Home › FAQs › What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

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

Who is eligible for CBILS?

To be eligible for CBILS, the British Business Bank has confirmed that businesses should be able to answer YES to the following points:

Your application must be for business purposes
You must be a UK-based SME with an annual turnover of up to £45m. This includes sole traders, freelances, body corporates, limited partnerships and limited liability partnerships. For sole traders to be eligible it is expected that sole traders will need to have a business account with its funders and not be operating via a personal account
Your business must generate more than 50% of its turnover from trading activity
Your CBILS-backed facility will be used to support primarily trading in the UK
You wish to borrow up to a maximum of £5m.

Businesses meeting these criteria from all sectors can apply save for Banks, Building Societies, Insurers and Reinsurers (but not insurance brokers), the public sector including state-funded primary and secondary schools, employer, professional, religious or political membership organisation or trade unions which are not eligible.

Your borrowing proposals must be considered viable by the relevant lender under normal circumstances aside from the Covid-19 outbreak, and the lender believes the provision of finance will enable the business to trade out of any short-to-medium term difficulty. Lending decisions are delegated to the accredited lenders and lenders will need further information to confirm eligibility.

The eligibility criteria for CBILS does not require lenders to take into account other forms of Government support that SME’s may already be benefiting from, most notably business rate relief.

We understand that ownership structure is not taken into account when confirming eligibility and that businesses back by a PE funder or a subsidiary of an overseas entity can be eligible if it meets the other criteria.

An update on eligibility – 3 April 2020

Previously, for facilities above £250,000, the lender must establish a lack or absence of security prior to businesses using the Scheme. The requirement for insufficient collateral has been removed allowing those SMEs who are considered to have sufficient collateral to access the Scheme. We would expect that where security is available, a lender will seek to take security over the relevant assets.

Are any suppliers exempt from this?

Small suppliers (defined by reference to certain financial indicators) are temporarily exempt from these new restrictions until 30th March 2021 in order to account for the difficulties to small suppliers during the Covid-19 pandemic.

There are also certain industries that are exempt from these restrictions (for example financial services). The Secretary of State may also create further exemptions framed by reference to kinds of company, supplier, contract, goods or services or in any other way.

Is there anything I need to put in place for their return? What are my responsibilities?

The basics of health and safety law requires that employers take “all reasonably practicable steps” to ensure workers’ safety and that a suitable and sufficient assessment of risk is undertaken. It is the individual assessment of Covid-19 risk in each workplace that will be central. Employers will be required to conduct a robust risk assessment and then, following the hierarchy of controls, put robust processes and safeguards in place to address those risks.

UK government guidance and HSE advice is continually evolving, which in practice means that any risk assessment will need to be reviewed very regularly as that guidance develops. There is flexibility for individual businesses within the overall government framework and there will need to be a process of evaluation to ensure that the measures in place continue to meet the requirements.

The starting point of avoid, eliminate and control means looking at individuals continuing to work from home where possible (the fewer the number of people back in the workplace the lower the risk), and if not look at risk management, which leads to administrative controls – i.e. changing work practices before ending up at PPE. PPE is generally seen as control of last resort but in practice – facemasks, disposable gloves and constant prompts to wash hands for example.

In terms of changing working practices, employers should be thinking about:

the workspace and how this is laid layout
how do we make sure it is kept clean and hygienic
how do we keep people apart
how can we use toilets, canteens or other shared spaces/facilities safely
how do we promote and enable higher levels of workplace hygiene
if we are going to rely on PPE – can we get it, and is it suitable
what about limiting customer interactions
will there be enough first aiders on site
can we manage fire safety, deliveries etc
what about higher risk workers
should work tools and equipment be allocated on an individual basis to employees.

These decisions need to be recorded and clearly communicated to staff members.

Business support organisations

The Confederation of British Industry

“What you need to know about coronavirus and how it will impact your business”. This includes the very influential and highly regarded daily webinars hosted by Director General Dame Carolyn Fairburn.
https://www.cbi.org.uk/coronavirus-hub/

The Entrepreneurs’ Forum

Links to valuable resources collected by the Entrepreneurs’ Forum team as requested by its members and partner network, including on People, Finances, Physical and Mental Wellbeing, Technology and Leadership.
https://entrepreneursforum.net/support-hub

RTC North

Billed as containing “all the UK government information in one place”, this resource includes information on access to finance, employees, planning and leadership, Growth hub toolkits, and working from home.
https://www.rtcnorth.co.uk/covid-19/

Newcastle Gateshead Initiative (NGI)

Businesses across the UK and around the world are sharing their expertise in everything from remote working to business planning. The team at NGI have collated some of the most useful resources, alongside its own content which is designed to help partner organisations and other businesses across North East England.
https://www.ngi.org.uk/covid-19-business-resources/

North East of England Chamber of Commerce

The NEECC brings together its latest advice and guidance for businesses, as well as some of its own FAQs.
https://www.neechamber.co.uk/covid-19

Greater Manchester Chamber of Commerce

The Chamber has pulled together information about how it and others in the area are supporting all businesses during the Covid-19 outbreak.
https://www.gmchamber.co.uk/covid-19-coronavirus/

North East Growth Hub

The North East Growth Hub toolkit is intended to provide businesses with the latest advice, guidance and support available from government in response to the COVID-19 pandemic. Topics covered include:

Financial support available for businesses
Official guidance for employees, employers and businesses
Advice on effective home working
How to care for staff/suppliers/customers and prevent the spread of COVID-19

https://www.northeastgrowthhub.co.uk/toolkits/covid-19-coronavirus-toolkit

Pro-Manchester

Links to valuable resources collected by the Pro-Manchester team, including national Government support and advice, regional support and cyber security advice.

https://www.pro-manchester.co.uk/home/covid-19-support/

Innovation SuperNetwork

The Innovation SuperNetwork, a “network of networks”, detail on their website what their team of Innovation Managers are offering during these difficult times, as well as details of funding available, and what is being offered by their numerous partners.

https://supernetwork.org.uk/

Can we rely upon the 'reasonable grounds' point to proceed with a petition?

If the debts owed to you pre-date Covid-19 and your debtor seemed unable to pay well before the Covid-19 pandemic took place, it is entirely possible that you will be able to present a petition on the grounds that the debtor would have been unable to pay its debts even if the Covid-19 had no effect on its financial position. We do not yet have any reliable precedent as to how the Courts are likely to deal with such cases. Whether you are likely to succeed will depend on the exact circumstances of the debt and your debtor. There has been one case decided in August 2020 where the Court concluded that Covid-19 did not have a financial effect upon the debtor and that the circumstances which gave rise to the petition had arisen long before Covid and would have occurred in any event. A winding up order was made in that case. What we do know about the court’s approach is that the purpose of the Act is to allow viable companies to trade through the current times and the Court is likely to set the bar high.

Please contact us if there a debt you would like to discuss. Even if presenting a winding up petition is not available for now, there may still be other forms of legal proceedings that you can use to collect money owed to you, like county court proceedings.