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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 I ask my employees to stay away from home overnight during the national lockdown?

As above, employees must not leave their home unless they have a ‘reasonable excuse’.

VIDEO: Redundancy exercises in the new normal – what should we do differently?

Following our webinars on all aspects of furlough and alternatives to redundancy, it is an unfortunate fact that a number of organisations are likely, sooner or later, to be forced to make some employees redundant.

Our employment experts Jamie Gamble and Roisin Patton take you through the key aspects of conducting cost reduction redundancies, but with a focus on aspects that make this exercise different this time. For instance:

  • How are you going to conduct sensitive meetings remotely?
  • How are you going to ensure that dismissing any furloughed staff will be fair? You may have furloughed at speed, but redundancy selection criteria cannot be defined by such factors.
  • Will you use this time to review your selection criteria if you already have some in place?
  • How will you deal with individuals who are shielding, have child care issues or are pregnant?
  • How do you ensure this is all done sensitively and fairly for those roles that are being made redundant, but also for those who continue to work for you but are still isolated on furlough or working from home?
  • And what are the risks for making redundancies in this “new normal”?

Although you may be perfectly familiar with redundancy exercises these are far from normal times and it is therefore worth pausing to think about the impact that Covid-19 might have and what else you need to think about or plan for.

The webinar was recorded on Thursday 2nd July.

 

What is the latest update from the Civil Court?

Almost two thirds of hearings conducted in the Civil Court will occur in person over the next few months as the Civil Court sees an influx in cases.

The Courts

In the Business & Property Courts, cases have been dealt with consistently since the start of the pandemic, except for trials that run for longer than 10 days in the Commercial & Admiralty Court. The Queen’s Bench Division and Administrative Court are also running as normal. If your case is listed for one of these courts, you do not need to be concerned that your case may take longer than anticipated, with conclusions still being reach at the normal rate.

Hearings

Since the start of the pandemic, most hearings have been conducted online through various platforms such as Skype for Business and Cloud Video Platform. The courts are of the view that remote hearings tend to take longer than those that are held in person. As a result, if your case is due to be held in person, the case may be heard in less time. HM Courts and Tribunals Service stated that:

Wherever possible we will look to facilitate face-to-face hearings, but our expectation is that remote hearings will continue to play an important role for the foreseeable future, given that social distancing will continue to limit courtroom capacity compared to pre-Covid levels.”

More courtrooms have become available since the start of the pandemic, resulting in more facilities for cases to be heard in person, which will have the aim of helping to rid of the backlog of cases, along with remote hearings being conducted too, which is a welcome step forward.

Approximately 300 additional support staff will be employed for remote hearings before the end of 2020, enabling better service with remote hearings. The Government has decided that some civil judges will have the option to extend operating hours for cases to be held in the evenings and on weekends too, which may be most suitable for small and fast-track claims, resulting in a potentially faster outcome. The efficiency of all the new measures are being monitored and changes are being implemented, such as increasing the capacity of the Small Claims Mediation Service.

Small Claims Mediation Service

With claims of a lower value, a high proportion of cases successfully settle outside of court, therefore, if you have a small claim, the mediation service may be suitable for your case. Mediation involves a trained impartial third party, with the parties to the case discuss the dispute with the assistance of the third party, aiming to reach a settlement. Now with the increased capacity, it may make the mediation service more accessible, meaning that an agreement can be reached more swiftly rather than waiting for the matter proceed to a hearing.

The courts have stated that:

We aim to increase capacity to accommodate 90% of parties who want mediation, rather than the current 40%. We are recruiting additional mediators and restructuring ways of working to achieve this.”

This is a positive shift for those with small and fast-track claims where legal costs ought to be kept to a minimum. Settling by mediation removes the need for trial costs, amongst other costs, and has additional benefits such as the matter being dealt with more amicably.

Capability issues

All organisations have underperformers. Capability is a potentially fair reason to dismiss and is separate to any redundancy procedures.

Generally, capability falls into either absences through illness or underperformance in the role. Those who are absent through sickness can be furloughed, but when furlough comes to an end they will need to go back onto sickness. If you are looking to tackle absence then you need to tackle long term and short term absence in a different way.

Long term absence: You need to establish whether the employee is able to return to work (with or without reasonable adjustments) in the medium term. This requires medical opinion and be careful of disability issues. Reasonable adjustments are likely to be important.

Short term absence: You will need to demonstrate that you have fair absence triggers in place and there is normally be a 3 stage procedure: warning and final warning followed by dismissal on notice. Each stage needs a fair procedure, with written information, a fair hearing and the opportunity to appeal. Be careful of disability issues.

As for underperformance: To tackle this, you will need to have clear SMART objectives in place and evidence of the employee failing to meet these. There would then normally be a 3 stage procedure: warning and final warning followed by dismissal on notice. Each stage needs a fair procedure, with written information, a fair hearing and the opportunity to appeal.

Can colleagues meet outside of work during the national lockdown?

Yes, but only for work purposes and where it is unreasonable to do so from home. Work colleagues cannot meet to socialise.