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DoLS in Care Homes — MRCPsych Paper B MCQ

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ModerateOld Age PsychiatryDoLS in Care HomesMRCPsych Paper B

A 79-year-old woman with dementia lives in a care home in England. She lacks capacity to consent to her residence and care arrangements. She repeatedly states that she wants to go home and attempts to leave, including at night in cold weather. The external doors are locked, staff supervise her throughout the day and would prevent her from leaving. Which legal framework should the care home seek to use to authorise these arrangements?

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Correct answer: B — Deprivation of Liberty Safeguards authorisation

The correct answer is B. The restrictions are imposed in a care home on a woman who lacks capacity and actively objects by repeatedly attempting to leave. Locked doors, ongoing supervision, the duration and manner of the restrictions, and their effect on her all strongly indicate a deprivation of liberty under the multifactorial approach applicable since 2 June 2026. The care home, as managing authority, should request DoLS authorisation from the local authority. A best-interests decision alone cannot authorise a deprivation of liberty. Section 3 authorises detention in hospital for treatment only. Guardianship can require residence but cannot authorise deprivation of liberty. Court of Protection authorisation is generally used for deprivation outside hospitals or care homes, or where the DoLS procedure is unavailable or inadequate.

Reference: Department of Health and Social Care, UK Supreme Court 2026 judgment on what constitutes a deprivation of liberty, sections 'Who this applies to' and 'Assessing deprivation of liberty', 15 June 2026. https://www.gov.uk/government/publications/changes-to-the-definition-of-deprivation-of-liberty/uk-supreme-court-2026-judgment-on-what-constitutes-a-deprivation-of-liberty