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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

Would you suggest using a different name for a MHFA, maybe a MH champion, to encompass the wider pro-active role?

This may be a good idea – whatever name they are given, it is essential that MHFAs are empowered to take a proactive approach to organisational mental health and that they have the bandwidth to be able to discharge their responsibilities.  The name should reflect the culture of the organisation, the key aspect is awareness and accessibility – identifying a name for your company that supports this is key.

Can I use my Contingent Business Interruption insurance to make a claim?

An extension to the traditional business interruption insurance, “contingent business interruption insurance” often covers areas such as business interruption due to damage to property of a customer or suppliers. Nonetheless, proving loss can be problematic.

Claims for loss of use of the property may be possible as a result of forced business closure due to lockdown.  Accordingly policies should be carefully reviewed to see if cover is available.

How do I go about registering a death at this time?

The Government has introduced legislation to expand the list of those who can register deaths to include Funeral Directors who are dealing with the funeral arrangements and who has been authorised by a relative of the deceased to register the death. Also, the medical cause of death certificate can be emailed to the Registrar’s office and arrangements made to have a telephone appointment to provide the Registrar with information to register the death. The requirement to attend the Registrar in person to sign the Register has been relaxed so that this is not necessary. It will however still be necessary to register the death within 5 days.

Should you rely upon Statutory Demands issued after 1 March to present a Winding Up petition?

No. No action need be taken in relation to the demand but we would advise against presentation of a petition based upon any Statutory Demand issued between 1 March 2020 and the end of the restrictions. As you may be aware, with Winding Up there is no requirement to issue a Statutory Demand notice before proceeding so this is unlikely to create too many issues – click here to see whether you should issue petitions on other grounds.

There is nothing to prevent statutory demands being served at this time. However, there may be limited benefit as it cannot form the basis of a future winding up petition.

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.