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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

I’m a social housing provider. What do I do if I know my tenants are flouting the social distancing guidelines?

If a tenant continues to refuse to take heed of the government’s social-distancing guidelines, for example by inviting large groups of people who do not reside there to their property, it can constitute a nuisance. One housing association successfully applied for an injunction. The injunction ordered by the Court stipulated that no persons, other than the children of the tenant, are to attend the property until the current social-distancing restrictions are lifted by the government.

A representative of the housing association highlighted the need for the current guidelines to be followed and the need for housing providers to ensure that all residents living in their communities are kept safe during this time of ‘unprecedented risk’.

This case demonstrates that flouting of the current restrictions is likely to be considered anti-social in the eyes of the courts – a point which all housing providers should bear in mind during this period. Further, it highlights the availability of an alternative remedy to the issuing of possession proceedings (in light of the government’s moratorium on evictions) to deal with anti-social behaviour during the next three months, Covid-19 related or not.

What criteria will HMRC use to assess applications for furlough from publicly funded organisations?

The government released further clarification on the Coronavirus Job Retention Scheme on 4 April. The wording referred to concerning public sector organisations and organisations receiving public funding remains the same.

The revised guidance does provide a helpful insight into how HMRC will deal with applications made to it for assistance under the scheme. It appears that there won’t be a particularly forensic approach adopted by HMRC. The guidance says you can furlough staff if you cannot maintain your current workforce because your operations have been severely affected by coronavirus.

It goes on to say that all employers are eligible to claim under the scheme and the government recognises different businesses/organisations will face different impacts from coronavirus. The need to demonstrate the impact of coronavirus on your business/organisation is not one of the criteria businesses/organisations are going to need to satisfy, so the government does not appear to intend to set a specific test to determine if a business/organisation is “severely impacted by coronavirus”. It is hoped that this should provide additional comfort to publicly funded organisations facing significant restrictions to their operations during the Covid-19 crisis.

Is there a matched funding scheme for the National Emergencies Trust?

The government has also confirmed it will match donations to the National Emergencies Trust as part of the BBC’s Big Night In fundraiser on 23 April – pledging a minimum of £20 million.

What facilities are available under CBILS?

Lenders implementing the Scheme can assist in a number of ways, including:

  • Term loans
  • Overdrafts
  • Invoice finance
  • Asset finance facilities

The maximum value available under the scheme is £5m, with repayment terms of up to six years for term loans and asset finance. Overdrafts and invoice finance facilities will be available for up to three years.

Can you still have people on furlough leave full-time after 1 July 2020?

Yes. You can continue to fully furlough employees until 30 September 2021 (but from between 1 August 2020 and 31 December 2020 and from 1 July 2021 you need to contribute to the cost). If on full-time furlough, employees continue not to be able to undertake any work for you. As before, they can undertake training, or volunteer or work for another employer or organisation (if contractually allowed).