Close to Home: Home Care and Human Rights

Thursday 24 November 2011

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The Equality and Human Rights Commission has published Close to Home: An inquiry into older people and human rights in home care. The report acknowledged that many older people are very happy with the home care that they receive but also found evidence of “many instances” of home care where human rights were breached or put at risk because of the way that care was delivered.

The report made a number of recommendations, including (i) legislation making the provision of home care by private sector organisations a “public function” for the purposes of the Human Rights Act 1998, (ii) developing greater awareness of human rights amongst older people and their families , (iii) co-operation between the CQC, local authorities and providers to develop better arrangements to detect threats to human rights in home care and (iv) steps to enhance the status and skill of care workers.

The recommendations specifically addressed to local authorities are as follows:

To address the lack of awareness among local authorities about what human rights obligations mean in practice:

8. Local authorities should mainstream human rights into their decisionmaking processes and business plans to ensure compliance with the HRA, including their positive obligations to promote and protect human rights. Human rights considerations should be at the centre of assessment, procurement and commissioning of home care, for example incorporating human rights requirements into care provider service specifications.

9. Before October 2012 local authorities should review their policies and practice in the light of this inquiry’s findings as to the causes of potential breaches of human rights in home care. As a minimum this should include examination of the following:

  • the effectiveness of systems to overcome barriers that older people experience in raising concerns or making complaints the design and operation of Resource Allocation Systems with a view to identifying and removing any age-related bias that may exist
  • the extent to which differential treatment linked to age is present in care planning and support for community participation whether the diverse needs of older people are being met through commissioning practices
  • the extent to which their commissioning supports the delivery of care by a sufficiently skilled, supported and trained workforce.

10. The Ministry of Justice, the Department for Communities and Local Government and the Department of Health should collaborate on producing guidance for local authorities on their duties under the HRA, including their positive obligations to promote and protect human rights, to provide a framework for operating more responsively to the needs of their communities when the Localism Bill is brought into force.

11. To enhance the leadership of local authority elected members, training and guidance should be provided on using their scrutiny function and their roles on Health and Wellbeing Boards to maximise the promotion and protection of the human rights of older people.

12. Through their guidance and training to HealthWatch Local organisations, HealthWatch England should adopt a proactive role in disseminating understanding of obligations under the HRA and the value of a human rights approach to home care.

13. To ensure maximum human rights protection, consideration should be given to incorporating HRA obligations into local authorities’ contracts with providers, to include clauses giving service users ‘third party’ rights to challenge the care provider for any breach of their human rights for which the care provider is directly responsible.

14. Commissioning practice needs to balance allocation of resources against assessed home care needs that must be met, to ensure contracted providers can pay at least the National Minimum Wage to care workers, including payment for time spent travelling.

15. The Commission will work with the Association of Directors of Adult Social Services to produce voluntary national standards and guidance for elected local authority members and local authority officers with responsibility for commissioning home care or assessing home care needs (a) on their obligations under the HRA, including positive human rights obligations, and (b) on the value of applying a human rights approach to home care services.

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