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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

Will there be further measures for self-employed announced?

The Government assured parity for the self-employed but it has since accepted that this would be difficult to achieve. The Association of Independent Professionals and the Self-Employed (IPSE) has worked closely with the Government on implementing the current self-employment income support scheme. IPSE has confirmed that it will continue to work on helping to extend measures to all freelancers in need as a result of Covid-19.

The Government announced an extension to the Self-Employment Income Support Scheme from 1 November 2020.

 

Should I have a homeworking policy?

If organisations don’t have a formal home working policy, then they should set out, as soon as possible, in clear terms, what is expected of employees from a data protection perspective when working from home. These might include:

  • If someone is using their own device for remote working, ensuring that any devices that hold work-related information have up-to-date anti-virus software and that broadband connections have properly configured firewalls
  • Reminding staff to contact the organisation’s IT department if they encounter any issues with home working, and not to try and resolve any issues themselves
  • Reminding staff that they should notify relevant individuals within the organisation if they consider that there might have been a personal data breach. A breach will still be notifiable even if it does occur at home during the pandemic. These should be logged by the organisation in their data breach log in the normal way
  • Ensuring staff lock their devices whenever they are not using them
  • Where possible, working in a separate part of the home to family members
  • Ensuring confidentiality of information – advising staff not to have phone calls where others are likely to hear the conversation. This might mean moving to a different room, closing the door, or arranging a call for a more convenient time. If employees have smart speakers, you may want to consider advising them to either turn these off, if they are working in the same room as it, or work in a different room
  • Wherever possible, avoid taking hard copy documents home, and, if papers are taken home, never placing those papers in a bin or using a home shredder – any such papers should be shredded back at the office in the usual way
  • Locking any papers in a safe place
  • Not using social media platforms (unless already used and permitted by the organisation) to discuss work matters
  • Advising extra caution with incoming emails as at times such as this there may be an increased risk of fraud, email hacking, spear phishing etc.
  • Avoiding information being sent to personal email accounts (for example, so it can then be printed at home)
  • Reminding staff of your organisation’s Information Security policies, procedures and protocols. These could be emailed to all staff working from home or they could be directed to such documents on the organisation’s intranet, for example

Organisations should also ensure that their remote access systems can cope with increased demand.

Whilst the ICO appreciates the unprecedented nature of this pandemic, it does not mean that organisations can forget about their obligations as controllers of personal data. If a major data security breach were to happen, there is still the possibility of enforcement action where the organisation didn’t put in place good risk mitigation measures.

We have a specialist team of data protection lawyers here at Ward Hadaway, and would be happy to discuss any data protection concerns or issues that you might have.

Other considerations – the mental health and wellbeing of BAME staff and others

Undeniably and understandably BAME staff, as well as those staff who are identified as being at a higher risk, are going to have high levels of stress and anxiety. For some, this may become of such severity that those staff should be considered to be disabled under the Equality Act 2010. The question as to whether someone is disabled is one that should be answered in conjunction with appropriate medical advice. But the question about how to support any staff suffering with stress and anxiety should not be left until that stage. Proactive steps need to be taken and expert advice obtained on what support measures should be put in place. We know that many NHS organisations are already giving the mental wellbeing of their staff the highest priority.

From our perspective, we would ask managers to be mindful that stress and anxiety is likely to feature in how an individual reacts to questions about the level of risk to their health and the impact on their duties. The conversations with some staff may not be easy to have and may be met with challenge.

For those staff who’s stress and anxiety is such that it would qualify as a disability, reasonable  adjustments will need to be considered to the processes that you are applying.

An additional point to consider – it might be worth writing to all staff, asking them to come forward if they have any health conditions that they think you ought to be aware of, assuring them that such information is being given in the strictest confidence. You want to make sure that you are taking the appropriate measures to ensure their health and safety.

Will councillors still be able to vote if they can’t meet in person?

Local government legislation formerly stipulated that councillors must be physically present to vote and this requirement has already led to the widespread cancellation of Council meetings.  There is a limit to what can be achieved under the chair’s emergency powers and delegation to officers.

The Government has now legislated to allow for remote voting until 7 May 2021. The secondary legislation required was issued in draft on 2 April and has been in force since Saturday 4 April.

The legislation allows for committee meetings to go ahead where members and any members of the public attending remotely can all times “hear (and where possible see) and be heard (and where possible be seen) by the other members in attendance”.

It remains to be seen how many local authorities take up the opportunity to hold a virtual committee meeting. Concern has been expressed that the demographic of local councillors may mean that members have difficulty with the technological mechanisms for holding such meetings. However, the message from the Secretary of State is clear that wherever possible, the planning system should keep moving in these current times.

What is the claim period for Flexible Furlough?

Employers had until 31 July 2020 to make any claims for claim periods up to 30 June 2020. That was the end of the old scheme.

From 1 July 2020, claim periods must start and end within the same calendar month and must be for at least 7 days unless you are claiming for the first few days or the last few days in a month.

You can only claim for a period of fewer than 7 days if the period you are claiming for includes either the first or last day of the calendar month, and you have already claimed for the period ending immediately before it.

For example, if an employee is furloughed for 7 days spanning a month. You can claim the last 3 in one month, and 4 from the next.

The crucial point is that you cannot make claims that cross calendar months.

The first time that you could make a claim for days in July 2020 was 1 July 2020. You could not claim for periods in July 2020 before this point.