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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

Can agency workers be furloughed?

Yes, if they are paid via PAYE. This includes agency workers engaged under umbrella companies.

The furlough should be agreed between the agency (the employer) and the worker and documented in accordance with the guidance. It is recommended that the decision to furlough is discussed with end user clients. Just like other employees, agency workers cannot perform work through or on behalf of the agency while furloughed. This includes work for the client.

For agency staff working under umbrella companies, it is for the umbrella company and the agency worker to agree on furloughing the worker.

Do I have to quarantine for 14 days when arriving in the UK?

From 8 June 2020, people entering the UK from overseas (excluding those entering from Ireland, the Channel Islands or the Isle of Man) must comply with a mandatory 14 day quarantine period. However, for those travelling to England, a number of country specific exemptions have been introduced.

A full list of the countries excluded from the quarantine provisions can be found on the gov.uk website which change on a regular basis, often on short notice.

Where a quarantine period does apply, a person will not be able to leave the place they are staying in for 14 days, except in some very limited circumstances.

These rules will apply to both British and foreign nationals, however there are some further exemptions to this rule where a person is coming to the UK to undertake a certain role (such as a healthcare professional coming to the UK to provide essential healthcare). A full list of the narrow exemptions can be found on the gov.uk website.

Before travelling, individuals will be asked to provide their contact details and information about their journey and the accommodation that they will be self-isolating in. To do this, individuals will need to fill in an online form on the gov.uk website. Individuals who refuse to fill in this form may be fined £100 and/or denied entry at the UK border should they not be a British citizen or UK resident.

The information provided in the form will ensure that the Government can check that an individual is self-isolating at the address given. Where an individual refuses to self-isolate they can be fined £1,000 if they are staying in England or Wales.

Once visa application centres re-open overseas and UK visa applications are processed, this 14 day period will need to be taken into consideration and may require employment start dates in the UK to be delayed.

What measures are being implemented to protect residential property tenants?

On 18 March 2020, the Government announced that it would pass emergency legislation which would prevent landlords, both social and private, from bringing possession proceedings against tenants who are unable to pay their rent. The Housing Secretary, Robert Jenrick, stated that “no renter who has lost income due to coronavirus will be forced out of their home, nor will any landlord face unmanageable debts.”

The announcement came after several organisations, including housing charity Shelter, expressed concerns that more than 50,000 households could face possession proceedings due to the economic uncertainty following the Covid-19 outbreak.

I pay child maintenance and half of my children's private school fees to my ex-partner but I have been placed on Furlough, with no top-up from my employer, so my income has dropped significantly. Is there anything I can do?

a. You should first try and discuss this with your ex-partner, either directly or through a Solicitor, to see whether an amicable agreement can be reached.

If you contribute to private school fees voluntarily, it is a matter for you and your ex-partner to resolve the issue with the school, depending whose name is on the bills. You may need to speak to the children’s school to see whether they can offer any reductions or remedies in relation to those payments. If you contribute to the school fees as part of a Court Order, you will need to ensure you do not breach the Order and you may need to consider applying for a variation of the Order if you can no longer afford the payments or reach a compromise agreement with your ex-partner.

You can use the Child Maintenance Service (CMS) calculator (https://www.gov.uk/calculate-child-maintenance) to recalculate your child maintenance obligations using your amended income. This recalculation can then be used in your discussions and you can formally instruct the CMS to verify that calculation if you and your ex-partner cannot reach an agreement about it. If you have already formally involved the CMS, they do carry out an annual review of child maintenance payments, however, they will also recalculate payments outside of the review period where there has been a change in income of 25% or more. We expect the CMS will be experiencing a high volume of enquiries at the present time so anticipate there may be delays in them assisting.

The position on child maintenance payments included in a Court Order are slightly more complicated and how you approach this will depend on how much time has passed since the date of the Order.

Introduction - How am I going to get people back into the workplace?

As we move to look at re-opening businesses and getting people back into the workplace there is work to be done by employers, firstly in planning how they are going to do this, and secondly, communicating those plans to staff. The only way in which businesses are going to be able to manage the transition back to some form of normality is by speaking to their staff and re-assuring them about the measures that will be put in place to safeguard their health and safety in order to enable them to return. Any successful return to work will need to based on carefully thought out plans and providing re-assurances to employees that necessary action is being taken.

Employers will be focusing on:

  • How do I get my workforce back safely, and
  • How do I give my workforce the confidence to return.