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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 are the data protection implications of holding Covid-19 health data?

The ICO is providing new guidance to organisations regarding data protection and coronavirus, which can be accessed here: https://ico.org.uk/for-organisations/data-protection-and-coronavirus/

Information about the Covid-19 health status of individuals is special category data under the GDPR. This means it is high risk which has implications for how you use it, store it and keep it secure.

You will already hold health data about your employees as this is necessary to provide a safe, accessible place to work and to make reasonable adjustments to the workplace. You now need to make sure that the information you gather about your employees, visitors to your sites, customers and suppliers about Covid-19 is processed in accordance with data protection laws.

Can a sponsor cut the salary or hours of a Tier 2 visa holder?

Yes but the sponsor must report this on the Sponsor Management System within 10 working days and must follow normal employment law principles.

If this results in the sponsored worker’s falling below the minimum required salary the usual position is that they cannot continued to be sponsored. However the government has implemented a concession for sponsors who have ceased trading or temporarily reduced trading which allows the salary to be reduced to 80% of the figure stated on the Certificate of Sponsorship or £2,500 per month, whichever is lower.

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
What can I do as an employer if employees are known to be breaking the local lockdown rules?

This will depend on the particular facts and the employee’s circumstances but an employee should co-operate with the employer so far as is necessary to enable compliance with any statutory duty or requirement relating to health and safety.

In addition, conduct outside of work can result in an employee’s dismissal if the conduct pertains to the employment relationship. If an employee breaches their lockdown rules and it affects their ability to work, such as it being no longer safe for them to attend work, or the reputation of the employer, these may be grounds for disciplinary action and subsequent dismissal.