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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

If, after deploying all control measures the risk is still deemed too great for employees to work safely, then what should employers do?

The law says that if after assessing a risk and considering all the control measures available to you, you cannot undertake a task safely – then you should not undertake the task.

If that means taking BAME workers out of higher risk frontline work, that is what will have to be done.

Beware of workers saying “we’ll accept the risk” – it does not protect you against regulatory/enforcement action or civil claims.

What is Coronavirus Business Interruption Loan Scheme (CBILS)?

The Coronavirus Business Interruption Loan Scheme (“CBILS“) is open for applications to provide small businesses with a loan of up to £5m to assist with the Covid-19 outbreak. The Scheme is aimed at businesses who are experiencing lost or deferred revenues, and who otherwise would be denied support from lenders, to be supported by a Government backed guarantee. The Scheme will initially run for six months with the possibility to be extended where required, so businesses should only approach a lender under the Scheme as and when they require assistance.

What should an employer do when an employee has been told to self-isolate under the coronavirus Test and Trace scheme?
  • Do not require them to work
  • Continue to communicate with and support them
  • Allow them to work from home, is there alternative work for them to do if they can’t do their work from home
  • Offer SSP or allow them to take holiday if they want to.
What sort of issues are likely to have arisen?

The Coronavirus pandemic will have impacted businesses in many different ways, but some of the most likely impacts that could have a legal implication are as follows:

  • Services were not performed in accordance with contract during the period of disruption. This could be a reduction in volume of services performed, a suspension of services, or performance in a way that does not comply with contractual KPIs
  • Late delivery or non-delivery of goods because of factory closures, or disruption in the supply chain
  • Changes being agreed between parties to contracts to deal with the consequences of the Covid-19 outbreak
I pay child maintenance and half of my children's private school fees to my ex-partner but I have been placed on Furlough, with no top-up from my employer, so my income has dropped significantly. Is there anything I can do?

a. You should first try and discuss this with your ex-partner, either directly or through a Solicitor, to see whether an amicable agreement can be reached.

If you contribute to private school fees voluntarily, it is a matter for you and your ex-partner to resolve the issue with the school, depending whose name is on the bills. You may need to speak to the children’s school to see whether they can offer any reductions or remedies in relation to those payments. If you contribute to the school fees as part of a Court Order, you will need to ensure you do not breach the Order and you may need to consider applying for a variation of the Order if you can no longer afford the payments or reach a compromise agreement with your ex-partner.

You can use the Child Maintenance Service (CMS) calculator (https://www.gov.uk/calculate-child-maintenance) to recalculate your child maintenance obligations using your amended income. This recalculation can then be used in your discussions and you can formally instruct the CMS to verify that calculation if you and your ex-partner cannot reach an agreement about it. If you have already formally involved the CMS, they do carry out an annual review of child maintenance payments, however, they will also recalculate payments outside of the review period where there has been a change in income of 25% or more. We expect the CMS will be experiencing a high volume of enquiries at the present time so anticipate there may be delays in them assisting.

The position on child maintenance payments included in a Court Order are slightly more complicated and how you approach this will depend on how much time has passed since the date of the Order.