DoLS After AGNI: What Should Providers Review Now?

The AGNI judgment has changed the way deprivation of liberty is understood, but it has not removed the need for strong records, clear decision-making or good governance.

The Department of Health and Social Care has published an official update following the Supreme Court judgment, confirming that the changes apply immediately and extend across the UK.

For care providers, registered managers and senior teams, the priority now is to review current arrangements carefully. This does not mean making rushed changes or removing restrictions without proper assessment. It means checking that records accurately reflect what is happening in practice and that any restrictions remain necessary, proportionate and clearly evidenced.

Start With The People Most Likely To Be Affected

Providers should begin by identifying people whose care arrangements involve higher levels of supervision, control or restriction.

This may include people who:

• have a current DoLS authorisation
• are awaiting a DoLS assessment
• have restrictions in place around leaving the service
• receive one-to-one supervision
• are subject to locked door arrangements
• use bed rails, sensor mats, lap belts or other restrictive equipment
• have restrictions around contact, visitors, activities or community access
• show signs of distress, resistance or objection to their care arrangements

This review should be individual. Providers should avoid making blanket decisions across a whole service.

Review MCA Assessments

Mental Capacity Act assessments should be decision-specific, up to date and clearly linked to the care arrangements in place.

Providers should check whether each assessment explains:

• what decision is being considered
• how the person was supported to make the decision
• what information the person could or could not understand, retain, use or weigh
• how the person communicated their decision
• whether the assessment reflects the person’s current presentation

Generic statements such as “lacks capacity” are unlikely to be enough. The assessment should show what the person can decide, what they cannot decide, and how this affects their care.

Check Best Interests Records

Where a person lacks capacity, providers must be able to show how decisions have been made in their best interests.

A strong best interests record should explain:

• the decision being made
• the risks being managed
• the options considered
• the least restrictive option
• the person’s wishes and feelings
• family, advocate or professional input where relevant
• why the final decision was reached
• when it will be reviewed

This is especially important where care includes restrictions such as locked doors, supervision, monitoring, restraint or limits on access to the community.

Look At Consent, Wishes And Objection

After AGNI, providers should be particularly careful not to assume that a person is content simply because they are not actively objecting.

Some people may show their views through behaviour, mood, body language, withdrawal, distress or repeated attempts to leave. Others may appear settled but still be unable to give valid consent to the arrangements in place.

Records should show how the person’s views have been explored, including:

• how they communicate agreement or disagreement
• whether they show signs of distress or resistance
• whether family or advocates have shared relevant views
• whether staff understand how the person expresses choice
• whether the arrangements remain the least restrictive option

The key question is not simply “are they objecting?” It is whether their rights, wishes, safety and day-to-day experience have been properly considered.

Review Care Plans Against Daily Practice

Care plans should match what staff are actually doing.

Providers should check whether care records clearly explain:

• whether doors are locked or access-controlled
• whether the person can leave independently
• what staff should do if the person tries to leave
• whether one-to-one support is in place
• whether any monitoring equipment is used
• whether contact, visitors or activities are restricted
• whether restraint is used, including physical, environmental or chemical restraint
• how restrictions are reviewed

If a restriction is part of daily practice, it should be visible in the care plan, risk assessment and governance records.

Review DoLS Applications And Authorisations

Providers should check current DoLS applications and authorisations, as well as restrictive care arrangements, in light of the updated position.

This does not mean withdrawing applications or changing arrangements without advice. It means understanding which people may be affected and whether further discussion is needed with the local authority, DoLS team or legal advisers.

Where there is uncertainty, providers should record the concern, the advice sought and the decision reached.

Strengthen Governance Oversight

This should not sit only with the registered manager.

Providers should bring DoLS, MCA and restrictive practice into wider governance. This may include:

• auditing MCA and best interests records
• reviewing people with the highest levels of restriction
• checking whether care plans match practice
• reviewing incidents linked to distress, refusal, restraint or attempts to leave
• discussing themes in quality or governance meetings
• adding actions to the service improvement plan
• checking staff understanding through supervision and team meetings

This helps show that the provider is not only aware of AGNI, but is actively reviewing the impact on practice.

What Providers Should Avoid

Providers should avoid:

• assuming AGNI means DoLS no longer matters
• removing restrictions without proper risk assessment
• relying on old MCA assessments
• treating silence or compliance as consent
• using generic best interests decisions
• leaving restrictive practice out of care plans
• making blanket decisions across a whole service

The legal position has changed, but the provider’s responsibility to protect people’s rights, dignity and safety remains firmly in place.

Fulcrum Care’s View

DoLS after AGNI should be approached carefully, practically and with good evidence.

For providers, the immediate focus should be on reviewing MCA assessments, best interests records, care plans, restrictions, consent, DoLS authorisations and governance oversight.

The strongest position is one where the provider can clearly show what has been reviewed, what decisions have been made, what advice has been sought and how the person’s rights and safety remain central to their care.

Need Support Reviewing DoLS, MCA Or Restrictive Practice?

Fulcrum Care supports providers with governance reviews, mock inspections, care record audits, compliance support and improvement planning.

If your service needs support reviewing DoLS arrangements, MCA records, restrictive practice, care plans or governance following the AGNI judgment, speak to our team.