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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 is the current guidance for court of protection hearings?

The current guidance issued by Mr Justice Hayden confirms that remote hearings may be conducted using the following facilities and that this will be the default position until further direction:

  • By way of an email exchange between the court and the parties;
  • By way of telephone using conference calling facilities;
  • By way of the court’s video-link system, if available;
  • The use of the Skype for Business App installed on judicial laptops;
  • Any other appropriate means of remote communication, for example BT MeetMe, Zoom or FaceTime.
How may proceedings change after Covid-19?

During the COVID-19 global pandemic, trials and hearings have been mostly conducted over Skype for Business and various other online platforms. Looking forward to the future, what we have experienced during the lock-down may continue and we believe will make litigation a more streamlined, user friendly experience for litigants.

One example of a regime which has been introduced is hybrid trials for lower value claims. Hybrid trials allow for parties and their witnesses to be linked into the court room by video link, whilst the judge and advocates are present in court. This makes it easier and frees up more time for witnesses, which would otherwise be spent in travel and waiting time, especially for those with other commitments.

With hybrid trials, clients still get a full legal experience and the judge will still apply normal legal principles during the trial. The procedure for the case is the same, both leading up to the trial or hearing and during the case itself; except without the need to physically attend court. It may also mean that there will be less of a backlog arising from the current crisis with cases continuing to be heard, allowing for matters to be listed earlier and a quicker outcome for the parties involved.

The shift to the use of online platforms may prove more practical for all those involved in legal matters. Interim hearings can be heard remotely resulting in a time and cost saving for litigants. Even for the final hearing only the legal representatives need to attend court – again resulting in time and cost savings for all concerned.

How do I guard against contractor insolvency in the construction industry?

It is almost impossible to completely guard against the risks associated with contractor insolvency, but there are some steps which can assist in mitigating and managing the risks involved.   To be in the best possible position, it is worth considering the following at the outset of any project:

  • Check the contractor’s financial position – particularly the specific company which will enter into the building contract, as the employer’s rights will be against this company rather than the business as a whole
  • Take legal advice to ensure that the building contract is properly drafted with appropriate provisions to deal with an insolvency event
  • Consider requiring a performance bond and/or parent company guarantee (each serve slightly different purposes)
  • Obtain collateral warranties from the consultants and sub-contractors involved, so that there are contractual rights against other parties if the contractor is no longer able to meet claims
  • Consider requiring retention bonds, advance payment bonds or vesting certificates if necessary
  • Project bank accounts and escrow accounts can also provide some further assurances for the parties involved
What is classed as a good ratio of MHFA to staff numbers?

There is not a magic number. It depends on the nature of the organisation, the work carried out, the organisational structure, the geographical spread, working patterns and conditions. We would give specific advice personalised to the organisation and taking all these and other factors in to consideration. There is no such things as too many MHFAs!

What if you want to terminate the contract completely?

If changed circumstances mean that a business wants to exit from a contractual arrangement, then before trying to terminate it, a careful review should be carried out to see whether a right to terminate actually exists. For example:

  • Not every contract for the sale of goods contains the right for the buyer to terminate in circumstances where the supplier hasn’t done anything wrong. If a business has entered into a contract on the supplier’s standard terms, it is unlikely to contain any such provision
  • A contract for the provision of services is unlikely, if drafted by the customer, to contain a provision that allows the supplier to walk away from the arrangement at short notice, or perhaps at all

If a party tries to terminate a contract when it doesn’t have the right to do so, the other party will likely claim breach of contract and could sue for damages. In the case of a long term or high-value contract, this could amount to a very significant liability.

Even if the right to terminate the contract does exist, there might be particular rules about the following:

  • How much notice has to be given
  • How such notice has to be served (for example, it might have to be in writing to a particular address)
  • When the notice can be served (perhaps on an anniversary of the start of the contract)
  • How much a party has to pay if it cancels (for example, for raw materials, for work done to date, or even the whole contract price)

All of these factors must be taken into account, and any contractual processes for termination are followed.