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Home care in England denies older people their human rights

News, 20 June 2011

Care of older people in their homes in England is so poor that in some cases their human rights are being denied, according to an inquiry by the Equality and Human Rights Commission (EHRC).

The EHRC, an independent governmental body, is investigating how well over-65s who receive homecare visits are looked after. Although the inquiry will report in November, the deadline for submission of evidence has already passed and the Commission says it reveals ‘major problems’.

The commission describes cases of people being left in bed for 17 hours or more because, although they cannot get themselves to bed at night or up again in the morning, their last carer has to finish by 5 pm while the next comes at 10 am.

Careworkers have also provided evidence of being expected to wash and feed a client in 15 minutes, which is hardly enough time to do either.

High staff turnover

“The high staff turnover rate impacts on older people,” says the Commission. “People have described the emotional impact of being washed and dressed by a large number of different people, and having to repeatedly disclose personal information every time a new care worker comes to the house.

“We will be exploring further the experiences of care workers themselves, together with the reasons for high staff turnover.”

Paul Burstow, care services minister in Britain’s Conservative-led coalition government, said: "There can be no place for poor quality care in care services, either in the home care system or in residential homes."

The inquiry would "help drive up standards of care and expose bad practice", he added, but it is unclear how that will happen when his own government is cutting public spending as drastically as it is.

Michelle Mitchell, charity director at Age UK, commented: "Despite government commitments made by both the previous and current government, basic rights to dignity, respect and autonomy are still being breached.

Budget cuts blamed

"The biggest threat to the human rights of older people receiving care at home is from cuts to adult social care budgets, and it is very unclear whether tightening eligibility criteria to care will allow local authorities to continue to meet their human rights obligations."

Explaining the background to its inquiry, the EHRC points out that “the nature of social care is changing rapidly with a greater emphasis on personalised services and choice”. It adds:

“The majority of social care services are already delivered by private sector agencies, either via contract with local authorities or directly with individuals through a mix of public and private funding. This complex web of transactions is combined with a narrow judicial interpretation of the meaning of 'public authority' under the Human Rights Act.

"This combination has created a confused picture concerning the duties and obligations of the various groups involved in respecting, protecting and promoting human rights.

“Further, an increasing number of care transactions are likely to take place at the margins of, or even outside of, regulated care. There is the possibility that these transactions are beyond the present human rights obligations of the State.

'Uncharted territory'

"We are also seeing the emergence of new on-line care marketing and brokerage services aimed at people purchasing social care with either 'individual budgets' or private funds.

“These marketing and brokering services are currently completely outside of the regulatory system with no means of monitoring the quality of the advice and services they offer. The Government wants to accelerate the pace of reform even further.

“While personalised care and support has many potential benefits, this is uncharted territory. There are concerns that human rights protection (and other issues) could fall between the gaps."

Having already identified high staff turnover as a factor in inadequate care services, it will be interesting to see to what extent the inquiry explores links between how care workers are employed and the quality of their work.

That is the core issue of Public World's Who Cares? project. For more information about that and the background to it, please email

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