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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

Can I switch an existing loan facility onto the CBILS scheme?

If a business has been provided with a loan from 23 March on commercial terms, providing the borrower meets the CBILS eligibility criteria, lenders have been asked to bring these facilities onto CBILS wherever possible (e.g. where the lender is accredited to offer the same facility through CBILS) and changes retrospectively applied as necessary. Please contact us if this applies to you and we can review facilities and advise upon the potential changes that may be made retrospectively to the benefit of the business.

Due to the lockdown and government guidelines, my partner and I have moved in to the house I own. Is there anything I need to be worried about?

Where a couple is not married, they have limited rights in relation to each other’s assets and these mainly relate to rights over property assets. There is complex Trust law which governs whether or not your partner could claim an interest in your property and it generally relates to where someone has invested in renovations on the property or promises have been made. If this is something you are concerned about, you and your partner could enter in to a Cohabitation Agreement. These Agreements can set out various matters, including who will pay the bills and where each of you would live if you separated. Most importantly, they can record your intentions about who owns the property and exclude any rights your partner would have against your property.

I pay child maintenance and half of my children's private school fees to my ex-partner but I have been placed on Furlough, with no top-up from my employer, so my income has dropped significantly. Is there anything I can do?

a. You should first try and discuss this with your ex-partner, either directly or through a Solicitor, to see whether an amicable agreement can be reached.

If you contribute to private school fees voluntarily, it is a matter for you and your ex-partner to resolve the issue with the school, depending whose name is on the bills. You may need to speak to the children’s school to see whether they can offer any reductions or remedies in relation to those payments. If you contribute to the school fees as part of a Court Order, you will need to ensure you do not breach the Order and you may need to consider applying for a variation of the Order if you can no longer afford the payments or reach a compromise agreement with your ex-partner.

You can use the Child Maintenance Service (CMS) calculator (https://www.gov.uk/calculate-child-maintenance) to recalculate your child maintenance obligations using your amended income. This recalculation can then be used in your discussions and you can formally instruct the CMS to verify that calculation if you and your ex-partner cannot reach an agreement about it. If you have already formally involved the CMS, they do carry out an annual review of child maintenance payments, however, they will also recalculate payments outside of the review period where there has been a change in income of 25% or more. We expect the CMS will be experiencing a high volume of enquiries at the present time so anticipate there may be delays in them assisting.

The position on child maintenance payments included in a Court Order are slightly more complicated and how you approach this will depend on how much time has passed since the date of the Order.

What perceived gaps do you see in the Building Safety Act 2022 (especially in terms of pending consultations and secondary instruments)?Comments on the value of the Martlet v Mulalley judgment in fire safety cases/unsafe cladding cases

The Act was obviously subject to much debate and criticism as the Bill passed through Parliament. It is difficult to properly assess any gaps until after the necessary secondary legislation has been published and comes into force (along with the remainder of the Act), but some of the likely issues include:

  • The impact on the insurance market, and the (lack of) availability and increased cost of insurance in light of the provisions of the Act
  • How the introduction of retrospective claims will affect the market, both in relation to how parties might go about trying to prove matters which are 30 years old, but also the lack of certainty for those potentially on the receiving end of these claims which they previously had by virtue of the Limitation Act provisions
  • Whether the definition of higher risk buildings is correct, or will require some refinement.

The Martlet v Mulalley case provides some useful observations and clarifications, for example that designers cannot necessarily rely on a ‘lemming’ defence that they were simply doing what others were doing at the time, that ‘waking watch’ costs are generally recoverable, and commentary on certain specific Building Regulations. The judgment however made clear that much of the case turned on its specific facts, so it is useful from the perspective of providing some insight as to how the Courts will deal with cladding disputes in future, rather than setting significant precedents to be followed.

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.