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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 I use flexible furlough to utilise an employee's holiday entitlement?

Employees are generally permitted to take holidays during furlough. However, Government guidance has been updated to state that “Employees should not be placed on furlough for a period simply because they are on holiday for that period.” If a period of furlough happens to coincide with an employee’s holiday then you should ensure that there are business grounds to support furlough being used in that instance so that it isn’t just being used as a means to fund holiday utilisation.

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 anything I can do to try and settle my claim?

There are several options that can be used at this time to try and settle disputes. If it is not possible to settle a dispute via direct discussions between the parties then some form of Alternative Dispute Resolution (“ADR”) might be appropriate. Mediation is the most popular form of ADR. Most people’s perception of mediation is that it needs to be in person but that does not have to be the case.

Mediation can take place online or on the telephone. Most, if not all, ADR providers remain open for business and are quickly changing their business model to ensure that mediations can still take place. Mediation can be arranged at reasonably short notice and certainly so far as the online model is concerned, it mirrors the process that is adopted when parties appear in person. Online mediation allows for joint sessions with the mediator to take place and also for the parties to break out into their respective rooms for private discussions. If a dispute settles at mediation – and the vast majority do – then the agreement reached between the parties is binding and can be enforced.

A group of senior former judges and legal academics have now called for an acceleration in the use of ADR in light of the current circumstances. They have stated that courts should promote “and where appropriate require” the use of ADR. Mediation has particularly seen an increase in growth at this time.

ADR normally results in a quicker outcome than if the matter proceeds in the courts. Due to its conciliatory nature it is a very useful process where parties continue to be in a trading relationship. Contracting parties should also consider building ADR into dispute resolution clauses in their contracts so that in the event there is a dispute the focus is on resolving the dispute as soon as possible before it escalates into litigation.”

What can I do to make sure my home-working people are doing so safely?
  1. Keep in touch. If contact is poor, workers can feel disconnected, isolated or abandoned. This can adversely affect stress levels and mental health – especially in the current crisis when everyone is feeling more anxious.
  2. Think about the use of laptops/devices (DSE) at home. Provide a basic form of risk assessment for self-completion.
  3. Remind workers of simple steps to reduce the risks from display screen work:
    • take regular breaks (at least 5 minutes every hour) or change activity
    • avoid awkward, static postures by regularly changing position
    • get up and move or do stretching exercises
    • avoid eye fatigue by changing focus or blinking from time to time
What type of bundle will be required by the COP for a remote hearing?

Physical bundles may not be regarded as safe for public health and there are obvious difficulties in providing them with the current restrictions in place. Electronic bundles should be provided in PDF format, preferably paginated, indexed and bookmarked. The bundles should only contain documents and authorities that are essential to the issues required to be decided at the remote hearing and should be filed with the court by email.