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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

What funding is the Government providing specifically for charities?

The Government has announced a £750 million funding package for charities to ensure they can continue their vital work during the coronavirus outbreak.  This is for a 3 month period and further specific funding may be made available.

Charities which are businesses can also access the Government’s Coronavirus Business Interruption Loan Scheme (CBILS) – Please see our Funding and Finance FAQ’s.

When will these temporary Right To Work measures end?

The Home Office has not stated when it will end these temporary measures, albeit it has stated that it will provide a warning. Where employers have carried out checks using the temporary measures, the Home Office has confirmed that it will require employers to carry out retrospective checks on any of the following:

  • Employees who started working for you when the temporary measures were in place
  • Employees who required a follow up check during the temporary measures (for example because their previous leave was coming to an end).

It is not explicit from the guidance but these retrospective checks must require you to have in your possession the physical ID in its original form. When carrying out the retrospective check, employers must record this using the following wording “the individual’s contract commenced on [insert date]. The prescribed right to work check was undertaken on [insert date] due to Covid-19.”

These further checks must be made within eight weeks of the temporary measures ending, and employers must keep records of both checks undertaken. Where the employer discovers that the employee does not have the right to work during the retrospective check they should stop employing them.

What guidance has the CMA issued about how it expects businesses to behave in response to the global pandemic?

On 30th April 2020, the CMA issued a guidance note setting out its views about how the law operates in relation to refunds.

Where a contract is not performed as agreed, the CMA considers that in most cases, consumer protection law will generally allow consumers to obtain a refund.

This includes the following situations:

  • Where a business has cancelled a contract without providing any of the promised goods or services
  • Where no service is provided by a business, for example because this is prevented by Government public health measures
  • A consumer cancels, or is prevented from receiving any services, because Government public health measures mean they are not allowed to use the services.

In the CMA’s view, this will usually apply even where the consumer has paid what the business says is a non-refundable deposit or advance payment.

This positon reflects the CMA’s previous guidance which they had issued in relation to the requirement of fairness in consumer contracts under the Consumer Rights Act 2015, which was that a clause in a contract that gives a blanket entitlement to a trader to cancel a contract and retain deposits paid is likely to be unfair, and therefore unenforceable – it would be unfair to a consumer to lose their deposit if the contract is terminated without any fault on their part, and if they had received no benefit for the payments made.

The CMA’s latest guidance therefore confirms their view that the Covid-19 outbreak does not change the basic rights of the consumer, and that they should not have to pay for goods or services that they do not receive.

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

Can the apprentice take a break or pause in learning due to coronavirus?

A break or pause in learning can be initiated where the interruption to learning due to Covid-19 is greater than four weeks. This must be reported as a formal break in learning. In such circumstance the funding to the training provider will be suspended for the duration of the break. Previously, the rules only allowed an apprentice to initiate this break in learning but this has been expanded to give employers and training providers the right to initiate this. Training providers should continue with their monthly IRL submissions to the ESFA. During breaks in apprenticeships it is not necessary for the apprentice to comply with the minimum of 20% on the job training requirement but this will resume when the break ends.