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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

Do I need to obtain consent from a member of staff if we have taken the decision to restrict/alter their duties?

If the duties are so fundamentally different from their contracted role, then yes. For example, if you are asking a frontline clinical member of staff to undertake administrative tasks in another area, then this will be a fundamental change to their terms and conditions for which you need their consent.

If there is a minor alteration to their duties, or the clause within their contract is wide enough to cover their amended duties, then arguably to do not need their consent but best practice would be to obtain their agreement.

What other financial support is there for businesses?

 Aside from the CBILS Scheme, the Government have, or are in the process of, implementing several different schemes to support businesses financially through the Covid-19 outbreak.

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.

What should be included in genuinely self-employed contractor terms?

If you consider the factors used to determine status you can include the following terms that are more in line with a self-employed relationship:

  • The right to provide a substitute of the contractor’s choice in the event the individual is not able to perform the services;
  • The ability to work for other businesses as long as doing so will not affect the services to be provided by the contractor;
  • The contractor should have sufficient control over how, when and where (if possible) they provide the services;
  • A degree of financial risk can be included for unsatisfactory work or failing to complete a project or task

We have terms that cover all of these points that can be tailored to your needs. The consultancy agreement is included in our IR35 toolkit.

What was the eligibility criteria for the Government’s self-employment income support scheme?

You will be eligible if you are a self-employed individual or a member of a partnership and you:

  • have trading profits of up to £50,000
  • earn the majority of your income from self-employment
  • have submitted a Tax Return for 2019
  • have traded in the tax year 2019/20
  • are trading when you apply for a grant, or would be except for Covid-19
  • intend to continue to trade in the tax year 2020/2021
  • have lost trading/partnership profits due to Covid-19