Fillable UK Gov Department of Health & Social Care - Deprivation of Liberty Form 18 Unauthorised Deprivation of Liberty

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UK Gov Department of Health & Social Care - Deprivation of Liberty Form 18 Unauthorised Deprivation of Liberty

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1
Mental Capacity Act 2005
DEPRIVATION OF LIBERTY FORM No. 18
UNAUTHORISED DEPRIVATION OF LIBERTY
SUPERVISORY BODY’S DECISION
For these purposes, there is an unauthorised deprivation of liberty if:
(a) a person is kept in a hospital or care home in circumstances that amount to depriving them of their
liberty, and
(b) their deprivation of liberty has not been authorised by an urgent or standard authorisation under the
Mental Capacity Act 2005, by detention under the Mental Health Act 1983
1
or by the Court of Protection,
and nor is a relevant authorisation presently being sought from that court.
PART A — BASIC INFORMATION
Full name of the relevant person
Their date of birth (or estimated age if
unknown)
Name and address of the relevant hospital
or care home
Name and address of the supervisory
body
Person to contact at the supervisory
body
Name
DOB d d m m y y y y
Est. age Years
Name
Address
Name
Address
Name
Telephone
Email
CASE
NUMBER
1 References in this form to provisions of the Mental Health Act 1983 include provisions of other enactments that have the same effect.
GFSB-Liberty Form 18.indd 1 19/2/09 11:40:36
2
PART B — FORMAL STATEMENT
The supervisory body has received the report of an assessment as to whether or not this person
is being kept in this hospital or care home in circumstances that amount to a deprivation of liberty.
PART C — THE SUPERVISORY BODY’S DECISION
The supervisory body has made the following decision:
Place a cross in ONE of the boxes below (C1–C4) Ø
C1 The assessment concluded that the person IS NOT being kept in this hospital or
care home in circumstances that amount to a deprivation of their liberty. Therefore,
no further action is required at this time.
C2 The assessment concluded that the person IS being kept in this hospital or care
home in circumstances that amount to a deprivation of their liberty. However, it appears
that the deprivation of liberty IS authorised under the Mental Capacity Act 2005.
Therefore, no further action by the supervisory body is required at this time.
Provide details of the authority for the deprivation of liberty in Part D below.
C3 The assessment concluded that the person IS being kept in this hospital or care
home in circumstances that amount to a deprivation of their liberty. However, the
deprivation of liberty appears to be authorised under the Mental Health Act 1983,
or by virtue of a court order or some other lawful authority. Therefore, no further
action by the supervisory body is required at this time.
Provide details of the authority for their detention in Part D below.
C4 The assessment concluded that the person IS being kept in this hospital or care
home in circumstances that amount to a deprivation of their liberty. It also appears to the
supervisory body that the deprivation of liberty IS NOT authorised under the Mental
Capacity Act 2005.
The supervisory body will therefore now take the steps referred to in Part E below.
PART D — THE SUPERVISORY BODY’S REASONS
The reasons for the supervisory body’s decision are as follows:
Give brief reasons for the decision. For example, describe any authority for the person’s deprivation of liberty, or
say why they are not being kept in circumstances that amount to a deprivation of their liberty.
GFSB-Liberty Form 18.indd 2 19/2/09 11:40:37
3
PART E — STEPS TO BE TAKEN IF THERE IS AN UNAUTHORISED DEPRIVATION OF LIBERTY
If a cross was placed in box C4 above, this means that the person IS subject to an unauthorised deprivation
of liberty.
If this is the supervisory body’s fi nding in relation to this person, the following steps must now be taken:
1. The managing authority of the hospital or care home is deemed to have requested a standard
authorisation in relation to the person.
2. The managing authority must therefore provide the supervisory body with the information that is
required whenever such a request is actually made. It should now complete Form 4 and send it to
the supervisory body.
3. The supervisory body will arrange for the assessments to be carried out that are required whenever
a request for a standard authorisation is received.
4. The present care and/or treatment arrangements have been found to amount to deprivation of
liberty. If the managing authority considers that these care and/or treatment arrangements should
continue while the assessments are carried out, it must give itself an urgent authorisation, and can
do so by completing Form 1.
5. If it does give itself an urgent authorisation then the necessary assessments must be completed
within the period of the urgent authorisation.
PART F — PROVIDING COPIES OF THIS DECISION
If you have received a copy of this decision notice, it is because the law requires the supervisory body to
give copies of this decision to:
GFSB-Liberty Form 18.indd 3 19/2/09 11:40:37
Please Use Continuation Sheet
4
(a) the person who made the request to the supervisory body, asking it to decide whether there was an
unauthorised deprivation of liberty
(b) the person to whom the request relates
(c) the managing authority of the relevant hospital or care home
(d) any IMCA instructed for the person in (b) under section 39A of the Mental Capacity Act 2005.
The person who made the request to the supervisory body is entitled to receive a copy of this decision
notice (Form 18) but not a copy of the assessor’s report (Form 17).
The person who was the subject of the request to decide whether or not there was an unauthorised
deprivation of liberty, the managing authority and any section 39A IMCA are entitled to receive copies of
both the assessor’s report and this decision notice.
Signed
(on behalf of the supervisory body)
Dated
Signature
Print name
Position
Date
GFSB-Liberty Form 18.indd 4 19/2/09 11:40:37
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UK Gov Department of Health & Social Care - Deprivation of Liberty Form 18 Unauthorised Deprivation of Liberty

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Completed 27 May 2020

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