Development of an assessment of the liberty protection safeguards. A mixed methods study.

Award Number
Award Type
HEE/ NIHR ICA Programme Clinical Doctoral Research Fellowship
HEE/NIHR Integrated Clinical Academic Programme
Status / Stage
4 February 2018 -
4 January 2021
Duration (calculated)
02 years 11 months
Funding Amount
Funder/Grant study page
Contracted Centre
Nottingham University Hospitals NHS Trust
Principal Investigator
Miss Catherine Brewin
WHO Catergories
Legislative and regulatory environments
Methodologies and approaches for risk reduction research
Disease Type
Dementia (Unspecified)

CPEC Review Info
Reference ID34
ResearcherReside Team


Award NumberICA-CDRF-2017-03-027
Status / StageCompleted
Start Date20180204
End Date20210104
Duration (calculated) 02 years 11 months
Funder/Grant study pageNIHR
Contracted CentreNottingham University Hospitals NHS Trust
Funding Amount£187,473.00


Development of an assessment of the liberty protection safeguards. A mixed methods study BackgroundOver 800,000 people in the UK have dementia. The majority of these people live at home and are cared for by over 600,000 carers (1,3). As dementia progresses the affected person may lose the ability to make some decisions, this is defined as a loss of capacity and may lead to the person attempting to leave their home unsafely. In a domestic setting carers may lawfully prevent this from happening whereas in the public sector the carers actions would be defined as a deprivation of liberty (DOL) and require formal legal authorisation (4). It is proposed the law will change and be extended to the domestic setting resulting in new regime referred to as the liberty protection safeguards (LPS). This process of DOL authorisation may be instigated by occupational therapists when services such as telecare or home adaptations are required or by other health and social care professionals (11). This intervention could represent the opportunity to identify those at risk of crisis and offer patient benefits such as sitting services and telecare technology (7, 15). Such interventions may facilitate the liberty of those who have dementia and reduce the pressure upon carers. Alternatively this assessment may place additional demands upon carers by specifying the care regime which must be provided and failing to incorporate any patient benefit.Aims.The primary aims areTo develop an OT assessment tool for the liberty protection safeguards which integrates law and needs of people living with dementia and carersTo inform statutory change and implementation with the experience of carers and people who have dementia Design and Method. The study has 3 componentsA mixed methods literature review of the literature relating to deprivation of liberty in a community setting. This review will integrate empirical clinical work and legal literature.A series of semi structured interviews with people who have dementia, carers and clinicians to identify experiences of deprivation of liberty in the community and perspectives of those affected on proposed legal change.Domains will be developed from the themes identified in stage 1 and 2 with legal input which will inform the development of an assessment tool. This assessment to be reviewed and developed by an expert panel in an online Delphi study. PPI Involvement This study was developed following consultation with a PPI group at Nottingham University Hospitals Trust. The group kindly reviewed this application. The concerns expressed by group members led to the formation of a small PPI group that could meet more frequently. PPI input led to the following significant changes.1. Initially it was not proposed people living with dementia were included in the research. Clinical staff and carers felt this exclusion would fail to present the views of people who have dementia being fully represented, accordingly the research design was amended to include participants who have dementia.2. Healthcare professionals felt the MCA was not well understood by clinical staff, the focus of the research was then changed to the development of an assessment.Dissemination and outputs The study will be written up in a doctoral thesis with the following outputs and dissemination1. Through publication of the study in peer reviewed journals, DOLs conferences and forums and lectures at clinical and legal conferences2. During the course of the study findings will be disseminated to the law commission and House of Commons Select Committee on dementia3. Through stage 3 of the study the assessment tool to be tied to government advice on the implementation of the amendments to the MCA 2005.


The study aims to develop a community OT assessment of the liberty protection safeguards which reflects the needs of people living with dementia and their carers