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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 type of matters are the Courts still dealing with?

Civil Court listing priorities, last updated by HMCTS on 24 April 2020, categorise the Court’s work into the following:

Priority 1 – work that must be done: this includes any applications in cases listed for trial in the next 3 months, any applications where there is a substantial hearing listed in the next month, all multi-track hearings where parties agree that it is urgent (subject to triage).

Priority 2 – work that could be done: Infant and Protected Party approvals, Applications for interim payments in multi-track / personal injury / clinical negligence cases, Applications to set aside Judgment in default, Preliminary Assessment of costs.

The full guidance can be found at:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881019/Civil_court_listing_priorities_24_April_2020.pdf

What is the new Permitted Development Right for restaurants, cafes and drinking establishments?

A new Permitted Development Right has been introduced providing restaurants and cafes, drinking establishments with expanded food provision to temporarily provide takeaway food. The new right came into force on 24 March 2020 and expires on 23 March 2021. The right is subject to three conditions:

  • The developer must notify the local planning authority if the building and any land within its curtilage is being used, or will be used, for the provision of takeaway food at any time during the relevant period
  • Change of use to the provision of takeaway food under the Right, does not affect the use class which the building and any land within its curtilage had before the change of use
  • If the developer changes use to the provision of takeaway food under the Right, the use of the building and any land within its curtilage reverts to its previous lawful use when the Right expires or, if earlier, when the developer ceases to provide takeaway food.

Alcohol will still be subject to the same licensing requirements. At this stage, it is not clear how the Right will interact with any current planning conditions placed on an establishment.  Enforcement however remains discretionary. A link to Statutory Instrument 2020 No.330 is below.

http://www.legislation.gov.uk/uksi/2020/330/made

What happens if I need to sign a new commercial lease in the future?

The outbreak is certainly going to have an impact on new lease negotiations.

Undoubtedly many transactions will be put on hold or indeed stop entirely. Where matters are ongoing, tenants may well look to strengthen rent suspension provision.

It is also possible that tenants and their representatives will also now seek to include termination rights for unseen events. In this regard, the concept of force majeure may start to appear more often in leases.

In both of the examples above, such attempts are not likely to be well received from landlords who will undoubtedly suggest that tenants ensure that their business interruption insurance policies are robust enough to protect the tenant in the event of any future pandemic events.

Another approach tenants might adopt going forwards in negotiations for a new lease (or indeed seeking to vary existing leases), is to move away from the traditional market rent model to a turnover rent arrangement. This will offer some protection going forward if trading conditions deteriorate, but again getting institutional landlords to agree such an approach may prove difficult.

I pay child maintenance and half of my children's private school fees to my ex-partner but I have been placed on Furlough, with no top-up from my employer, so my income has dropped significantly. Is there anything I can do?

a. You should first try and discuss this with your ex-partner, either directly or through a Solicitor, to see whether an amicable agreement can be reached.

If you contribute to private school fees voluntarily, it is a matter for you and your ex-partner to resolve the issue with the school, depending whose name is on the bills. You may need to speak to the children’s school to see whether they can offer any reductions or remedies in relation to those payments. If you contribute to the school fees as part of a Court Order, you will need to ensure you do not breach the Order and you may need to consider applying for a variation of the Order if you can no longer afford the payments or reach a compromise agreement with your ex-partner.

You can use the Child Maintenance Service (CMS) calculator (https://www.gov.uk/calculate-child-maintenance) to recalculate your child maintenance obligations using your amended income. This recalculation can then be used in your discussions and you can formally instruct the CMS to verify that calculation if you and your ex-partner cannot reach an agreement about it. If you have already formally involved the CMS, they do carry out an annual review of child maintenance payments, however, they will also recalculate payments outside of the review period where there has been a change in income of 25% or more. We expect the CMS will be experiencing a high volume of enquiries at the present time so anticipate there may be delays in them assisting.

The position on child maintenance payments included in a Court Order are slightly more complicated and how you approach this will depend on how much time has passed since the date of the Order.

I work in construction. Can I still travel to work?

The CLC has also prepared a template letter that firms may adopt and issue to their workforce regarding travel to work. This can be accessed at download document.

The CLC’s current advice to those carrying out works on site is to carry out your own risk assessment on each site and determine whether or not it is safe to continue to work in accordance with the Public Health England instructions and the CLC Site Operating Procedures.  If it is not possible to work in accordance with the above they should not work.