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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

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 I need to obtain consent from a member of staff if we have taken the decision to restrict/alter their duties?

If the duties are so fundamentally different from their contracted role, then yes. For example, if you are asking a frontline clinical member of staff to undertake administrative tasks in another area, then this will be a fundamental change to their terms and conditions for which you need their consent.

If there is a minor alteration to their duties, or the clause within their contract is wide enough to cover their amended duties, then arguably to do not need their consent but best practice would be to obtain their agreement.

Should my apprentice continue their training during the coronavirus outbreak, even if they’re furloughed?

The Government maintains that apprenticeships will be an important part in the economic recovery post-lockdown and therefore ESFA is encouraging training under apprenticeships to continue, even where an apprentice is furloughed, provided that the training does not provide services to or generate income for their employer. E-learning is being encouraged as a method of delivery.

What support did the Chancellor announce for employers to be attracted to take on apprentices?

The Chancellor announced that employers will be given £2,000 to employ apprentices and £1,500 for apprentices over the age of 25 for each apprentice they hire from 1 August 2020 to 31 January 2021. These payments will be in addition to the existing £1,000 payment the Government already provide for new 16-18 year old apprentices.

He also announced that employers would be given £1,000 for taking on trainees in response to the traineeship scheme being extended.

What allowances has the Government proposed for company meetings?

The Government’s Corporate Insolvency and Governance Act introduces amendments to the current rules for companies on holding meetings, to address the difficulties companies are facing due to the Covid-19 pandemic.

The new provisions apply to meetings held between 26 March 2020 and 30 September 2020 (referred to as the “Relevant Period”). Subsequent regulations by the Government can be used to shorten this period or extend by up to 3 months but not past 5 April 2021.

The provisions will have retrospective effect, so meetings that were held after 26 March 2020 that may not have met the usual legal requirements due to lockdown, will be validated under these new provisions. These provisions under the Act make amends to relevant legislation and override a company’s articles of association.

For general meetings and certain other meetings of companies, the Act states that:

  • The meeting need not be held in any particular place;
  • The meeting may be held, and any votes may be cast, by electronic means or other means;
  • The meeting may be held without anyone being in the same place
  • Persons attending the meeting no longer have the following rights: the right to attend in person, the right to participate in the meeting other than by voting, or the right to vote by particular means.

The aim of these changes is to facilitate virtual meetings, and remove the need for a physical venue.

Where a company was required to hold its AGM between 26 March and 30 September 2020, it can be held at any time before 30 September 2020.  The Secretary of State has the power to make regulations to further extend the deadline.