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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 are the consequences of the shake up of the planning Use Class system?

The Town and Country Planning (Use Classes) (Amendment) (England Regulations) 2020 were laid before Parliament and come into force on 1 September 2020. They apply in England only.

The changes include the revocation of the following Use Classes;

  • A1 – shops
  • A2 – financial and professional services
  • A3 – restaurants and cafes
  • A4 – drinking establishments
  • A5 – hot food takeaways
  • B1 – business. Also revoked are the sub parts of B1;
    • B1(a) – offices
    • B1(b) – research and development of products and processes
    • B1(c ) – industrial process
  • D1 – non residential institutions
  • D2 – assembly and leisure

The changes include the amendment of the following Use Class;

  • B2 (industry)

The changes include the introduction of the following Use Classes;

  • E – commercial, business and service
  • F.1 – learning and non-residential institutions
  • F.2 – Local community

There are no changes to the following Use Classes;

  • C1 – hotels, boarding and guest houses
  • C2 – residential institutions
  • C3 – dwellinghouses
  • C4 – small HMO

From 1 September 2020;

  • Small retail shops (not more than 280 sq metres net sales area) selling essential goods including food and at least 1 kilometre from another shop will cease being an A1 use and will become a F.2 (local community) use;
  • Other A1 shops will become an E (commercial, business and service) use;
  • A2 uses will become an E (commercial, business and service) use;
  • A3 uses will become an E (commercial, business and service) use;
  • A4 uses will not be in a Use Class, they will be sui generis, ie not in any use class;
  • A5 uses will not be in a Use Class, they will be sui generis, ie not in any use class;
  • B1 uses (included B1(a), B1 (b) and B1 (c) will become an E (commercial, business and service) use;
  • B2 uses will either be B2 uses or will be Class E uses.
  • Clinics, health centres, creches, day nurseries and day centres (previously D1 uses) will become an E (commercial, business and service) use;
  • Schools, non residential education and training centres, museums, public libraries, public halls, exhibition halls, places of worship, law courts (previously D1 uses) will become an F.1 ( learning and non-residential institutions) use;
  • Cinemas, concert halls, live music performance venues, bingo halls and dance halls (previously D2 uses) and will be sui generis, ie not in any use class;
  • Gyms, indoor sport, recreation or fitness not involving motorised vehicles or firearms principally to visiting members of the public (previously D2 uses) will become an E (commercial, business and service) use;
  • Hall or meeting place for the principal use of the local community (previously D2 uses) will become an F.2 (local community) use;
  • Indoor or outdoor swimming baths, skating rinks, outdoor sports or recreation grounds (not involving motorised vehicles or firearms) (previously D2 uses) will become an F.2 (local community) use.

Changes of use within a Use Class do not constitute development. That being the case, provided the Order is applicable, its operation not having been restricted by planning condition, Agreement or Article 4 (1) Direction for example, planning permission would not be required, development as defined not happening.  If legally binding confirmation is required that planning permission is not required this can only be obtained by way of a successful application for a Certificate of Lawfulness. In the absence of such, there is some risk.

It remains the case that planning permission may be required for operational works to buildings. It also remains the case that other consents and permissions may be necessary for example licenses. Furthermore amendments to leases may be required if the property is rented.

The Regulations additionally include transitional arrangements because of permitted development rights for changes of use in the Town and Country Planning (General Permitted Development) (England) Order amongst others.  To respond to this Regulations introduce a ‘material period’ which is defined as meaning the period beginning 1 September 2020 and ending 31 July 2021. It is expected during the material period the Orders giving permitted development rights for changes for use which do constitute development will be amended / updated to reflect the new use classes.

Click here to view the Regulations.

The above is based on our understanding of the new Regulations at the time of issue and in advance of planning practice guidance being issued.

Can I use flexible furlough to utilise an employee's holiday entitlement?

Employees are generally permitted to take holidays during furlough. However, Government guidance has been updated to state that “Employees should not be placed on furlough for a period simply because they are on holiday for that period.” If a period of furlough happens to coincide with an employee’s holiday then you should ensure that there are business grounds to support furlough being used in that instance so that it isn’t just being used as a means to fund holiday utilisation.

What fees will I pay for a loan under CBILS?

Borrowers will not have to pay a guarantee fee. Lenders will pay a fee to access the scheme. The Government will make a Business Interruption Payment to cover the first 12 months of interest payments and any lender-levied fees, allowing smaller businesses to benefit from no upfront cost.

British Business Bank has indicated that following earlier discussions with the banking industry, some lenders indicated that they would not charge arrangement fees or early repayment charges to SMEs borrowing under the scheme. Each business should check the terms of the loans being made to ensure this is the case and what the interest rate and prepayment fees will be following the period in which the Government makes payment of these amounts.  

BSA 2022 states that RP’s will have greater powers (to encourage residents to provide access and to fulfill their duties). What are these powers and when are they expected?

Residents will be obliged to:

  • Not act in a way that creates a significant risk of a building safety risk materialising
  • Not interfere with building safety equipment in the common parts
  • Comply with an Accountable Person’s request for information in relation to the assessment and management of building safety risks.

The Accountable Person then has powers in relation to these duties, including:

  • Issuing a contravention notice, requiring a resident to pay for replacement or repair of safety equipment which they have interfered with
  • Applying for court orders in certain situations
  • Requesting access at a reasonable time (in writing with at least 48 hours’ notice) to a resident’s property for the purposes of assessing or managing building safety risks, or checking compliance with the resident’s duties as above.

Secondary legislation is still awaited to bring these provisions into force, so the timing is unknown, but it will likely be within the next 12 months in line with the anticipated timetable for the remainder of the Act.

Will site visits, hearings and inquiries still take place?

Due to the new guidance on social distancing and remote working, the Planning Inspectorate initially stated that site visits, hearings and inquiries would be cancelled. However, there is very much a push from the Secretary of State to keep the planning system moving notwithstanding the requirements to adapt to new ways of working. The Government now expects all hearings to be conducted virtually and where a virtual hearing is not possible, the expectation is that alternative arrangements will be put “speedily” in place and in accordance with social distancing requirements.

The Planning Inspectorate have been exploring ways of conducting hearings and inquiries remotely using technological means and conducted their first “digital” hearing on 11 May .

The Business and Planning Act 2020, which entered the statute books on 22 July 2020, includes provisions which allow more flexibility in relation to how appeals are determined including an ability for the Secretary of State to decide to adopt a procedure which is a combination of written representations, a hearing and/or an inquiry.

Site visits have re-commenced where it is safe to do so. The Inspectorate is looking at whether a site visit is necessary and has conducted a trial of “virtual site visits” where sites are assessed by means of photographs or video evidence.

The Planning Inspectorate have subsequently been scaling up conducting digital hearings, which also includes holding virtual local plan examination hearings.