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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 is the reaction to the funding?

The reaction from NCVO is that this is an important first step.  However, it will not stop well run charities from closing and others will look very different in a few months’ time.

Do employers still have to enrol and reenrol employees?
  • Yes, and this includes furloughed employees under the Coronavirus Job Retention Scheme.
  • Employers must continue to assess their new employees or newly eligible existing employees and enrol them where required, but can make use of the statutory postponement procedure which allows them to delay for up to three months the assessment of new employees for the purpose of enrolment (see further details here on the Pensions Regulator’s website). Declarations of compliance for new employers must still be completed in the normal way.
  • Postponement cannot be used for re-enrolment. The Regulator recommends employers use the re-enrolment date tool on the Regulator’s website to choose a date up to three months after the third anniversary of enrolment to assess staff for re-enrolment. Further information about employers’ obligations about reenrolment from the Pensions Regulator can be found here. Re-declarations of compliance for new employers must still be completed in the normal way.
Can the apprentice take a break or pause in learning due to coronavirus?

A break or pause in learning can be initiated where the interruption to learning due to Covid-19 is greater than four weeks. This must be reported as a formal break in learning. In such circumstance the funding to the training provider will be suspended for the duration of the break. Previously, the rules only allowed an apprentice to initiate this break in learning but this has been expanded to give employers and training providers the right to initiate this. Training providers should continue with their monthly IRL submissions to the ESFA. During breaks in apprenticeships it is not necessary for the apprentice to comply with the minimum of 20% on the job training requirement but this will resume when the break ends.

What should I be mindful of in relation to pregnant workers? Is there a right to suspend?

Yes, but as a last resort. In summary, the law requires employers:

  • to assess the workplace risks posed to new or expectant mothers or their babies;
  • to alter the employee’s working conditions or hours of work to avoid any significant risk to them;
  • where it is not reasonable to alter working conditions or hours, or would not avoid the risk, to offer suitable alternative work on terms that are not “substantially less favourable”;
  • where suitable alternative work is not available, or the employee reasonably refuses it, the employer should consider whether it is appropriate to suspend the employee on full pay.
Can I progress an application for EIA development?

Where a development is considered to be “EIA development” (being development where an Environmental Impact Assessment or Environmental Statement is required to be submitted) there are additional statutory publicity and notice requirements over and above the requirements for a standard planning application. Regulations usually require that the environmental statement is to be made available for inspection by the public at all reasonable hours at an address in the locality for a period of at least 30 days. Copies of the environmental statement are also to be made available for people to take away from that address. This clearly requires physical copies to be available at a specified location for a prolonged period of time, which may prove problematic during the current health crisis.

New regulations came into effect on 14 May 2020 which will temporarily suspend the above requirements and will instead require the Environmental Statement to be available for inspection online. The applicant must however provide a certificate to the Local Planning Authority stating what steps have been undertaken to bring the application (and the Environmental Statement) to the attention of people who are likely to have an interest and why it considers that such steps were reasonable.