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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 if an employee cannot work from home but is genuinely afraid of travelling / going into work - what options do I have?

There is less guidance in respect of whether an employee can refuse to go into the workplace as a result of health and safety concerns about their commute. An employer’s duties to ensure the health, safety and welfare of its employees only extend to the workplace or where an employee is acting in the course of their employment. This does not include the risks of travelling to and from work by public transport.

As there are various ways in which an employee can travel to work, it will be difficult for them to legitimately refuse to come to work due to their commute.  Employers should discuss any concerns with the employee and seek to find an appropriate resolution. The government has published guidance on safer travel for passengers during the Covid-19 pandemic and employers should encourage flexibility as far as possible, such as allowing employees to travel at off-peak times and staggering workers’ hours.

What will happen to patent, trade mark and design registration applications that are currently being processed or which I want to file?

In recognition of the problems that the current situation is causing, the UK IPO classed the 24th March and all subsequent days as “interrupted days” which means that deadlines that fall within this period will be extended until the UK IPO declares that the interrupted days have ceased. As lockdown has begun to be eased, the IPO has now reviewed its position and has confirmed that the “interrupted days” period will come to an end on the 29 July 2020. This means that Thursday 30 July 2020 will be the first normal day of operation, therefore all “interrupted days” deadlines will expire on this day. Similarly, if your deadline falls after the period of interruption ends, this deadline will not be automatically extended.

The IPO is conscious that many businesses may still be in challenging positions when the period of “interrupted days” end. They will endeavour to continue to provide flexibility and support to assist businesses with their applications. They hope to temporarily remove fees for requests for extensions of deadlines, and will give further updates when this fee exemption is in place.

The IPO continues to encourage applicants to meet original deadlines where they are able.  As their offices are closed, the UK IPO is not currently processing paper forms (i.e. hard copy) and faxes. However, they are processing forms which have been submitted electronically, or via email and have made a new email address available for the submission of forms.

Intellectual Property Offices covering other territories have made their own announcements about the extension of deadlines. The EUIPO’s period of extension of deadlines came to an end on the 18th May. However, they have published a Guidance Note and accompanying webinar on the EUIPO website, detailing options for parties who may struggle to meet deadlines and remedies for those who may have missed deadlines.

In a situation where a building has a B1 EWS1 rating but the insurance companies are either refusing to quote or saying the cladding is a fire risk (due to the result of the intrusive survey for the EWS1 rating) and quadrupling insurance premium, is there anything that will help with this situation in the Building Safety Act or the secondary regulations when they come in or do you think it is something case law will have to address?

The amount an insurer charges for providing cover is a critical aspect of the underwriting process. The premium must be sufficient to cover expected claims but must also take into account the possibility that the insurer will have to access its capital reserve –it is risk assessment based and the greater the risk, the higher the premium. Historically, insurers of high-rise buildings would have only had to prepare for a loss caused by damage to just a few flats within a building. That is because the design and construction of that building, with the right materials and fire safety provisions in place, should have limited the spread of fire and allowed the damage to be contained –or at least make this an extremely low risk. Now we know that many buildings have been designed, built and signed off in a regulatory system that an independent Government review has found was not fit for purpose. Premiums will reduce overtime but will be dependent upon the perceived level of risk reducing as the regulatory regime, BSA and BSR become more established.

If, after deploying all control measures the risk is still deemed too great for employees to work safely, then what should employers do?

The law says that if after assessing a risk and considering all the control measures available to you, you cannot undertake a task safely – then you should not undertake the task.

If that means taking BAME workers out of higher risk frontline work, that is what will have to be done.

Beware of workers saying “we’ll accept the risk” – it does not protect you against regulatory/enforcement action or civil claims.

What options do I have if I have staff with childcare responsibilities but their job cannot be done at home?

If it is not possible to find work for the employee to do at home, you do have the option of putting the employee on furlough.