Fillable UK Gov Department of Health & Social Care - Deprivation of Liberty Form 15 Notice That A Suspension Has Been Lifted

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UK Gov Department of Health & Social Care - Deprivation of Liberty Form 15 Notice That A Suspension Has Been Lifted

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The UK Gov Department of Health & Social Care - Deprivation of Liberty Form 15 Notice That A Suspension Has Been Lifted form is 2 pages long and contains:

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1
Mental Capacity Act 2005
DEPRIVATION OF LIBERTY FORM No. 15
NOTICE THAT A SUSPENSION HAS BEEN LIFTED
PART A — BASIC INFORMATION
Full name of the person who is subject to the
standard authorisation
Their date of birth (or estimated age if unknown)
Name and address of this hospital or care home
Person to contact at the hospital or care home
Name of the PCT or local authority to whom this
form is being sent (‘the supervisory body’)
PART B — WHEN THE STANDARD AUTHORISATION WAS SUSPENDED
During the previous 28 days, the managing authority of this hospital or care home gave the supervisory
body notice that the above person was no longer eligible to be deprived of their liberty under the Mental
Capacity Act 2005. The effect of that notice was to suspend the standard deprivation of liberty authorisation
The managing authority now gives the supervisory body notice that the person once again meets the
eligibility requirement and that this suspension has been lifted.
Name
DOB d d m m y y y y
Est. age Years
Name
Address
Name
Telephone
Email
Name
CASE
NUMBER
GFMA-Liberty Form 15.indd 1 19/2/09 13:20:08
2
PART C — REASON WHY THE PERSON AGAIN MEETS THE REQUIREMENT
The reason why the person once again meets the eligibility requirement is as follows:
(Explain briefl y why the reason the standard authorisation was suspended no longer applies. For
example, if it was suspended because the person was detained under the Mental Health Act 1983
1
,
state ‘The person is no longer detained under the Mental Health Act 1983’.)
PART D — THE EFFECT OF THIS NOTICE
The effect of this notice is that the previous suspension of the standard authorisation no longer applies. The
person may again be deprived of liberty under the Mental Capacity Act 2005
PART E — GIVING COPIES OF THIS NOTICE
You have been given a copy of this notice because the law requires the supervisory body to give notice that
the suspension of the standard authorisation has ceased to:
(a) the person
(b) the person’s representative
(c) any IMCA instructed for the person under section 39D of the Mental Capacity Act 2005.
Signed
(on behalf of the managing authority)
Dated
Signature
Print name
Position
Date
1 References in this form to provisions of the Mental Health Act 1983 include provisions of other enactments that have the same effect
GFMA-Liberty Form 15.indd 2 19/2/09 13:20:08
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UK Gov Department of Health & Social Care - Deprivation of Liberty Form 15 Notice That A Suspension Has Been Lifted

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Completed 27 May 2020

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