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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 make a claim under my cancellations/abandonment insurance?

Cancellation insurance usually covers certain expenses and loss of profit, as long as the reason for cancellation is not excluded. These exclusion clauses are often quite wide and exclude avian, swine flu, quarantine, and restrictions of movement as a result of communicable disease. This means that you may not be entitled to compensation under this cover.

Who is expected to be principal accountable person in local authorities who are landlords of high rises?

This will be dependent upon the how the leasehold structure is set up for each relevant building, but it may be the local authority. We would be happy to provide further advice in relation to specific buildings if you contact us separately with the relevant details and documents.

Can employees volunteer if they have been furloughed?

Yes. The Government has confirmed that those on furlough will also be permitted to volunteer to help the NHS during the coronavirus outbreak without risking their pay.

Do I have to continue to pay furloughed staff while furloughed? Can I wait until I receive the money from the government?

To qualify for a grant under the scheme you must pay your furloughed staff the wages you are claiming for. Failure to do so may result in a HMRC investigation and/or claims from furloughed staff for unlawful deductions from wages and possibly constructive dismissal claims.

Normal benefits including non-monetary benefits should continue during furlough unless the individual has agreed in writing to reduce or remove a benefit during this time.

Employers are expected to apply for one or more of the financial support schemes available to be able to continue to pay staff.

What are the early warning signs that a contractor may be in financial difficulty?

As the project progresses, it is important to continually monitor the contractor’s performance.  Any one or more of the items below can be early warning signs that the contractor is in financial difficulty, and that further actions may be necessary:

  • Decrease in labour or contractor’s personnel on site, and/or rapid turnover of contractor’s personnel
  • Slowdown in progress on site
  • Plant, equipment or materials suddenly disappearing from site for no apparent reason – unpaid subcontractors may unilaterally decide to remove items from site regardless of their contractual rights to do so
  • An increasing number of defects and reduction in the quality of the contractor’s work
  • The contractor seeking changes in the payment arrangements, and in particular early payments
  • The contractor making spurious claims or contra charges
  • The contractor seeking assignment of its benefit of the building contract
  • Late filing of accounts by the contractor at Companies House
  • Unsatisfied court judgements against the contractor
  • Subcontractors and suppliers not being paid or being paid late
  • Rumours in the press, in the industry, on site or elsewhere regarding the solvency of the contractor
  • Unusual visits to site, for example from the contractor’s senior management or other personnel who had not previously been present or are not expected to be present
  • Increasingly aggressive behaviour by the contractor
  • The contractor’s parent company or another company within the contractor’s group displaying any of the above signs