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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

Which charities will benefit from this funding and when – Key Services?

The Government will allocate £360 million to charities providing key services and supporting vulnerable people during the crisis.  £200 million of this amount will be paid to Hospices UK to be distributed to hospices to help increase capacity and give stability to the sector.  The remaining amount is to be allocated to:

  • St Johns Ambulance to support the NHS
  • victims charities, including domestic abuse, to help with potential increase in demand for charities providing these services
  • charities supporting vulnerable children, so they can continue delivering services on behalf of local authorities;
  • disabled people
  • Citizens Advice Bureau to increase the number of staff providing advice during this difficult time

The Government Departments will identify priority recipients, with the aim that these charities will receive money in the form of a cash grant over the next few weeks and by the end of April to assist in paying amongst other costs April’s wage bill.

How much notice do I need to give people to return to work?

There is no minimum period of notice you are required to give employees of their return, but from a good HR practice point of view you should be speaking to your staff and letting them know what the plan is; giving people a reasonable amount of notice of return will allow them to prepare both practically and psychologically.

Do I need to obtain consent from a member of staff if we have taken the decision to restrict/alter their duties?

If the duties are so fundamentally different from their contracted role, then yes. For example, if you are asking a frontline clinical member of staff to undertake administrative tasks in another area, then this will be a fundamental change to their terms and conditions for which you need their consent.

If there is a minor alteration to their duties, or the clause within their contract is wide enough to cover their amended duties, then arguably to do not need their consent but best practice would be to obtain their agreement.

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.

Can we rely upon the 'reasonable grounds' point to proceed with a petition?

If the debts owed to you pre-date Covid-19 and your debtor seemed unable to pay well before the Covid-19 pandemic took place, it is entirely possible that you will be able to present a petition on the grounds that the debtor would have been unable to pay its debts even if the Covid-19 had no effect on its financial position. We do not yet have any reliable precedent as to how the Courts are likely to deal with such cases.  Whether you are likely to succeed will depend on the exact circumstances of the debt and your debtor. There has been one case decided in August 2020 where the Court concluded that Covid-19 did not have a financial effect upon the debtor and that the circumstances which gave rise to the petition had arisen long before Covid and would have occurred in any event.  A winding up order was made in that case.  What we do know about the court’s approach is that the purpose of the Act is to allow viable companies to trade through the current times and the Court is likely to set the bar high.

Please contact us if there a debt you would like to discuss. Even if presenting a winding up petition is not available for now, there may still be other forms of legal proceedings that you can use to collect money owed to you, like county court proceedings.