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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

Can directors, partners or those working under umbrella companies be furloughed?

Yes. The updated government guidance has confirmed that office holders (including company directors), salaried members of Limited Liability Partnerships (LLPs) individuals working under umbrella companies (including agency workers) and individuals who are classified as ‘workers’ rather than employees can be furloughed but only to the extent that they are paid via PAYE. Therefore director’s fees can be claimed (subject to the cap) but dividends are excluded, as are bonuses and commission payments.

Those who are paid annual are now eligible to make a claim, subject to meeting the remaining requirements. This includes being notified to HMRC on an RTI submission on or before 19 March 2020 which relates to a payment of earnings in the 19/20 tax year.

The decision to furlough a director or office holder should be adopted as a formal decision of the company or LLP which should be minuted and notified in writing.

Company directors can only undertake work to fulfil a duty or other obligation arising from an Act of Parliament relating to the filing of company accounts or provision of other information relating to the administration of the director’s company while furloughed and they cannot carry out work that would generate revenue or perform services to or on behalf of their company. This also applies to salaried individuals who are directors of their own personal service company (PSC).

Can I use my Business Interruption insurance to make a claim?

The FCA’s test case in the Supreme Court ruled overwhelmingly in favour of policyholders.  However, business interruption cover generally has the prerequisite of physical damage or loss to the property (or in some circumstances, the presence of a notifiable disease at the property or within a certain radius of it), to recover losses caused by the interruption to your business. The onus is on insurers to re-assess those claims which are impacted by the Supreme Court’s judgment and to make contact with the policyholders regarding next steps. If you have not already made a claim, in the first instance the terms of any policy should be checked carefully to see whether business interruption cover is provided.

What do I do if I have been endorsed for a Global Talent, Start-up or Innovator visa but my endorsement is due to expire?

Endorsing bodies are still processing applications for these visa types and endorsements are still being issued. You usually have to apply for your visa within 3 months of receipt of your endorsement. In most cases you will still be able to submit your application online within this timeframe however it will not be completed as visa application centres across the world are closed. If you cannot apply because you haven’t been able to travel and your endorsement has expired, you may still be eligible for a visa. You should make your application as planned and UKVI will consider all applications on a case by case basis.

What if I have missed the January deadline for submitting my 2018/2019 tax return?

You had until 23 April 2020 to submit your return in order to be considered for eligibility.

Can you require an employee to tell their employer whether they have been tested for coronavirus/the results of that test?

Yes, this is very likely to amount to a reasonable management instruction which is put in place for public health reasons. Employers should make it clear to their employees that this is something they are required to do and that if they fail to do so this may lead to disciplinary action.