Home care problems leading to breaches of older people's human rights: EHRC

Major problems in the home care system mean that older people’s basic human rights are being overlooked, the Equality and Human Rights Commission has warned.

The watchdog added that the extent of human rights breaches was likely to be masked by a fear of complaining and the low expectations about the quality of homecare that many older people believe they are entitled to.

The EHRC said it had uncovered “many worrying cases” as part of its evidence-gathering for a major inquiry into home care for people over 65.

These include: people being left in bed for 17 hours or more between care visits; a failure to wash people regularly and provide people with the support they need to eat and drink; and people being left in soiled beds and clothes for long periods.

The research has also revealed high staff turnover, with some people having a huge number of different carers for tasks such as washing and dressing. The EHRC cited the case of one woman who recorded having 32 carers over a two-week period.

The Commission said it had identified several key issues with the system already. They are:

• Inadequate time to deliver care: “The very brief time allocated to homecare visits – just 15 minutes in a number of cases – does not allow even basic essential tasks to be done properly,” the EHRC said. “As a result people sometimes have to choose between having a cooked meal or a wash. The short visits also mean that staff have to rush tasks like washing and dressing.” According to the watchdog, older people and care staff alike had expressed dissatisfaction and frustration about the issue.
• Lack of control over timing of care visits: “Many older people have little or no control over what time the homecare visit happens,” the EHRC said. “As a result, we have heard of people being put to bed at 5pm and not helped to get up until 10am, a period of 17 hours.”
• Failure to deliver adequate homecare: “We have had some reports of neglect, in which people have been left in filthy nightwear and bedding after a homecare visit or without a wash or hair wash for several weeks.”
• Lack of staff awareness and training:
“Some older people have described feeling that their privacy and dignity is not respected,” the EHRC suggested. The watchdog said a thorough training process would make sure staff took the simple steps required to avoid basic mistakes. “This would have a huge impact on the day-to-day lives of those they care for.”
• High staff turnover: “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,” the Commission said, adding that it would be exploring further the experiences of care workers themselves, together with the reasons for high staff turnover.
• Lack of complaints and low expectations: One in five older people who responded to the call for evidence said that they would not complain because they didn’t know how to, or for fear of repercussions, the EHRC said. The Commission said it would explore what protection and support is in place for whistleblowers who want to expose poor or abusive practices.

Michelle Mitchell, Age UK's Charity Director, said: "Despite commitments made by both the previous and current government, basic rights to dignity, respect and autonomy are still being breached. 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.

"We all share a responsiblity to ensure that we respect and care for those in the last years of their lives. We need to ensure that the funding, training and systems are in place to ensure that every single older person is allowed to live safely and with dignity. That is why the Dilnot commission must act as a clarion call to government to create a social care structure that ensures a sustainable and fair provision for this generation of older people and those to come.”

The Commission has been gathering evidence from a range of sources, including 54% of local authorities and 250 home care providers. It received 503 written submissions to its call for evidence, including 344 from individuals (older people, their friends and family).

A full report will be published in November 2011.

Philip Hoult