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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 perceived gaps do you see in the Building Safety Act 2022 (especially in terms of pending consultations and secondary instruments)?Comments on the value of the Martlet v Mulalley judgment in fire safety cases/unsafe cladding cases

The Act was obviously subject to much debate and criticism as the Bill passed through Parliament. It is difficult to properly assess any gaps until after the necessary secondary legislation has been published and comes into force (along with the remainder of the Act), but some of the likely issues include:

  • The impact on the insurance market, and the (lack of) availability and increased cost of insurance in light of the provisions of the Act
  • How the introduction of retrospective claims will affect the market, both in relation to how parties might go about trying to prove matters which are 30 years old, but also the lack of certainty for those potentially on the receiving end of these claims which they previously had by virtue of the Limitation Act provisions
  • Whether the definition of higher risk buildings is correct, or will require some refinement.

The Martlet v Mulalley case provides some useful observations and clarifications, for example that designers cannot necessarily rely on a ‘lemming’ defence that they were simply doing what others were doing at the time, that ‘waking watch’ costs are generally recoverable, and commentary on certain specific Building Regulations. The judgment however made clear that much of the case turned on its specific facts, so it is useful from the perspective of providing some insight as to how the Courts will deal with cladding disputes in future, rather than setting significant precedents to be followed.

Can I require my staff to inform me should their circumstances be such that they need to self-isolate?

Yes.

Workers (and agency workers) who are aware of the requirement to self-isolate and are due to work during their isolation period at a place other than their designated place (see below) must, as soon as reasonably practicable and in any event before they are next due to start work within the isolation period, tell their employer that they are self-isolating, and set out the start and end dates of their isolation period.

Clear communication to all workers about their obligation to do this is strongly recommended.

How does salary sacrifice affect the Government's Coronavirus Job Retention Scheme?
  • Employee pensions contributions are often paid by way of salary sacrifice arrangements.
  • Use of such arrangements may reduce the amount of wage an employer can claim under the Coronavirus Job Retention Scheme, as the reimbursement is calculated by reference to an employee’s actual pay as at 28 February 2020, hence post sacrifice pay.
  • Using the Coronavirus Job Retention Scheme does not in itself bring a salary sacrifice arrangement to an end, but where an employer wishes to maximise the amount of an employee’s pay that will be covered by the CJRS, the employer and employee(s) concerned may agree to terminate the salary sacrifice arrangement as part of furlough. HMRC has recently announced that the Covid-19 pandemic will be considered a “life event” (i.e. one of the permitted reasons to break a salary sacrifice arrangement mid-term), if the employment contract is updated accordingly.
I’m a landlord. How do I comply with Regulation 36 of the Gas Safety Regulations 1998 during the coronavirus outbreak?

Under their obligations arising from Regulation 36 of the Gas Safety (Installation and Use) Regulations 1998, landlords must service domestic gas appliances on an annual basis and provide tenants with a record of the service within 28 days of that service. Failure to comply can result in prosecution by the Health and Safety Executive (HSE) or downgrading by the Regulator.

We know how important this is. But how can you comply with your obligations during the Covid-19 epidemic?

The latest restrictions on leaving the home, currently allow registered gas engineers to undertake essential work, whilst taking the appropriate precautions advised to avoid spreading or contracting the virus in a new setting.

Do I need to give a personal guarantee to access finance under the Coronavirus Business Interruption Loan Scheme (CBILS)?

A number of our clients and networks raised issues in the early stages of the Scheme around the requirement for personal guarantees to access finance under the Scheme. The Scheme has now been updated so that:

  • For facilities under £250,000, personal guarantees cannot be taken to support lending under the Scheme.
  • For facilities above £250,000, personal guarantees may still be required by a lender but the amount which can be recovered under these guarantees is capped at a maximum of 20% of the outstanding balance of the CBILS facility after taking into account any other recoveries from business assets.