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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

Are there steps to ensure they will have access to an open register (BSR) & building safety assessments etc?

The Act should make it easier for residents to obtain relevant information. It includes an obligation for the Principal Accountable Person to prepare a strategy for promoting the participation of residents, including the information to be provided to them and consultations about relevant decisions. The strategy must be provided to residents, and there will be provision for residents to be able to request information and copies of documents from the Principal Accountable Person. The type of information and the form in which it is to be provided will be set out in secondary legislation in due course, but the explanatory notes anticipate that it will include:

  • Full current and historical fire risk assessments•Planned maintenance and repair schedules
  • The outcome of building safety inspection checks
  • Information on how assets in the building are managed
  • Details of preventative measures
  • Details of fire protection measures and the fire strategy for the building
  • Information on the maintenance of fire safety systems
  • Structural assessments
  • Planned and historical changes to the building
Are all employees required to stay at home?

No, where employees cannot work from home, and it is safe for them to return to work, they should do so.

What are the alternatives to an injunction?

A quicker and more cost-effective option may be the involvement of the police given their recent allocation of emergency powers to disperse, fine or even arrest persons who flout these rules. Nevertheless, it appears that the Court is willing to support housing providers in their efforts to tackle anti-social behaviour during this time.

What should I do if I have a hearing scheduled in the COP?

Parties are encouraged to review upcoming matters to assess the viability for there to be any agreement which can be reached in relation to the issues in dispute or to consider whether the case needs to proceed to a remote hearing. If directions or issues can be agreed between the parties, reducing the need for remote hearings, then that is the preferred option.

Can I require employees to take holiday during furlough?

Yes. Government guidance now confirms that employers can be required to take holiday during a period of furlough, so long as they are given minimum notice to do so. The notice required is double the length of the holiday.

Employers are also able to cancel employees’ holidays (or require them not to take holiday) if they are on furlough, for example if they are not in a position to pay the additional 20% top up to their normal wages (or more where they earn in excess of the £2,500 monthly cap on furlough payments). Again, employers are required to provide a minimum period of notice of cancellation, which in this case, is the length of the planned holiday.

Employers can ask employees to take or cancel holiday with less notice but they would need to get their agreement to do so.

Government guidance has been updated to state that “Employees should not be placed on furlough for a period simply because they are on holiday for that period.” If a period of furlough happens to coincide with an employee’s holiday then you should ensure that there are business grounds to support furlough being used in that instance so that it isn’t just being used as a means to fund holiday utilisation.