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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 I make a Will while I am self-isolating?

Your lawyers can take your instructions by telephone, Skype, Zoom or a similar tool. However, the formal requirement to make a valid Will requires two witnesses to be present with you when you sign the Will and they must then add their signatures. The witnesses or their spouse cannot be beneficiaries or they will forfeit their inheritance.

The main challenge is how to have your witnesses with you at a time when we are being advised to socially distance. One option would be for the witnesses to stand outside your window or at a safe distance from you where they have a clear line of sight. The witnesses can watch you sign and then you could post your Will through your letterbox or leave it on a surface for them to pick up so that they can then sign their names too. If the witnesses live together then they do not need to keep two meters apart from each other.

The Wills Act 1837 requires that your witnesses must be physically present when you sign your Will and therefore it is not possible to do this by Skype, Zoom or similar video conferencing means. You may however want to video record the process by which you and your witnesses signed your Will so that you have a record of what was done, particularly if you are worried that someone might challenge the validity of your Will in due course.  You can of course re-execute your Will once social distancing has been relaxed if you are particularly concerned.

Be aware that the virus can remain on documents for more than 24 hours so it would be sensible for everyone to wear disposable gloves and in any event to wash hands thoroughly after handling the Will.

Emergency legislation may be passed regarding the requirement to make a valid Will but you must follow the current rules unless or until new legislation is passed.

What options do I have if my employee, who can work from home, is struggling to do so because they have young children at home who need "teaching" and supervision?

This is likely to be a common situation and employers and employees are going to have to take a pragmatic approach. You could enter into a temporary flexible working arrangement perhaps agreeing to vary working hours/days or reducing targets or agree to use some annual leave.

Employees could ask to take a period of unpaid leave, asserting their right to time off to care for a dependant but the lack of pay is likely to be unappealing.

Alternatively employees who are unable to work because they have caring responsibilities as a result of COVID-19, which includes childcare responsibilities, can be furloughed.

What are the changes to the law?

On 25th June 2020, the Corporate Insolvency and Governance Act, among other things, introduced new restrictions on suppliers of goods and services to terminate the contract in the event that the customer enters an insolvency process.  This has very important consequences for many businesses as it could expose them to greater financial risks.

Can I reduce the risk of IR35 applying?

It is possible to review working arrangements for contractors before the new rules come into effect. This will require immediate action.

You could consider terminating current contracts and entering into new terms that reflect working arrangements for a self-employment arrangement.

Another possibility is encouraging contractors to abandon the PSC model and provide services under a compliant umbrella company.

In the event of a determination of employed status you should seek to enter new terms that at the very least reflect the new tax arrangements .

What do I do if I can't travel to the UK to activate my visa?

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.