Skip to content
Menu

Home › FAQs › What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

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 other options are there to reduce employment costs?

If you don’t want to make redundancies, or if you can’t reduce employee resource, either in a particular department or across the workforce as a whole, then you need to think about alternatives to redundancy.

Equally, you may want to flex the resource you have available to you – without making drastic changes.  For example you may want to consider:

  • unpaid leave and sabbaticals
  • retraining and redeploying
  • forcing annual leave
  • flexible working
  • capability issues
  • lay off
  • short time working
  • reductions in salary
  • reductions in working hours
  • changing to shift working

Last updated on 6th May, 2020

What first steps would you recommend to creating a strategy to integrate pro-active mental health first aid across the workforce?

The Thriving at Work Report and the recent NICE Workplace Mental Health Guidelines provide a good baseline for what all organisations should be doing on workplace mental health – this includes some guidance on training. There does need to be a plan in place and we recommend taking a holistic view of the integration of mental health first aiders into a business – ie it should be one component in a strategy that also comprises training for line managers, awareness training and education for all staff, peer support, and a documented framework for support and signposting.  It is also worth ensuring you have senior manager sponsorship, strong links with Occupational Health if available and also raising awareness via any works councils or employee forums helps ensure there is buy in at all levels.

Last updated on 8th April, 2022

Can I offer credits or re-booking as an alternative to a refund?

The financial implications of having to repay all deposits and advance payments could be very serious for some businesses. As an alternative to a refund, many are offering customers the opportunity to re-book at a later date, or a voucher that can be redeemed against a subsequent booking.

The CMA’s view on this practice is that consumers can in many situations be offered alternatives of this type, but they should not be “misled or pressured” into accepting this. Their view is that a refund should be an option that is just as clearly and easily available. The CMA also points out that any restrictions that apply to credits, vouchers, re-booking or re-scheduling, such as the period in which credits must be used or services re-booked, must also be fair and made clear to consumers.

The full CMA guidance re “The Coronavirus (Covid-19) pandemic, consumer contracts, cancellation and refunds” can be found here.

Last updated on 7th May, 2020

What can I do if someone refuses to wear PPE for cultural and/or religious observance reasons?

Again, the primary point must be that an open dialogue is held with that individual to understand their concerns and to properly consider the impact that not wearing PPE will have on their abilities to undertake their duties. Consideration must be given as to whether there are any parts of their duties that they can undertake and whether they can remain in their role. Engage with the individual to ensure that you understand their point of view. What other duties can they do if they cannot do fulfil all the duties of their role?

Last updated on 19th May, 2020

How should contracting authorities work with PFI providers?
  • Working with PFI providers to get contingency plans up to date
  • If a PFI provider is struggling to achieve service delivery requirements due to Covid-19, then local arrangements should be put in place to:
    • maintain unitary charge payments
    • revise contract requirements/standards

moderating payment and performance regimes where appropriate.

  • In any event, you may wish to review and adjust your requirements to reflect the current situation. It is possible that some requirements can be relaxed, whereas others need to be tightened. For example, there may be an increased need for cleaning and maintenance in certain areas of your PFI premises or the layout of the premises and/or room uses may have temporarily changed. With staff illness and shortage likely to be an issue, you may also wish to consider if the resource can be moved from one area to another to help maintain essential services.
  • When putting local bespoke arrangements into place it is vital that:
    •  Contract requirements or performance standards are not relaxed to the point where health and safety are put at risk.
    • It is made clear that the arrangements are temporary and that matters will return to normal as soon as the Covid-19 emergency is over. Indeed the guidance note makes clear that if assets temporarily close they should be kept in such condition that they can be immediately up and running when this emergency is over. In such instances, likely a basic level of maintenance and security will therefore be required as a minimum.

Last updated on 6th April, 2020