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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 I rotate staff who are furloughed? Can I put someone on furlough, bring them back when I need to, and then put them back on furlough, as demand requires? And practically how can we deal with this for those who want to rotate?

You can rotate staff on furlough or flexible furlough.

One option is to make it clear in the letter agreeing to being furloughed that there is an open ended right to rotate and to be able to take them off furlough and bring them back and put them back on.

So the employer reserves the ability to rotate by building into the agreement, but only exercises it if it is permissible.

Rotation is quite key for employers who need to make a temporary reduction to their overheads but want to retain the skills base to call back when work picks up. Having furloughed staff return on a part-time basis may reduce the need to rotate.

It also helps in the employer being able to show that they are treating the workforce as fairly as possible and everyone is taking a reduction. Get in touch if you need help preparing the documentation for furlough that will permit rotation or flexible furlough.

Read more about flexible furlough and how this can be used as part of the CJRS.

 

What processes can I adapt regarding Housing Disrepair?

As we all adjust and adapt in line with the Government’s guidance throughout this uncertain time, we must consider how we can revise current processes and implement new ones to maintain effective and compliant ways of working. We have identified several key issues that all housing providers should consider.

Protocol Compliance

Housing providers will continue to receive new disrepair claims. Throughout the disruption caused by coronavirus, landlords will still be expected to respond to these claims and comply with the Pre-Action Protocol for Housing Conditions Claims whilst doing so. We address the issue of disclosure in particular below.

Letters of claim will continue to be sent by post to your Registered Office, and the deadlines will run from the date of deemed service. Ensure you have systems to enable you to scan correspondence and forward it to the responsible officer who will handle the claim so deadlines are met.

Under the Protocol, the deadline for disclosure is 20 working days from deemed service of a letter of claim (2 working days after it is sent). So, for example, a letter dated 2 March 2020 would be deemed served on 4 March 2020 and disclosure would therefore be due by 1 April 2020. All housing providers must continue to comply with the Protocol and so landlords should begin preparing now.

Failure to meet deadlines often result in the issuing of further applications to court by tenant’s solicitors which in turn will lead to unnecessary costs orders against landlords.

Therefore, all records, particularly relating to customer contact and repair logs, should be held electronically. If required, this will allow for such documentation to be redacted for GDPR purposes remotely and disclosed to the tenant’s solicitor simply and efficiently.

Remember it is possible to request an extension to all Protocol deadlines and it is inevitable in these unusual times, this will need to be utilised, and should not be refused. Request extensions to deadlines at the earliest opportunity to enable an achievable timescale. It would be a difficult lawyer that would not agree to such a request.

Should I pay my apprentice to continue training?

Employers should ensure that apprentices are paid at least the Apprenticeship Minimum Wage, National Living Wage or National Minimum Wage (AMW/NLW//NMW) as appropriate (and taking into account the new rates which will take effect from 1 April 2021) for training carried out where their wage received through the Coronavirus Job Retention Scheme does not cover this.

What can I do to make sure my home-working people are doing so safely?
  1. Keep in touch. If contact is poor, workers can feel disconnected, isolated or abandoned. This can adversely affect stress levels and mental health – especially in the current crisis when everyone is feeling more anxious.
  2. Think about the use of laptops/devices (DSE) at home. Provide a basic form of risk assessment for self-completion.
  3. Remind workers of simple steps to reduce the risks from display screen work:
    • take regular breaks (at least 5 minutes every hour) or change activity
    • avoid awkward, static postures by regularly changing position
    • get up and move or do stretching exercises
    • avoid eye fatigue by changing focus or blinking from time to time
Can I still have my domestic gas appliances tested during the coronavirus outbreak?

Yes. The Health and Safety Executive has stated (as quoted from the Gas safe register site):

“Landlords have a legal duty to repair and maintain gas pipework, flues and appliances in a safe condition, to ensure an annual gas safety check on each appliance and flue, and to keep a record of each safety check.

“If you anticipate difficulties in gaining access as the Covid-19 situation progresses, you have the flexibility to carry out annual gas safety checks two months before the deadline date. Landlords can have the annual gas safety checks at their properties carried out any time from 10 to 12 calendar months after the previous check and still retain the original deadline date as if the check had been carried out exactly 12 months after the previous check.

“You are encouraged to arrange your annual gas safety checks as early as possible, as a contingency against tenants being in self-isolation for 14 days (in line with current guidelines), or gas engineers being unavailable due to illness. The two-month period to carry out annual gas safety checks should provide adequate resilience in most situations.

“In the event you are unable to gain access to the property, e.g. persistent refusal of access due to vulnerable tenants self-isolating, you will be expected to be able to demonstrate that you took reasonable steps to comply with the law, and that you are seeking to arrange the safety check as soon as all parties are able. This will need to include records of communication with the tenant, and details of your engineers attempts to gain access.”

Many Registered Providers have been suspending all gas and electrical testing where internal access is required, continuing checks in communal areas and are carrying out emergency repairs only, whilst void works are suspended and staff are working from home. This does not comply with the legislation, or the guidance.