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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

Have you had any safeguarding issues in relation to staff they see and do you follow your normal safeguarding pathway?

Safeguarding issues are relatively uncommon, however, if they do occur, the normal safeguarding procedure of the organisation should be followed.

My business involves providing services to consumers. What are my legal obligations in relation to deposits paid by consumers for services that I have been unable to perform due to government restrictions?

Many businesses that supply directly to consumers have been concerned to understand their legal position in relation to services that have been cancelled, or that they have been unable to perform, because of the Covid-19 pandemic, and in particular how to deal with deposits paid by consumers for such services. With some degree of restriction on the hospitality and tourism sectors likely to remain in place for some time, such questions will remain important for the foreseeable future.

Can employees reduce their pension contributions?
  • Remember that employees will also be making contributions on any reduced wage under the Coronavirus Job Retention Scheme. The amount contributed may be less, but the contribution rate will be the same, unless the following applies.
  • Employees may reduce their DC employee contributions if their scheme rules allow them to do so, but no further than the statutory minimum if the scheme qualifies as the employer’s auto-enrolment vehicle.
  • Employees might choose to opt-out or cease active membership of their scheme, which might cause a spike in administration at a time when administrators are likely to be understaffed. It is important that employers remember they must not do anything to encourage or induce employees from leaving an auto-enrolment vehicle as this may constitute an offence.
  • Employees who leave their scheme in this way will have to be re-enrolled in due course as and when required by law.
  • For DB schemes, specific considerations apply (see the last section, below).
Can I enact a rent suspension clause in my commercial lease?

Most rent suspension clauses in commercial property leases are unlikely to come to the assistance of the tenant. These clauses normally apply only where the premises has suffered substantial physical damage and are, as a consequence, incapable of being occupied, used or accessed. The coronavirus pandemic does not involve any physical damage to a property, loss from the crisis will be purely financial. Such losses then will not be covered by the landlord’s buildings insurance policy in a way that will allow a tenant to claim rent suspension.

How are civil hearings being conducted?

The majority of hearings are taking place by video or phone.

Court guidance has been issued on telephone and video hearings during the coronavirus outbreak:

https://www.gov.uk/guidance/hmcts-telephone-and-video-hearings-during-coronavirus-outbreak

Where a Judge orders “teleconferencing”, it will take place using BTMeetMe, or video conferencing using Skype for Business or Cloud Video Platform.

All hearings are subject to the relevant jurisdictional rules and practice directions and usual court etiquette, including wearing appropriate attire and not eating or drinking during a hearing.

Electronic bundles of documents and authorities (if required) need to be prepared, indexed and paginated and sent to the Court well in advance of any hearing.