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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.

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Is there anything I need to put in place for their return? What are my responsibilities?

The basics of health and safety law requires that employers take “all reasonably practicable steps” to ensure workers’ safety and that a suitable and sufficient assessment of risk is undertaken. It is the individual assessment of Covid-19 risk in each workplace that will be central. Employers will be required to conduct a robust risk assessment and then, following the hierarchy of controls, put robust processes and safeguards in place to address those risks.

UK government guidance and HSE advice is continually evolving, which in practice means that any risk assessment will need to be reviewed very regularly as that guidance develops. There is flexibility for individual businesses within the overall government framework and there will need to be a process of evaluation to ensure that the measures in place continue to meet the requirements.

The starting point of avoid, eliminate and control means looking at individuals continuing to work from home where possible (the fewer the number of people back in the workplace the lower the risk), and if not look at risk management, which leads to administrative controls – i.e. changing work practices before ending up at PPE. PPE is generally seen as control of last resort but in practice – facemasks, disposable gloves and constant prompts to wash hands for example.

In terms of changing working practices, employers should be thinking about:

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  • what about limiting customer interactions
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  • what about higher risk workers
  • should work tools and equipment be allocated on an individual basis to employees.

These decisions need to be recorded and clearly communicated to staff members.

Last updated on 6th May, 2020

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Employment costs are one of, if not the, largest cost to your organisation. These costs will have an effect on your financial well-being – and many organisations are now considering how to reduce employment costs. That said, your workforce is also your most important asset and as we get back to business, you will need your workforce to run the organisation, produce your goods, deliver your services and deal with your customers.

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If your 30-day visa to travel to the UK (vignette) has expired or is about to, you can request a replacement free of charge until the end of 2020 by contacting the Coronavirus Immigration Help Centre. This can be granted with new and extended validity dates to allow travel once you are able to.

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What is in the WH Toolkit?

We have developed a toolkit to assist with compliance. The Toolkit contains a specimen contract; detailed guidance; step by step guides and flowcharts; details of the factors to take into account for the status determination test; procedures for challenging the determination; and standard letters for the process.  Click here to fill in a form and register your interest in the Toolkit, which contains:

  1. Detailed guidance in the form of Key Facts
  2. Employment status checklist
  3. Employment status assessment flowchart
  4. Status questionnaire and guidance
  5. Letter confirming self-employed status (agency)
  6. Letter confirming employed status (agency)
  7. Letter confirming self-employed status (direct with PSC)
  8. Letter confirming employed status (direct with PSC)
  9. Status disagreement process guidance
  10. Status disagreement process flowchart
  11. Letter confirming outcome of status disagreement process
  12. Consultancy agreement

Last updated on 4th February, 2021