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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 furloughed employees carry out work for another business during furlough?

Yes, if there is a contractual right to do so. Furloughed employees who start work with another employer during this time must inform HMRC that they have another job.

Can I move house during the coronavirus pandemic?

Yes unless you are self-isolating, infected with Covid-19 or within a vulnerable group.

The Government has issued updated guidance on 13 May providing comprehensive advice to reflect the move to relax lock down restrictions and encourage house sales. The advice can be found here:

https://www.gov.uk/guidance/government-advice-on-home-moving-during-the-coronavirus-covid-19-outbreak

Key points to note

Unless you are self-isolating, infected with covid 19 or vulnerable, the guidance states that you can move house, provided you comply with social distancing measures at every stage, whether visiting a seller’s house or accepting visitors or professional for viewings, surveys and removals.

All businesses such as surveyors, estate agents and removals, linked to the housing market may now operate, provided that social distancing measures are observed and safe working procedures (see link below) are followed.

https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/homes

House viewing should be conducted virtually wherever possible, and open-house viewings should not be conducted. Houses should be cleaned before and after visitors come, and home owners should vacate during viewings and surveys to minimise the chance of contact. Doors and windows should be left open, and sinks made available for hand washing.

Agents can supervise, provided they maintain social distancing.

New homes show houses should be operated on an appointment basis, and cleaned between viewings, with hand washing facilities made available. Staff should adopt safe working procedures. Housebuilder sale-staff, tradespeople, fitters and NHBC inspectors can all attend to facilitate viewings, fit out, commission equipment and inspect completed homes.

Solicitors and Estate Agents remain unable to open their premises to members of the public, for the time being. Government guidance advises that solicitors adopt special covid 19 clauses to permit flexibility on completion dates where parties become unable to move or complete for reasons connected with the pandemic.

The Law Society in conjunction with other trade and professional bodies in the sector, has published links to pan-industry guidance on the re-opening of the housing market:

https://www.lawsociety.org.uk/news/press-releases/industry-issues-guidance-kickstart-housing-market/

Is there a matched funding scheme for the National Emergencies Trust?

The government has also confirmed it will match donations to the National Emergencies Trust as part of the BBC’s Big Night In fundraiser on 23 April – pledging a minimum of £20 million.

What impact does the Regulations have in respect of matters which arise from Fire Safety Audits - e.g. if balconies with wooden/decking elements are now considered higher risk and whether that would fall to developer to remedy the materials used to construct balconies?
The duty would fall on the owner of the building to control the hazards presented by balconies made from combustible materials. There may be scope (via warranties/indemnities or other terms) arising from the contract between the developer and owner for the owner to seek to recover the cost of remedial works.
My business has a contract with a public sector body – what guidance has the Government issued about payment under contracts between public and private sector bodies?

The Cabinet Office has published a helpful Procurement Policy Note (“PPN”) on relief available to suppliers due to Covid-19 (available here). This can include making advance payments to suppliers, if necessary. The PPN sets out actions that public sector bodies should take (until at least 30 June 2020) to ensure continuity of service and to ensure that its suppliers can resume normal contract activity once able to.

The actions public sector bodies should be taking include:

  • Informing its suppliers (that they believe are at risk) that they will continue to be paid as normal until the end of June 2020 (even if service delivery is currently interrupted). Risk might include supply chains collapsing and/or significant financial implications for a supplier
  • If a contract involves a payment by results mechanism, basing payments on previous months (e.g. the average monthly payment over the previous 3 months), and
  • Ensuring that invoices submitted by suppliers are paid immediately to maintain cash flow in the supply chain and help to protect jobs.

If you are a supplier to a public sector body, you must act transparently and on an open-book basis, making cost data available to your public sector clients. You must also continue to pay your employees and subcontractors / suppliers. Suppliers to the public sector must not expect to make profits on any undelivered elements of a contract. The PPN makes clear that, should suppliers be found to be taking undue advantage, or failing to act transparently, a public sector body can take action to recover payments made to that supplier.

The PPN requires public sector bodies to urgently review their contract portfolios and take steps to support suppliers who they believe are “at risk”. However, no definition of “at risk” is given in the document.  We would suggest that if you are a supplier and you have yet to hear from a public sector client, you should seek to get in touch with them as soon as possible, particularly if you have concerns about your supply chain, staff retention and/or are experiencing financial difficulties currently. Given the requirement for transparency, you may be required to provide evidence, so it may be helpful to have any relevant documentation ready to send, if necessary, as this may help ensure a decision is made by the public sector client more promptly, particularly as the public sector body may have a number of contracts to consider.