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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 enact a rent suspension clause in my commercial lease?

Most rent suspension clauses in commercial property leases are unlikely to come to the assistance of the tenant. These clauses normally apply only where the premises has suffered substantial physical damage and are, as a consequence, incapable of being occupied, used or accessed. The coronavirus pandemic does not involve any physical damage to a property, loss from the crisis will be purely financial. Such losses then will not be covered by the landlord’s buildings insurance policy in a way that will allow a tenant to claim rent suspension.

How are the Courts applying the new guidance?

Overall it is our experience that the Courts are quickly adapting in the context of the Coronavirus epidemic and making pragmatic decisions. The Judges seem live to the difficulties currently been faced by practitioners dealing with litigation and they are applying the new guidance.

The Courts are also mindful of pressures on NHS frontline staff and are taking steps not to put additional pressures on them at this time, including in our experience vacating an imminent Trial.

Reductions in working hours

Another obvious cost cutting measure is to reduce working hours, either temporarily or permanently. Again, it should be done fairly, either across the board or by selecting teams/individuals based on objective business reasons. Imposing without agreement would create significant risk, therefore would require fair selection and consultation.

I’m a social housing provider. What do I do if I know my tenants are flouting the social distancing guidelines?

If a tenant continues to refuse to take heed of the government’s social-distancing guidelines, for example by inviting large groups of people who do not reside there to their property, it can constitute a nuisance. One housing association successfully applied for an injunction. The injunction ordered by the Court stipulated that no persons, other than the children of the tenant, are to attend the property until the current social-distancing restrictions are lifted by the government.

A representative of the housing association highlighted the need for the current guidelines to be followed and the need for housing providers to ensure that all residents living in their communities are kept safe during this time of ‘unprecedented risk’.

This case demonstrates that flouting of the current restrictions is likely to be considered anti-social in the eyes of the courts – a point which all housing providers should bear in mind during this period. Further, it highlights the availability of an alternative remedy to the issuing of possession proceedings (in light of the government’s moratorium on evictions) to deal with anti-social behaviour during the next three months, Covid-19 related or not.

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.