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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

How do you manage employees who aren't furloughed and are unhappy that they still have to work?

Although there is no formal selection process that must be followed in order to furlough staff, the basis for selecting who will be furloughed should be explained to all relevant staff. Basing this on work levels, required skills or whether work can in fact be carried out efficiently from home will help this process. Staff can be invited to volunteer to be furloughed or re-furloughed. Any requests can be considered on a case by case basis. It may be that a particular skill set is required which may result in an employee’s request being refused.

Can I move house during the coronavirus pandemic?

Yes unless you are self-isolating, infected with Covid-19 or within a vulnerable group.

The Government has issued updated guidance on 13 May providing comprehensive advice to reflect the move to relax lock down restrictions and encourage house sales. The advice can be found here:

https://www.gov.uk/guidance/government-advice-on-home-moving-during-the-coronavirus-covid-19-outbreak

Key points to note

Unless you are self-isolating, infected with covid 19 or vulnerable, the guidance states that you can move house, provided you comply with social distancing measures at every stage, whether visiting a seller’s house or accepting visitors or professional for viewings, surveys and removals.

All businesses such as surveyors, estate agents and removals, linked to the housing market may now operate, provided that social distancing measures are observed and safe working procedures (see link below) are followed.

https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/homes

House viewing should be conducted virtually wherever possible, and open-house viewings should not be conducted. Houses should be cleaned before and after visitors come, and home owners should vacate during viewings and surveys to minimise the chance of contact. Doors and windows should be left open, and sinks made available for hand washing.

Agents can supervise, provided they maintain social distancing.

New homes show houses should be operated on an appointment basis, and cleaned between viewings, with hand washing facilities made available. Staff should adopt safe working procedures. Housebuilder sale-staff, tradespeople, fitters and NHBC inspectors can all attend to facilitate viewings, fit out, commission equipment and inspect completed homes.

Solicitors and Estate Agents remain unable to open their premises to members of the public, for the time being. Government guidance advises that solicitors adopt special covid 19 clauses to permit flexibility on completion dates where parties become unable to move or complete for reasons connected with the pandemic.

The Law Society in conjunction with other trade and professional bodies in the sector, has published links to pan-industry guidance on the re-opening of the housing market:

https://www.lawsociety.org.uk/news/press-releases/industry-issues-guidance-kickstart-housing-market/

What happens if a patient is admitted to critical care during the pandemic?
  • On admission to critical care, the risks, benefits and likely outcomes of the different treatment options should be discussed with patients, families and carers so they can make informed decisions about their treatment wherever possible.
  • A member of the critical care team should be involved in these discussions whenever the patient or team needs advice about critical care to make decisions about treatment.
How does a Public Body amend its contracts to enable continued payment to contractors?

The latest Cabinet Office guidance published Monday 6 April 2020 titled ‘Procurement Policy Note PPN 02/20: Additional guidance. FAQs and model terms for construction’ provides model deeds of variation for JCT and NEC3 contracts to provide for such payments to be made. As the Cabinet Office guidance states, legal advice is likely to be required to make sure that the model variations work with your specific contracts. Please contact one of our construction specialists if you need advice and assistance.

For a copy of the guidance note click here: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/878338/PPN_02_20._Additional_guidance__FAQS_and_model_terms_for_construction.pdf

Can I apply a Force Majeure clause?

If a contract contains a force majeure clause this may become operative due to the coronavirus pandemic and related emergency legislation. Such clauses exist to ensure that if some unforeseen event prevents a party from being able to perform their obligations under a contract, either on time or at all, they will be excused from their obligations and not be held liable for non-performance.

The clause must actually be written into the contract to have effect – a force majeure clause cannot be implied into a contract. Whether it can be relied on by a party will depend on the wording of the clause itself as it may only be applicable in certain limited circumstances.

You should seek legal advice at an early stage if you think that force majeure is relevant, because a number of potentially complex issues must be addressed, many of which will turn upon the exact wording of the force majeure clause in the contract in question:

  • Has a force majeure event actually arisen?
  • What notification process do you have to follow to rely on the provision?
  • What mitigation steps do you have to take?
  • What is the effect of the force majeure event – is the contract suspended, or can it be terminated (which might not be what you want)?