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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 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 are the responsibilities of employers under the coronavirus Test and Trace scheme?

The Government has produced workplace guidance for employers, setting out 2 key messages for employers:

  • Continue to make workplaces as safe as possible; and
  • Encourage workers to heed any notifications to self-isolate and to support them while they are require to isolate

Government guidance can be accessed here: How it works (an overview) and Workplace guidance for employers.

The proposed start date on the Certificate of Sponsorship is about to pass, what do I do?

Sponsors should update the proposed start date by adding a sponsor note to the CoS via the Sponsor Management System.
Does a sponsor need to report a change in workplace if a Tier 2 visa holder is working from home as a result of Covid-19?

How can RPs carry out Person Centred FRAs/PEEPs on tenants within directly managed supported living units where the RP is not providing support and any floating support provider doesn't see it as part of their responsibility?

There is no simple answer.

The NFCC guidance states:

“The person-centred fire risk assessment is intended only as a simple means for non-specialists who have suitable understanding of relevant fire risks to determine whether additional fire precautions might be needed. The person who carries out the person-centred fire risk assessment will depend on the circumstances of the housing and support provision. It can be carried out by those who regularly engage with the resident, with input from specialists where necessary. Assessments will normally be undertaken with residents themselves.

In sheltered housing with scheme managers, the scheme managers normally engage with residents on a routine basis, enabling residents who need a person-centred fire risk assessment to be identified. Many vulnerable residents will be in receipt of care, so enabling the care provider to identify residents in need of a person-centred fire risk assessment. Providers of regulated care are required to take into account risks to people from their wider environment, to take steps to help people ensure that they are dealt with by appropriate agencies, or to raise safeguarding alerts when this is appropriate. Where a ‘stay put’ strategy is adopted, there will be a need to identify residents who need assistance from the fire and rescue service to evacuate the building.

In supported housing, the number of residents in each property is usually quite small. This, and the nature of the care service normally provided, enables person-centred fire risk assessments to be carried out asa matter of course, when a resident first moves into the property.

Where additional fire precautions cannot be provided in the short term, the risk should be reduced as far as reasonably practicable and an adult at risk referral should be made to Adult Social Care.”

Ideally then the RP will need to engage with any care providers in order to conduct the PCRA and identify risk mitigation measures. If they are reluctant to do so, the RP should engage with the individual in any event in undertaking the assessment.

Is there going to be any support after October 2020 for employers to try and protect jobs?

The Chancellor announced:

  • A new “job retention bonus” for employers to access for furloughed employees subject to certain conditions being met – see below for more information.
  • A “Kickstart scheme” which will directly pay employers to create jobs for any 16-24 year old at risk of long-term unemployment.
  • Incentives for employers to take on apprentices.

As a result of the CJRS being extended, the Job Retention Bonus will no longer be paid in February 2021.