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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 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.
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.

What has been the response from the Competition and Markets Authority (CMA)?

The CMA is the government body that is responsible for protecting consumers from unfair trading practices. It has announced programme of work to investigate reports of businesses failing to respect cancellation rights during the Coronavirus pandemic.

Based on the complaints received by them from consumers, the CMA has identified three sectors of particular concern:

  • Weddings and private events
  • Holiday accommodation
  • Nurseries and childcare providers

The CMA has expressed concern about the number of complaints that it has received about businesses seeking to retain deposits for cancelled events, undue restrictions being placed on use of vouchers provided for cancelled bookings, and payments being demanded to hold open nursery places.

The CMA has said it will prioritise investigation of these sectors, and then move on to other sectors.

Can construction work be undertaken outside of any permitted hours to make up for site closures?

Many planning permissions contain a condition restricting the hours within which a developer can carry out construction work or are subject to an approved construction management plan setting out the permitted construction hours.

The Business and Planning Act 2020 entered the statute books on 22 July 2020. Section 16 of the Act incorporates a new S.74B into the Town and Country Planning Act 1990. The effect is that any condition/approved document which limits construction hours on a site could be amended through an application to the local planning authority. The application to the local planning authority must set out the date on which the proposed extension to construction hours shall cease (such date being no later than 1 April 2021, after which the original conditions over construction hours will resume). The local planning authority must determine the application within 14 days (beginning with the day after the application was submitted) otherwise there is deemed approval.

New guidance has been published alongside the Act and is available here

What can I do to make sure my home-working people are doing so safely?
  1. Keep in touch. If contact is poor, workers can feel disconnected, isolated or abandoned. This can adversely affect stress levels and mental health – especially in the current crisis when everyone is feeling more anxious.
  2. Think about the use of laptops/devices (DSE) at home. Provide a basic form of risk assessment for self-completion.
  3. Remind workers of simple steps to reduce the risks from display screen work:
    • take regular breaks (at least 5 minutes every hour) or change activity
    • avoid awkward, static postures by regularly changing position
    • get up and move or do stretching exercises
    • avoid eye fatigue by changing focus or blinking from time to time