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What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

Related FAQs

What does information and consultation involve?

There are two stages:

  • Stage 1 – The provision of written information to the representatives.
  • Stage 2 – Consultation on the proposed redundancies “with a view to reaching agreement” about certain matters

Stage 1: Provision of information

The first stage in the collective consultation process is to provide the representatives with written information including details of the proposed redundancies (often called a section 188 letter). This information must be given to the appropriate representatives and the time limit before dismissals can take effect does not start to run until they have received it. It is this information which ‘starts the clock’.

It is possible that there will be changes to the proposals during the consultation process: indeed that is part of the reason for the process. The employer’s obligation is not just to provide the appropriate representatives with the relevant information at the start of the process. It is under a continuing obligation to provide them with information in writing about any developments during the consultation process (although later changes do not ‘restart the clock’ before dismissals can take effect).

Stage 2: Consultation on the proposed redundancies “with a view to reaching agreement” about certain matters

The consultation process must include consultation “with a view to reaching agreement with the appropriate representatives” on ways of:

  • Avoiding the dismissals
  • Reducing the number of employees to be dismissed
  • Mitigating the consequences of the dismissals
Is there a time limit on making an insurance claim?

All policies will impose a stringent obligation, often with time limits, for you to notify insurers of circumstances that may give rise to a potential claim under the policy and non-compliance may well negate your cover. If therefore you have potential cover under your policy you must make a precautionary notification to Insurers as soon as possible.

Are all employees required to stay at home?

No, where employees cannot work from home, and it is safe for them to return to work, they should do so.

Will there be further measures for self-employed announced?

The Government assured parity for the self-employed but it has since accepted that this would be difficult to achieve. The Association of Independent Professionals and the Self-Employed (IPSE) has worked closely with the Government on implementing the current self-employment income support scheme. IPSE has confirmed that it will continue to work on helping to extend measures to all freelancers in need as a result of Covid-19.

The Government announced an extension to the Self-Employment Income Support Scheme from 1 November 2020.

 

Can I dismiss an employee if they refuse to have the vaccine?

See above FAQ about whether you can demand that your employee has the vaccine.

Dismissal for failing to follow a reasonable instruction would be a possibility but it should be the last resort.

First you will need to be able to show that you have reasonable grounds for insisting that they have the vaccine. You will then need to demonstrate that you have taken into consideration the reasons why the employee has refused and why they are not considered reasonable. Before taking a decision to dismiss you should look at alternatives such as other duties/other roles.