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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 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.

Do you recommend a structured approach to MHFA supervision?

Yes – there should be a framework in place to ensure that MHFAs are fully supported themselves and so that individuals are supported beyond the support the MHFAs provide.

How does this protect businesses entering into an insolvency process?

The Act is intended to facilitate the rescue of businesses that are in financial difficulty by preventing suppliers from invoking certain termination clauses under a supply contract, and therefore maintaining supply of goods and services to the business whilst plans to save the business can be considered.

Supply contracts often contain a clause enabling them to terminate the contract, or take other steps such as requiring payment in advance,  in the event that the customer enters an insolvency procedure.

This new Act removes any such contractual right by dis-applying any clause that allows the supplier to terminate the contract, or take any other step, due to the customer entering an insolvency process.

Suppliers are also prevented from demanding payment for pre-insolvency debts owed by the customer as a condition of continued supply.

Additionally, where the supplier had a contractual right to terminate the contract due to an event occurring before the customer went into the insolvency process (whether or not linked to payment issues), the supplier loses this right for the duration of the insolvency process.

Can employees with caring responsibilities be placed on Flexible Furlough?

Employees who are unable to work because they have caring responsibilities resulting from the coronavirus can continue to be furloughed. For example, employees that need to look after children can be furloughed, as you have previously submitted a claim for them in relation to a furlough period of at least 3 consecutive weeks taking place any time between 1 March 2020 and 30 June.

As more people return to work, there is an increased chance of more parents having childcare issues until Schools are fully open. However, they can’t be placed on furlough unless they had been on it before. So it would likely be unpaid leave, unless the government amends the scheme to grant an exemption.

What are the data protection implications of holding Covid-19 health data?

The ICO is providing new guidance to organisations regarding data protection and coronavirus, which can be accessed here: https://ico.org.uk/for-organisations/data-protection-and-coronavirus/

Information about the Covid-19 health status of individuals is special category data under the GDPR. This means it is high risk which has implications for how you use it, store it and keep it secure.

You will already hold health data about your employees as this is necessary to provide a safe, accessible place to work and to make reasonable adjustments to the workplace. You now need to make sure that the information you gather about your employees, visitors to your sites, customers and suppliers about Covid-19 is processed in accordance with data protection laws.