Skip to content

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

VIDEO: SRA Standards and Regulations

Damien Charlton, Julie Huntingdon and Chris Hugill look at the SRA Standards and Regulations (STaRS) for solicitors which came into effect late 2019, and represented a whole new regulatory landscape for the legal profession. The enhanced reporting and transparency obligations have an important impact on in-house practice, so this webinar gives you the opportunity to reflect on how the new rules impact on in-house lawyers, in both your professional and personal lives.

This webinar is part of a series designed for in-house lawyers. If you would like to register to receive invitations to future events for in-house legal counsel, please email damien.charlton@wardhadaway.com.

Which charities will benefit from this funding and when – Key Services?

The Government will allocate £360 million to charities providing key services and supporting vulnerable people during the crisis.  £200 million of this amount will be paid to Hospices UK to be distributed to hospices to help increase capacity and give stability to the sector.  The remaining amount is to be allocated to:

  • St Johns Ambulance to support the NHS
  • victims charities, including domestic abuse, to help with potential increase in demand for charities providing these services
  • charities supporting vulnerable children, so they can continue delivering services on behalf of local authorities;
  • disabled people
  • Citizens Advice Bureau to increase the number of staff providing advice during this difficult time

The Government Departments will identify priority recipients, with the aim that these charities will receive money in the form of a cash grant over the next few weeks and by the end of April to assist in paying amongst other costs April’s wage bill.

How do you support your Mental health first aider (MHFA) team?

We recommend that ongoing support is provided to all MHFA’s beyond completion of the MHFA training. It is necessary to do refresher training (approx. every 3 years) and ideally ongoing ‘continued professional development’ should be provided as well as regular opportunities for debriefing / seeking support. One way of supporting your MHFAs in the workplace is by creating a buddy system amongst the MHFAs. That way the individuals carrying out the role of MHFAs have a support structure in place amongst themselves. All trained MHFAs can also reach out to management to discuss any concerns they have or to seek any further support they need.

Should I continue to carry out housing inspections during the coronavirus outbreak?

As the pandemic progresses, more and more people will be forced to self-isolate and, inevitably, both tenants and staff will be affected. Put plans in place to mitigate the impact that this may have, particularly regarding staff shortages. The most important focus here should be communication.

The Covid-19 outbreak will affect the pace of everyday life and delays will be expected. Rather than allowing the pandemic to take over completely, it is important to maintain open communication with tenants as much as possible and inform them of any front-facing challenges that you may face.

The Protocol does envisage that delays may occur and allows for some degree of flexibility. Whilst all efforts should be made to conduct inspections where practical and possible, it should be expected by all parties that timescales will be extended during this crisis. It is fundamental, however, that all changes made to standard practice are communicated and explained to tenants to manage expectations.

Similar flexibility should be afforded to tenants. As households are required to isolate it will not always be possible to gain access to properties as would usually be expected and required. Likewise, vulnerable people will wish to protect themselves and their families and may refuse access on this basis. During this period, a degree of understanding must be exercised and concessions made.

Inspections may be delayed if anyone in the household has  symptoms. A questionnaire should be prepared for those visiting properties to assess so far as possible the risk; Personal Protective Equipment should be issued to those visiting, and government guidelines followed.

Are permitted development rights now in existence for the creation of emergency medical facilities?

Yes. The Town and Country Planning (General Permitted Development) (Coronavirus) (England) (Amendment) Order 2020 came into force on 9 April 2020 giving permitted development rights for emergency development. The permitted development right is available to local authorities and health service bodies (as defined) on land owned, leased, occupied or maintained by it for the purposes of:

  • Preventing an emergency
  • Reducing, controlling or mitigating the effects of an emergency
  • Taking other action in connection with an emergency

It could cover, for example, the temporary change of use of buildings into a Nightingale Hospital or the establishment of a testing centre.

The permitted development right is not permitted in certain instances and is subject to a number of conditions including the notification of the local planning authority and the cessation of the use before 31 December 2020.

Further detail of the permitted development right is available at the link below.

http://www.legislation.gov.uk/uksi/2020/412/made