DoLS, Deprivation of Liberty and Restrictive Practice Governance in PBS
Restrictive practice in PBS sits directly within a legal and ethical framework. Within Human Rights, Legal Context & Ethical Decision-Making and the PBS principles and values, providers must show that restrictions are not simply “what works”, but what is lawful, necessary, proportionate and the least restrictive available option.
This article explains how providers recognise when PBS restrictions may amount to deprivation of liberty, how they evidence lawful authority and consent or best interests, and how restrictive practice governance is run day-to-day so it stands up to commissioner scrutiny and inspection.
Why deprivation of liberty risk shows up in PBS
PBS aims to improve quality of life and reduce behaviours of concern, but many services rely on measures that can restrict liberty: locked doors, constant supervision, blocked access to community activities, restrictions on contact, or routines that a person cannot realistically refuse. Risk escalates when several restrictions combine, when they are applied routinely rather than situationally, or when “support” becomes control.
Providers do not need to be legal specialists to get the basics right. They do need a reliable internal test: “Is the person under continuous supervision and control, and are they free to leave?” Even where a restriction feels protective, governance must demonstrate lawful authority and a structured approach to reducing restriction over time.
Operational example 1: environmental restrictions drifting into deprivation
Context: A supported living service used keypad locks and internal door alarms because one person frequently attempted to leave during periods of distress and would become lost. Over time, the alarms were left active permanently and were applied to shared areas, limiting the person’s and others’ freedom to move.
Support approach: The provider reviewed the PBS plan using a restrictive practice lens, separating situational safety measures from blanket restrictions, and introduced a time-limited, clearly defined safety plan aligned to capacity/best-interest decision-making.
Day-to-day delivery detail: Staff recorded when alarms were activated, why, and what de-escalation support was tried first. The service introduced structured community access support at predictable times, a “walk-and-talk” routine after triggers, and proactive sensory regulation. Environmental changes were trialled (clear exit signage, visual cues, and agreed safe routes) to reduce the need for alarms.
How effectiveness is evidenced: Restriction logs showed reduced alarm use and increased successful supported outings. The restrictive practice register documented rationale, review dates and reduction targets. The person’s quality-of-life indicators (time out, preferred activities) improved alongside stable safety outcomes.
Commissioner expectation: lawful authority and review cadence
Commissioner expectation: Commissioners expect providers to identify restrictions early, evidence lawful authority, and demonstrate a structured reduction plan. They look for routine review cycles (not ad hoc reviews only after incidents) and documentation that connects restrictions to assessed risk, PBS function and outcomes.
Regulator expectation: least restrictive practice with auditable oversight
Regulator / Inspector expectation (CQC): Inspectors look for evidence that restrictions are minimised and reviewed, people are involved as far as possible, and the provider can show a clear governance trail: what the restriction is, who authorised it, how it is monitored, and how reduction is pursued.
What “good” restrictive practice governance looks like in PBS
Strong governance usually includes:
- A restrictive practice register (what restrictions exist, where, for whom, and why).
- Clear links to capacity/consent or best-interest rationale.
- Monitoring data (frequency, duration, triggers, and alternative strategies attempted first).
- Planned reduction targets (step-down criteria, skill-building, environmental adjustments).
- Escalation pathways when restrictions increase or become routine.
Operational example 2: continuous supervision becoming the default
Context: After an incident in the community, staff began providing 1:1 support at all times, including at home, and stopped supporting independent activities. The restriction was framed as “support”, but the person could not choose to be alone and was prevented from leaving without staff.
Support approach: The provider carried out a structured risk assessment and PBS review to identify the function of the behaviour and the drivers behind staff over-control (fear of blame, lack of confidence, unclear risk appetite).
Day-to-day delivery detail: The service introduced graded independence: short periods of planned alone time with agreed check-ins, pre-briefing for outings, and staff coaching in proactive support. Incident analysis was used to refine triggers and early warning signs. The person was supported to choose activities, routes and timings, rather than having “safe” options imposed.
How effectiveness is evidenced: Supervision levels reduced in a staged way, recorded through rota notes and supervision plans. The PBS plan documented step-down criteria and what would trigger review. The person reported improved privacy and autonomy, and behaviour frequency reduced as anxiety drivers reduced.
When restrictions are “protective” but still rights-restricting
Providers sometimes over-rely on the argument that “it keeps them safe”. In PBS, safety is essential, but safety does not automatically justify restriction. The defensible approach is to show proportionality: the restriction is targeted, time-limited, reviewed, and paired with skill-building or environmental change that aims to remove the restriction.
Practical questions that help teams stay lawful:
- What is the restriction preventing, and what is the evidence it is necessary?
- What alternatives have been tried first?
- How is the person involved and supported to express preferences?
- What is the reduction pathway?
Operational example 3: contact restriction handled with governance discipline
Context: A person’s contact with a family member was restricted due to repeated distress following visits. Staff began limiting calls and visits without clear decision records, creating safeguarding and rights risks.
Support approach: The provider introduced a formal decision-making process: capacity assessment for contact decisions, best-interest meeting if required, and a safeguarding-informed plan that balanced the person’s wishes with emotional safety.
Day-to-day delivery detail: Staff used planned contact routines with clear preparation, debriefing and emotional regulation support. Visits were structured around predictable timeframes and agreed boundaries. The PBS plan documented escalation signs and when contact would pause temporarily, with explicit review points.
How effectiveness is evidenced: Records showed the person’s expressed wishes, the rationale for time-limited restrictions, and evidence that contact arrangements were adjusted based on outcomes rather than staff preference. Distress reduced and contact became more sustainable.
Putting it together
In PBS, restrictive practice governance is not paperwork for its own sake. It is the mechanism that ensures practice remains lawful, least restrictive and defensible. Providers who can show clear rationale, monitoring and reduction pathways are far better placed to evidence rights-respecting PBS in commissioning and inspection contexts.