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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 you protect MHFAs from the potential stresses of the role?

There should be some data collected as to the type and number of interactions MHFA are having, to ensure no one individual or individuals are overloaded. MHFAs should be encouraged to maintain regular self-care practice, to lean in to all support provisions available in their organisation, to engage in peer support, and to take a break from their role as a  MHFA to prioritise their own wellbeing as needed. It is also important that those who volunteer to be MHFAs have the support of their managers.  So they have the time to do both their core role and their MHFA duties without feeling pressurised to cram work into spare time to make up for time spent on MHFA duties.

If an employee refuses to come into work is their absence unauthorised and do I have to pay them?

This would depend on the reason as to why the employee is refusing to come into work. An unauthorised absence is where an employee fails to attend work and they do not have a statutory or contractual right, or their employer’s permission, to do so. An employer will not be obliged to pay employees their normal pay for periods of unauthorised absence.

There are some absences which may be viewed as authorised which would entitle the employee to their full pay. For instance, employees who believe that they are in serious and imminent danger by coming to work would be entitled to stay at home and receive pay if their belief is deemed reasonable.

An employer should always try to discuss any unauthorised absences with an employee. They may then consider whether to take disciplinary action against the employee.

Can you ask employees for evidence of the requirement to self-isolate under the Test and Trace scheme?

Yes, you can ask to see any information/documentation sent to an employee informing them that they should self-isolate.

Alternatives to redundancy toolkit

We have developed a Toolkit to help with these issues. The Toolkit contains:

  • LO1 How to Guide: Lay off and short time working
  • LO2 Letter directing employee to take annual leave
  • LO3 Letter confirming lay off (contractual right)
  • LO4 Letter confirming short time working (contractual right)
  • LO5 Letter proposing lay off (no contractual right)
  • LO6 Letter proposing short time working (no contractual right)
  • LO7 Counter notice disputing entitlement to claim redundancy payment
  • LO8 Script for announcing lay off or short time working (contractual right)
  • LO9 Script for announcing lay off or short time working (no contractual right)
  • LO10 Letter proposing reduction in working hours and pay

The cost of this Toolkit is £500 plus vat. If you would like to find out more about the Toolkit, please speak to your usual Ward Hadaway employment contact, or get in touch one of the contacts at the bottom of this page.

What is the penalty for failing to comply with the collective consultation obligations?

Failure to comply with the collective inform and consult obligations could impact on the fairness of any dismissals – see next question. In addition, a Tribunal can award a protective award of up to 90 days gross pay for each affected employee. The purpose is intended punish the employer for not complying with the obligations, not to compensate the employee for their individual financial loss.