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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 type of agreements are we talking about?

To respond to the crisis businesses might need to exchange information to a greater extent than they would usually. They might need to discuss capacity and to coordinate supply chains (both upstream and downstream). They might need to purchase or sell jointly to ensure vital supplies are maintained. In general agreements or collaboration which:

  • Avoid a shortage, or ensure security, of supply
  • Ensure a fair distribution of scarce products
  • Continue essential services
  • Provide new services such as food delivery to vulnerable consumers
Would you suggest using a different name for a MHFA, maybe a MH champion, to encompass the wider pro-active role?

This may be a good idea – whatever name they are given, it is essential that MHFAs are empowered to take a proactive approach to organisational mental health and that they have the bandwidth to be able to discharge their responsibilities.  The name should reflect the culture of the organisation, the key aspect is awareness and accessibility – identifying a name for your company that supports this is key.

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 on fixed-term contracts be furloughed?

Yes. Their contracts can be renewed or extended during the furlough period without breaking the terms of the scheme.

If the employee’s contract has not already expired, the contract can be extended or renewed. The employee may be furloughed provided that they were employed on or before 30 October 2020. You must also have made a RTI submission to HMRC between 20 March 2020 and 30 October 2020.

If the employee’s contract expired on or after 23 September 2020, the employee can be re-employed and furloughed. Please note that the employee must have been employed by you on 23 September 2020 and you must have made a RTI submission to HMRC between 20 March 2020 and 30 October 2020.

 

If an employer identifies that higher PPE spec is required for BAME employees undertaking a particular task, is it necessary to increase the spec for all employees working in that area?

It is. If you assess a risk and identify a control measure then fail to deploy it, then you are breaching your legal duties under HASWA and potentially committing a criminal offence. So if you decide for example that N95 respirators have to be used by everyone, you have a duty to provide them.

So the short answer is yes.