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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 should be included in genuinely self-employed contractor terms?

If you consider the factors used to determine status you can include the following terms that are more in line with a self-employed relationship:

  • The right to provide a substitute of the contractor’s choice in the event the individual is not able to perform the services;
  • The ability to work for other businesses as long as doing so will not affect the services to be provided by the contractor;
  • The contractor should have sufficient control over how, when and where (if possible) they provide the services;
  • A degree of financial risk can be included for unsatisfactory work or failing to complete a project or task

We have terms that cover all of these points that can be tailored to your needs. The consultancy agreement is included in our IR35 toolkit.

How can workers get to work safely?

The Government’s guidance says walk, cycle or drive to work and avoid public transport if you can. Businesses will need to support workers in adopting alternative travel methods to reduce exposure to the virus. You could consider staggering start and finish times for shifts to reduce commuting during peak hours, or support cycling with secure storage facilities and a drying room.

Can employees who are self-isolating or on sick leave be placed on Flexible Furlough?

Employers had the ability to furlough extremely vulnerable employees who needed to shield.

If your employee is on sick leave or self-isolating as a result of Coronavirus, including as a result of track and trace, they’ll be able to get Statutory Sick Pay, subject to other eligibility conditions applying.

There is no special exemption for them, so they would need to meet the usual requirements to be placed on Flexible Furlough after 1 July 2020. i.e. They had to have been placed on furlough for at least 3 weeks before 1 July. Otherwise, they could not be furloughed.

Who is exempt from wearing a face mask at work?

Those individuals who are already exempt from the existing face covering obligations, will continue to be exempt from the new rules. These include:

  • Those unable to put on or wear a face covering because of a physical or mental illness or disability
  • People for whom wearing or removing a face covering will cause severe distress
  • Anyone assisting someone who relies on lip reading to communicate
Who decides on carrying-over holiday entitlement?

The Regulations do not require any prior agreement between an employer and employee that it was not reasonably practicable for holiday to be taken for it to be carried over.

However, if an employee requests holiday then an employer must have ‘good reason’ for refusing it due to coronavirus. The term ‘good reason’ is not defined so the Government will expect employers, employees and (if necessary on any dispute) the Courts to apply common sense.

The Regulations are not confined to key workers so could, in principle, be used by employers for a wider range of employees.

The Government guidance suggests that the following factors should be taken into account when considering whether it was reasonably practicable to take the leave in the relevant year:

  • Whether the business has faced a significant increase in demand due to COVID-19 that would reasonably require the worker to continue to be at work and cannot be met through alternative practical measures.
  • The extent to which the business’ workforce is disrupted by COVID-19 and the practical options available to the business to provide temporary cover of essential activities.
  • The health of the worker and how soon they need to take a period of rest and relaxation.
  • The length of time remaining in the worker’s leave year.
  • The extent to which the worker taking leave would impact on wider society’s response to, and recovery from, the effects of COVID-19.
  • The ability of the remainder of the available workforce to provide cover for the worker going on leave.