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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

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.

What should I do about non-urgent repairs?

As discussed above, Covid-19 will inevitably deplete the workforce of housing providers in the foreseeable future. It would be prudent to consider making short-term policy changes to deal with this situation and manage the expectations of tenants going forward. A key policy change to consider is the extension of the standard lead-time for completing all non-urgent repairs and inform tenants of this change.

Such a change will also reduce pressure on landlords and front-facing staff.

As above, employers must protect the interests of their staff, particularly regarding health and safety. Extra care should be exercised when assessing the level of emergency of a repair on a case by case basis. All efforts should be made to reduce the number of attendances at properties by repair staff, whilst keeping all tenants safe.

As ever, communication is key – the pandemic cannot be used as a blanket excuse for abstaining from all duties and obligations. Housing providers must take a pragmatic approach in safeguarding customers whilst considering the interests of is workers. Maintaining lines of communication with all parties remains paramount.

VIDEO: SRA Standards and Regulations

Damien Charlton, Julie Huntingdon and Chris Hugill look at the SRA Standards and Regulations (STaRS) for solicitors which came into effect late 2019, and represented a whole new regulatory landscape for the legal profession. The enhanced reporting and transparency obligations have an important impact on in-house practice, so this webinar gives you the opportunity to reflect on how the new rules impact on in-house lawyers, in both your professional and personal lives.

This webinar is part of a series designed for in-house lawyers. If you would like to register to receive invitations to future events for in-house legal counsel, please email damien.charlton@wardhadaway.com.

How important is social distancing when planning your workplace?

It is absolutely critical to creating a safe workplace and to making workers feel secure.

This could include floor markings every 2m (as we’ve seen in grocery stores), stopping or limiting/staggering access to communal or common areas such as toilets and kitchens, rearranging workstations to maintain a 2 metre distance or, where this is not possible (for example in manufacturing facilities or production lines), erecting physical barriers and avoiding face to face working, encouraging the use of stairs and discouraging lift-use, designing a one-way system for entry and exit and looking at aircon/heating systems to see if any modifications are possible to prevent the spread of airborne particles. If you can increase ventilation in your workplace, it will help reduce risk.

The government has published detailed social distancing guidance for workplaces across sectors including manufacturing, retail, offices, construction and transport; it has also promised to continue to add to this.

What perceived gaps do you see in the Building Safety Act 2022 (especially in terms of pending consultations and secondary instruments)?Comments on the value of the Martlet v Mulalley judgment in fire safety cases/unsafe cladding cases

The Act was obviously subject to much debate and criticism as the Bill passed through Parliament. It is difficult to properly assess any gaps until after the necessary secondary legislation has been published and comes into force (along with the remainder of the Act), but some of the likely issues include:

  • The impact on the insurance market, and the (lack of) availability and increased cost of insurance in light of the provisions of the Act
  • How the introduction of retrospective claims will affect the market, both in relation to how parties might go about trying to prove matters which are 30 years old, but also the lack of certainty for those potentially on the receiving end of these claims which they previously had by virtue of the Limitation Act provisions
  • Whether the definition of higher risk buildings is correct, or will require some refinement.

The Martlet v Mulalley case provides some useful observations and clarifications, for example that designers cannot necessarily rely on a ‘lemming’ defence that they were simply doing what others were doing at the time, that ‘waking watch’ costs are generally recoverable, and commentary on certain specific Building Regulations. The judgment however made clear that much of the case turned on its specific facts, so it is useful from the perspective of providing some insight as to how the Courts will deal with cladding disputes in future, rather than setting significant precedents to be followed.