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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

Are all employees now required to wear face coverings?

The guidance states that people should aim to wear a face-covering in indoor spaces where social distancing is not always possible and they come into contact with others, for example on public transport or in some shops, and potentially in the workplace. Face coverings do not mean face masks such as clinical masks worn by certain key workers as PPE, which should be reserved for those people.

Staff working in areas that are open to the public must wear face coverings, this includes:

  • shops
  • supermarkets
  • bars
  • pubs
  • restaurants
  • cafes
  • banks
  • estate agents
  • post offices
  • public areas of hotels and hostels

If these businesses have taken steps in line with Health and Safety Executive guidance for COVID-19 secure workplaces to create a physical barrier between workers and members of the public then staff behind the barrier will not be required to wear a face covering.

For other indoor settings, employers should assess the use of face coverings on a case by case basis depending on the workplace environment, other appropriate mitigations they have put in place, and whether reasonable exemptions apply.

Are there any differences in employment status for employment law or for tax purposes?

The key factors for determining status for employment and tax purposes are generally the same. However there are some cases that highlight the different approaches taken by employment tribunals and HMRC when determining status. The important thing to consider for IR35 purposes is that being deemed employed for tax purposes does not mean a contractor is ’employed’. PSC’s can still be used in moving forward but there are likely to be discussions on the commercial aspects of the contractor arrangement. Employment status for tax purposes is likely to come at a cost for both parties.

Do I need to give a personal guarantee to access finance under the Coronavirus Business Interruption Loan Scheme (CBILS)?

A number of our clients and networks raised issues in the early stages of the Scheme around the requirement for personal guarantees to access finance under the Scheme. The Scheme has now been updated so that:

  • For facilities under £250,000, personal guarantees cannot be taken to support lending under the Scheme.
  • For facilities above £250,000, personal guarantees may still be required by a lender but the amount which can be recovered under these guarantees is capped at a maximum of 20% of the outstanding balance of the CBILS facility after taking into account any other recoveries from business assets.
Do you think MHFA will become a legal requirement for businesses eventually?

This is something which is certainly on the Government’s radar as there is currently a Bill being heard in Parliament about making MHFAs a legal requirement for workplaces. It is still in the very early stages and therefore it is not clear at this stage what the outcome will be. What is clear is that this is an area which is being taken very seriously and it would not be surprising if measures were put in place regarding MHFAs in the workplace.

Does this apply to bankruptcy petitions?

No. This bill relates to corporate insolvencies only. Should you require any advice as to personal insolvency situations, please contact our team.