017-18
Data Tables - Demographics Annex B
Data Tables - Applications Annex A, C, D, E, H
Data Tables - Timeframes

Annex F

CSV - Applications N/A
CSV - Demographics N/A

Data quality key information

Data quality is measured on submission of annual data by local authorities, and processes are followed to try and improve quality of data submitted. Summary measures indicate that the data submitted was valid and complete to a high degree. The quality of data has generally improved over time and therefore users should be aware of the following specific issues:

Not completed applications

As in previous years, NHS Digital has used the data available to calculate the estimated volumes of applications not completed at year end. An estimated number of applications not completed can be created by taking last year’s reported number of applications not completed, adding the number of applications received and then subtracting the number of applications completed.

This calculation produces an estimated figure greater than the equivalent figure reported by local authorities. NHS Digital has worked with local authorities to try to understand the reasons for this. From the local authorities who provided explanations for their variation, one common theme was that this variation could be explained by the figures from the previous reporting period being higher than they should have been. This was due to several reasons, such as the previous return including applications that should have had a status of Not Granted but the application was still showing as in progress, or data quality issues caused by migrating data from older reporting systems, or through duplicate recording of applications.

Variance in active authorisations

The DoLS data collection should include all applications that were active at any point in the year. During the analysis of the data, it was noticed that a number of local authorities had once again not submitted data for authorisations that had been started in the previous year but had finished in the current year. During the data validation process, many local authorities resolved this issue and included the missing authorisations for their final data return. Some local authorities reported to NHS Digital that the variance was a result of a data cleansing exercise on their 2018-19 data or that was due to a change in system supplier.  Others did not have the capacity to correct their data.

As a result, nineteen local authorities are showing significantly lower numbers of active authorisations on 1 April 2019, the opening date of the 2019-20 collection, compared with the previous day, 31 March 2019, the closing date of 2018-19 collection. Having these data allows us to accurately measure the actual duration of granted authorisations and also measure the number of authorisations in place throughout the year. NHS Digital will continue to provide the guidance document and encourage all local authorities to review this document each year to ensure they are including the correct records.

Incomplete Actual End Dates

During the data validation process, NHS Digital identified approximately 4,700 cases across 61 local authorities where the Planned End Date of the authorisation was during the current reporting period however the Actual End Date had been left blank, indicating the unlikely scenario that the authorisation was still in place. NHS Digital worked with the local authorities in question to resolve this issue which reduced the number of these cases to approximately 3,300. This issue has the effect of inflating the figure reported in Table 6 in the Time Frames data tables, which is the number of authorisations in place on 31st March 2020.

Start Date of Authorisation recorded earlier than Date Application Received

There were approximately 6,600 authorisations across twenty three local authorities where the Start Date of Authorisation had been recorded earlier than the Date Application Received.  Some local authorities provided the explanation that this was an accurate reflection of local practice.

Some local authorities gave comments in their data return to explain errors or issues with their data. NHS Digital would like to thank these local authorities for their transparency. The table below summarises specific key issues that are not covered by the general comments above.

 

Local Authority Table Affected - reference Table Affected - details Local Authority comment
209 - Bradford Demographics Data Tables - Table 1 Count of Ethnicity and Sexual Orientation recorded as 'Not Known' Bradford Council advised that they are aware that the data proportions are skewed towards 'Not Known' and that significant work has taken place to ensure that they can report demographic data on the majority of their DoLS records.  They have advised that they are looking to amend their care management system so that it is easier for them to report on this data for next years collection.
327 – Cheshire West and Chester Applications Data Tables – Table 9 Count of Not Completed Applications under reported Cheshire West and Chester Council advised the majority of their approximately 570 not completed applications from 2018-19 have not been carried over onto their 2019-20 return.  This has the effect of lowering their count of not completed applications.  They advised that they are working with their system supplier to resolve the issue.

 

Impact of Coronavirus (COVID-19)

England went into national lockdown following the outbreak of Covid-19 in March 2020. Although the majority of the data collected relates to pre-lockdown, local authorities had to support the Covid-19 response and so may have had less resource to work on the national data collections. NHS Digital extended the timelines for collecting the data to give local authorities more time to complete the data returns.

We have also tried to look holistically across all local authorities at the possible impact dealing with the pandemic has had on data quality, in terms of reduced capacity to collate and review the data before sending it to NHS Digital. We have concluded that data quality has not been adversely affected at national level. As mentioned above, like in 2018-19, all local authorities made a valid submission by the final deadline and the final returns yielded a very high national completeness and validity score (99.81%). The annex tables that accompany this publication also includes some data integrity checks. There are 11 data integrity checks that are carried out across each record in each local authority return. In 2018-19, there were almost 14,000 validation breaches, in 2019-20 there were approximately 13,000. In addition, we have looked at whether there has been more of a propensity to return ‘not known’ values for certain data items – this is true for a small number of local authorities for some demographic data but does not significantly impact on the national picture.

A noticeable increase compared to last year has been seen in the number of records where it has not been possible to match to a known CQC registered Service Provider for the same period. For future years we will look to incorporate additional checks within the data submission window to enable an improved match rate.

Please see the Data Quality Statement for more information on data quality.



Last edited: 7 June 2021 10:08 am