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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 form does the relaxation take?

The European Commission has reintroduced its “comfort letter” system for cooperation in relation to shortage of supply. This allows cooperating businesses to check what the Commission’s view of their proposals are before implementing them.

In the UK context the SMA has introduced an exemption for suppliers of healthcare services to the NHS. This allows:

  • Sharing information about capacity
  • Coordination of staff deployment
  • Joint purchasing of goods, services and facilities
  • Sharing or lending of facilities
  • Division of activities, including agreeing whether to expand or reduce the volume or type of services provided by suppliers

In relation to whether the CMA will investigate cooperation, it has indicated:

  • The CMA will use its discretion as to the prioritisation of its enforcement action to permit some agreements/collaboration which would otherwise potentially give rise to enforcement action (including potentially attracting fines of up to 10% of group worldwide turnover)
  • The CMA will use its existing power to exempt certain agreements under the Competition Act 1998 where these are in the public interest
Can a Charity use its restricted funds for its general funding in the current circumstances?

Many charities have money that are considered restricted funds which are given to the charity or raised for a specific purpose.  The Charity Commission gives guidance on this, please see the link below. Depending on the circumstances in which these monies have been given to a charity or raised you may or may not be able to use them.

Monies raised in an appeal or specific fund raising campaign are unlikely to be available as it is likely to be impossible to get the permission of the donor to change the use.  If however you have had monies donated for a specific purpose and you can identify the donor you can use these funds for general overheads and to pay wages etc. if you receive the donor’s specific permission to do so.

Are there any limitations on who can be furloughed?

 

Employees on any type of employment contract including full-time, part-time, agency, flexible or zero hours and foreign nationals who are eligible to work in the UK on any visa can be furloughed subject to the following excluded categories:

  • Anyone who was not employed prior to 30 October 2020
  • Anyone for whom you haven’t made a PAYE Real Time Information submission to HMRC between 20 March 2020 and 30 October 2020.
  • Employees who are working but on reduced hours or for reduced pay
  • Employees currently receiving SSP (see FAQ on SSP and self-isolation below)
  • Public sector employees
  • Employees of businesses or organisations in receipt of public funding for staff costs (except for those who are not primarily funded by the government and whose staff cannot be redeployed to assist with the Covid-19 response)
Is there a cap on the number of employees on Flexible Furlough?

Be careful, there is now a cap on the number of employees you can have on furlough at one time.

The number of employees you can claim for in any claim period starting from 1 July cannot exceed the maximum number of employees you claimed for under any claim ending by 30 June 2020. So this cap is going to be specific to each employer.

It may catch out, in particular, employers who had been rotating employees on furlough.

What security will be required for CBILS?

At the discretion of the lender, the Scheme may be used for unsecured lending for facilities of £250,000 and under.

Lenders were required to demonstrate lending additionality (i.e. lending that without the Scheme, wouldn’t have otherwise taken place). The Scheme has been extended to those businesses who would have previously met requirements for a commercial facility and would not have been eligible for CBILS.  As a result  it is suggested that all viable small businesses affected by Covid-19, and not just those unable to secure regular commercial financing, will now be eligible should they need finance to keep operating.

Primary Residential Property cannot be taken as Security under the Scheme. If the lender can offer finance on normal commercial terms without the need to make use of the Scheme, they will do so.