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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 I demand that my employees have the vaccine?

In most circumstances the answer will be no. It would be an infringement of their human rights. It could also be a criminal assault.

However where there is a high risk to employees of exposure to COVID-19, such as care homes and healthcare environments, you might be able to make it a requirement of their role to have the vaccine.

First, consider whether you need to have a blanket requirement covering all employees or whether only certain groups who work in the most high risk areas require the vaccine.

You will need to do a thorough risk assessment balancing the amount that the risk of exposure would be reduced against the interference with the employee’s human rights. Consideration will need to be given as to whether insisting on the vaccine is proportionate to the risk and whether other less invasive steps could be taken instead, such as maintaining social distancing, wearing a mask, washing hands.

Any requirement for employees to be vaccinated should be communicated clearly to employees and trade unions together with a clear explanation for why it is necessary.

How do I guard against contractor insolvency in the construction industry?

It is almost impossible to completely guard against the risks associated with contractor insolvency, but there are some steps which can assist in mitigating and managing the risks involved.   To be in the best possible position, it is worth considering the following at the outset of any project:

  • Check the contractor’s financial position – particularly the specific company which will enter into the building contract, as the employer’s rights will be against this company rather than the business as a whole
  • Take legal advice to ensure that the building contract is properly drafted with appropriate provisions to deal with an insolvency event
  • Consider requiring a performance bond and/or parent company guarantee (each serve slightly different purposes)
  • Obtain collateral warranties from the consultants and sub-contractors involved, so that there are contractual rights against other parties if the contractor is no longer able to meet claims
  • Consider requiring retention bonds, advance payment bonds or vesting certificates if necessary
  • Project bank accounts and escrow accounts can also provide some further assurances for the parties involved
What fees will I pay for a loan under CBILS?

Borrowers will not have to pay a guarantee fee. Lenders will pay a fee to access the scheme. The Government will make a Business Interruption Payment to cover the first 12 months of interest payments and any lender-levied fees, allowing smaller businesses to benefit from no upfront cost.

British Business Bank has indicated that following earlier discussions with the banking industry, some lenders indicated that they would not charge arrangement fees or early repayment charges to SMEs borrowing under the scheme. Each business should check the terms of the loans being made to ensure this is the case and what the interest rate and prepayment fees will be following the period in which the Government makes payment of these amounts.  

Do employers still have to enrol and reenrol employees?
  • Yes, and this includes furloughed employees under the Coronavirus Job Retention Scheme.
  • Employers must continue to assess their new employees or newly eligible existing employees and enrol them where required, but can make use of the statutory postponement procedure which allows them to delay for up to three months the assessment of new employees for the purpose of enrolment (see further details here on the Pensions Regulator’s website). Declarations of compliance for new employers must still be completed in the normal way.
  • Postponement cannot be used for re-enrolment. The Regulator recommends employers use the re-enrolment date tool on the Regulator’s website to choose a date up to three months after the third anniversary of enrolment to assess staff for re-enrolment. Further information about employers’ obligations about reenrolment from the Pensions Regulator can be found here. Re-declarations of compliance for new employers must still be completed in the normal way.
How do EWS1 form requirements apply to leasehold flats sold to secure tenants exercising their Right to Buy under the Housing Act 1985 whether in low, medium or high rise blocks?

Where a lender requires a EWS1 as part of the mortgage requirements for a flat this will apply regardless of its tenure and will therefore apply to applicable RTB properties. It may also be required in order to obtain a valuation for the disposal notices and issues in obtaining it could cause problems in serving this within relevant deadlines required by legislation.