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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 NHS or local authority workers be furloughed?

It is envisaged that employees of organisations falling into the first two categories set out above and won’t be eligible for the job retention scheme in relation to the majority of their employees. It is envisaged that NHS Trusts for example are going to require their staff to be working at full capacity where possible. However, the guidance doesn’t definitely exclude public sector organisations from furloughing employees and notably the government expects such organisations to use public money to continue to pay staff and not furlough them, rather than say requires. In reality, it is difficult to see how such an organisation will be able to rely on the scheme, but the guidance doesn’t completely rule it out.

How do I reduce employment costs? Are we talking about redundancy?

The obvious option to reduce the cost of your workforce is redundancy. However, that also reduces the number of employees and therefore your capacity.

How important is social distancing when planning your workplace?

It is absolutely critical to creating a safe workplace and to making workers feel secure.

This could include floor markings every 2m (as we’ve seen in grocery stores), stopping or limiting/staggering access to communal or common areas such as toilets and kitchens, rearranging workstations to maintain a 2 metre distance or, where this is not possible (for example in manufacturing facilities or production lines), erecting physical barriers and avoiding face to face working, encouraging the use of stairs and discouraging lift-use, designing a one-way system for entry and exit and looking at aircon/heating systems to see if any modifications are possible to prevent the spread of airborne particles. If you can increase ventilation in your workplace, it will help reduce risk.

The government has published detailed social distancing guidance for workplaces across sectors including manufacturing, retail, offices, construction and transport; it has also promised to continue to add to this.

Can landlords re-possess properties if tenants can’t afford to pay the rent because of the coronavirus outbreak?

After 25 March 2020, and until 30 September 2020, a landlord can only start possession proceedings against a tenant if they have served 3 months’ notice upon the tenant – irrespective of any grounds relied upon.

On 27 March 2020, the Court introduced new rules to put all possession proceedings (except against trespassers) on hold until 25 June 2020 – it means that the Court cannot make an order for possession or any other order that would cause someone to be evicted during that time.

These rules do not just apply to tenants who have fallen into rent arrears.

On 5 June 2020, the Government announced that this stay would be extended further until 23 August 2020.

This means that you can issue new possession proceedings (provided you have complied with the new temporary rules in relation to notice periods, if the notice was served since 25 March 2020) and you can continue with existing possession proceedings.

However, any progress you may be able to make in dealing with those proceedings is likely to be very limited – the Court will allow you to comply with directions orders that have already been made but non-compliance will not be punished (at least for the time being).

These rules, and the latest announcements, are in keeping with the Government’s expectation that landlords show compassion towards affected tenants and that all parties will work together to establish a suitable repayment plan to allow tenants to repay the arrears at an affordable rate.

What are the current planning restrictions on supermarkets, food retailers and distribution centres concerning deliveries?

On 13 March 2020 the Secretary of State for Housing, Communities and Local Government issued a Written Statement in respect of delivery restrictions.

In this respect, many supermarkets, food retailers and distribution centres in England operate under planning restrictions (conditions and/or obligations) which limit the time and number of deliveries from lorries and other delivery vehicles which can take place particularly at night primarily to protect the residential amenity of nearby residential property.

Key points in the Statement include;

  • Given the exceptional challenges facing the UK from the coronavirus, it is vital that deliveries of food, sanitary and other essential products over the coming weeks can be made as quickly and safely as possible, minimising disruption to the supply chains. The likely pressures on driver capacity mean additional flexibility is needed so that retailers can accept deliveries throughout the day and night where necessary.
  • That planning enforcement is discretionary and that local planning authorities should act proportionately in responding to suspected breaches of planning control.
  • That local planning authorities should not seek to undertake planning enforcement action which would result in unnecessarily restricting deliveries of food and other essential deliveries during this period having regard to their legal obligations.

The Statement acknowledges that the increased frequency of deliveries particularly at night could have a temporary impact on residents. It therefore concludes that the Government will review the need for the flexibility outlined in the Statement after the pressure from the coronavirus has reduced and that it is the intention to withdraw it once the immediate urgency has subsided.

A link to the Written Statement is below.

https://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2020-03-13/HCWS159/