England’s elderly face human rights breaches in home care system

Wednesday, November 23, 2011

A report published today by the Equality and Human Rights Commission (EHRC) finds that, in many cases, England’s home care system breaches the human rights of the elderly it is supposed to serve. The Close to home: older people and human rights in home care report is the result of a twelve-month investigation into care generally provided by local authorities.

Approximately half of those receiving home care, plus friends and family, providing evidence to the inquiry were satisfied with the quality of care provided. However, the report stresses that there are “systemic problems” arising from “a failure to apply a human rights approach to home care provision”. The report asserts that it is generally not the fault of individuals providing care, but serious problems exist as local authorities seem unaware of their obligations under the Human Rights Act and fail to commission, procure, and monitor care accordingly.

The report says articles two, three and eight of the European Convention on Human Rights are frequently being breached. These, respectively, cover an individual’s right to life, protection from inhumane and degrading treatment, and respect for dignity and personal independence. Criticisms include that care is not provided in a common-sense manner, and funding of care for the elderly is at lower levels than for younger people with similar problems and needs.

The EHRC’s investigation highlights a range of recurring complaints and attempts to identify the underlying causes; cost is repeatedly mentioned, with use of the private-sector leading to some local authorities offering a “one size fits all” service leaving many elderly feeling they are “a task to be undertaken” and have “little or no choice” as to help received, or when care workers visit. A failure to invest in care workers is noted, with significant responsibility and the wide range of skills required being rewarded with low pay and status; this, the report states, adversely impacts staff retention and, a high turnover of care workers can put the security of care recipients at-risk.

Within the wider investigation, a commissioned independent social report by The Arndale Centre conducted in-depth interviews with a cross-section of 40 elderly individuals receiving home care. As-stressed in the report, those selected were not on the basis of good, or bad, experiences with their – mainly local authority-provided – care. It highlights a widespread feeling amongst those interviewed that they are treated “like a number”, and that aspects of the care provided lead to, or fail to resolve, feelings of social isolation.

The Manchester-based Arndale Centre report concludes that, “[t]he general picture is of a wider home care system in which older people are not effectively involved: which they do not understand, and which does not often make the extra effort required to involve them in ways tailored to their state of health and other needs”.

A recurring theme in the responses of those interviewed is the social isolation that their home care is not adequately addressing. One male interviewee in his seventies who previously used a scooter to get about said in his interview, “I haven’t been out of the house now for about four weeks. I daren’t. The last time I went out on the scooter I hit the kerb and it frightened the living daylights out of me.” Another, an 85-year-old woman who lives alone, expressed sadness at her inability to do normal things, “I would love to go to town to do some shopping. I haven’t been to town for about two years… Wander round the town and have a cup of tea… I’d love that.”

The social isolation many elderly experience was summed up neatly by another woman in her eighties in her interview: “When you go now, I will maybe not talk to anybody till tomorrow; maybe the whole of tomorrow nobody to talk [to]… face to face. Nobody will knock on that door, that is it, a life of isolation.”

The EHRC, having commissioned this report in the face of funding changes and reform of the care system, intends to press for legislative changes to ensure those receiving care at home are given the same protections under the Human Rights Act as those in residential care. In the conclusions of their report they offer to work with, and support, local authorities in understanding and delivering care that respects peoples’ rights and dignity; and, recommend better guidance as to the choices available to the elderly, and their families, be made available.