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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

I'm self-isolating and understand that it takes some time to get a Lasting Power of Attorney registered. What can I do in the meantime to enable someone else to operate my bank account and pay my bills?

The Office of the Public Guardian is continuing to accept applications to register Lasting Powers of Attorney but their usual estimated timescale of eight to ten weeks is likely to be affected by the current situation.

Consequently, an alternative or interim measure if you need something quickly is to execute a General Power of Attorney to authorise someone to act as your Attorney to undertake day to day financial transactions for you. The General Power of Appointment only needs to be executed by you in the presence of a witness (not the Attorney) to be valid and does not need to be registered with the Court of Protection. However, the Power of Attorney would cease to have effect if you become incapable of managing your affairs. It should be seen as a stop-gap only.

How do I carry out a Right to Work check during the Covid-19 pandemic?

The Home Office has provided useful guidance on how to carry out a compliant Right to Work check using the temporary adjustments in place for Covid-19. In summary:

  • You will need to ask the job applicant to send you digital copies of their original documents, for example by scan, photo or mobile app.
  • Hold a video call with the job applicant and ask them to show their original documents on camera so you can check them against the digital copies you have already received.
  • On the date you made the check, record that you have done this by using the following wording “adjusted check undertaken on [insert date] due to Covid-19”. Evidence of right to work checks still need to be held securely either in paper or electronic format.
  • You can use the online RTW checking service where the job applicant has Biometric Residence Permit or pre-settled or settled status under the EU Settlement Scheme. You should do this whilst on the video call with the applicant/employee, and you must first obtain their permission to view their details on this scheme.
Do I have to quarantine for 14 days when arriving in the UK?

From 8 June 2020, people entering the UK from overseas (excluding those entering from Ireland, the Channel Islands or the Isle of Man) must comply with a mandatory 14 day quarantine period. However, for those travelling to England, a number of country specific exemptions have been introduced.

A full list of the countries excluded from the quarantine provisions can be found on the gov.uk website which change on a regular basis, often on short notice.

Where a quarantine period does apply, a person will not be able to leave the place they are staying in for 14 days, except in some very limited circumstances.

These rules will apply to both British and foreign nationals, however there are some further exemptions to this rule where a person is coming to the UK to undertake a certain role (such as a healthcare professional coming to the UK to provide essential healthcare). A full list of the narrow exemptions can be found on the gov.uk website.

Before travelling, individuals will be asked to provide their contact details and information about their journey and the accommodation that they will be self-isolating in. To do this, individuals will need to fill in an online form on the gov.uk website. Individuals who refuse to fill in this form may be fined £100 and/or denied entry at the UK border should they not be a British citizen or UK resident.

The information provided in the form will ensure that the Government can check that an individual is self-isolating at the address given. Where an individual refuses to self-isolate they can be fined £1,000 if they are staying in England or Wales.

Once visa application centres re-open overseas and UK visa applications are processed, this 14 day period will need to be taken into consideration and may require employment start dates in the UK to be delayed.

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.

What type of matters are the Courts still dealing with?

Civil Court listing priorities, last updated by HMCTS on 24 April 2020, categorise the Court’s work into the following:

Priority 1 – work that must be done: this includes any applications in cases listed for trial in the next 3 months, any applications where there is a substantial hearing listed in the next month, all multi-track hearings where parties agree that it is urgent (subject to triage).

Priority 2 – work that could be done: Infant and Protected Party approvals, Applications for interim payments in multi-track / personal injury / clinical negligence cases, Applications to set aside Judgment in default, Preliminary Assessment of costs.

The full guidance can be found at:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881019/Civil_court_listing_priorities_24_April_2020.pdf