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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

What is the new Permitted Development Right for the construction of new dwellinghouses?

A new Permitted Development Right has been introduced by The Town and Country Planning (Permitted Development and Miscellaneous Amendments) (England) (Coronovirus) Regulations 2020 providing for the construction of new dwellinghouses on detached blocks of flats.

The new Right comes into force on 1 August 2020 and from this date development consisting of works for the construction of up to two additional storeys of new dwellinghouses immediately above the existing topmost residential storey which is a purpose-built, detached block of flats is permitted development.  The Right additionally covers specified associated works, the construction of fire escapes and ancillary structures, bin stores for example.

The Right is subject to detailed criteria being met and to a prior approval process to the Local Planning Authority who can consider the acceptability of the proposed development in a range of respects.  A link to the Regulations is here.

The Regulations additionally include a number of further amendments including additional rights for the holding of markets and for additional temporary uses of land for a time limited period.  They additionally include amendments to existing permitted development rights for the change of use of buildings to dwellinghouses through a requirement that there be adequate natural light in all habitable rooms.

Can we still use the furlough (coronavirus job retention scheme)?

Yes. For further guidance, please see our FAQs section on Furlough.

I’m a housing provider. How do I continue to manage disrepair during the coronavirus outbreak?

The practicalities and processes regarding disrepair claims will undoubtedly be affected. Housing providers will have to adopt a risk-based approach and consider government guidance to handle claims going forward. Key points to consider are:

  • Compliance with the Pre-Action Protocol for Housing Conditions Claims (particularly disclosure)
  • The practicalities of inspection
  • Non-urgent repairs
How do I make arrangements for end point assessments for apprentices?

Arrangements for end point assessments can be modified or rescheduled. End point assessment organisations should engage with External Quality Assurance Providers to agree arrangements for the end point assessments where face-to-face assessments are being modified. Where rescheduling is required due to Covid-19 issues and there is a specified time limit for the ESA post gateway, a further pause of 12 weeks is allowable. This should be recorded by the training provider in the ILR.

Who decides on carrying-over holiday entitlement?

The Regulations do not require any prior agreement between an employer and employee that it was not reasonably practicable for holiday to be taken for it to be carried over.

However, if an employee requests holiday then an employer must have ‘good reason’ for refusing it due to coronavirus. The term ‘good reason’ is not defined so the Government will expect employers, employees and (if necessary on any dispute) the Courts to apply common sense.

The Regulations are not confined to key workers so could, in principle, be used by employers for a wider range of employees.

The Government guidance suggests that the following factors should be taken into account when considering whether it was reasonably practicable to take the leave in the relevant year:

  • Whether the business has faced a significant increase in demand due to COVID-19 that would reasonably require the worker to continue to be at work and cannot be met through alternative practical measures.
  • The extent to which the business’ workforce is disrupted by COVID-19 and the practical options available to the business to provide temporary cover of essential activities.
  • The health of the worker and how soon they need to take a period of rest and relaxation.
  • The length of time remaining in the worker’s leave year.
  • The extent to which the worker taking leave would impact on wider society’s response to, and recovery from, the effects of COVID-19.
  • The ability of the remainder of the available workforce to provide cover for the worker going on leave.