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Thursday, December 1, 2011

Home care 'breaches human rights'

 Ministers have already promised they will be revamping social care Basic care for the elderly in their own homes in England is so bad it breaches human rights at times, an inquiry says.

The home care review by the Equality and Human Rights Commission highlighted cases of physical abuse, theft, neglect and disregard for privacy and dignity.

It said on many occasions support for tasks such as washing and dressing was "dehumanising" and left people "stripped of self-worth".

The findings have added weight to calls for a complete overhaul of the system.

Campaigners described the situation as "shameful", while councils, which are in charge of providing such services, said without urgent reform services would just get worse.

There are currently nearly 500,000 people who are getting council-funded support in their own homes.

The home care review said about half of people who had given evidence reported real satisfaction with care, but a number of common complaints were made by others. These included:

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The physical abuse reported was most often in the form of rough handling or unnecessary physical force.

A 78-year-old woman who lives alone told the commission about her treatment.

She said: "Most of the girls [from the agency] were nasty. They were rough. Rather than say 'Sit in the chair', they'd push me back into the chair, that sort of thing, and I didn't like that.

"I couldn't do anything about it. I can't even walk and I think they know this, you see. They know you're vulnerable."

Older people not being given enough support to eat and drink, with some staff arguing health and safety restrictions prevented them preparing hot mealsNeglect because care workers stick rigidly to their tasks, such as a case when a woman was left stuck on the toilet because staff were too busyFinancial abuse, including money being systematically stolen over a period of timeChronic disregard for privacy and dignity, such as leaving people unwashed and putting them to bed in the afternoonPatronising behaviour, with cases highlighted including staff talking on mobile phones while they tended to clientsPhysical abuse involving pushing and rough handlingThe commission said such problems could be said to be in breach of various parts of the European Convention on Human Rights.

Ann Reid says one of her husband's carers refused to help him go to the toilet, because he was reading the newspaper

In particular, it highlighted article eight, which guarantees respect for dignity and personal autonomy, article three, which covers the prohibition of inhuman and degrading treatment, and article two, governing the right to life.

To rectify the situation, the Equality and Human Rights Commission (EHRC) said the law needed extending to clear up a potential loophole.

Councils are already covered by the Human Rights Act, but as they buy most home care services from the voluntary and private sector, it remains unclear how well protected the elderly are.

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A number of people complained that services were inflexible with staff keeping rigidly to set tasks. Taken to the extreme, this can result in serious situations being ignored.

A council officer recounted a case where one woman's pleas for help were ignored by her carer.

"I had a lady who was on the toilet when the carer came. She shouted 'I'm stuck, I need some help'. The carer shouted up: 'Can't do that, but I've made you a butty and I'm going now.'"

The commission also called on councils to ensure they balanced quality of service with price when tendering for services.

But it made clear that part of the problem was a basic lack of compassion and common sense among staff, pointing out simple measures such as staff covering someone with a towel while washing them could make all the difference.

Age discrimination was also highlighted as a significant barrier as older people were getting less money towards their care than younger people with similar problems.

But the commission suggested the prospects for the future looked bleak as one in three councils had already cut back on home care spending while a further one in five were planning to.

'Simply unacceptable'

EHRC commissioner Baroness Sally Greengross, who led the report, said it was time home care provided by councils was encompassed by the Human Rights Act.

She told BBC Radio 4's Today programme: "Two messages came out loud and clear. This poor care mustn't continue.

"And one of the ways to stop it continuing is to close the loophole, which means that any care that's commissioned by a local authority or another public body should come under the Human Rights Act so people are protected from abuse."

Linda Stephens, whose mother suffered from dementia and had home care, and who also worked as a carer herself, told the BBC there had been a lack of understanding of people and their needs.

She said: "Although I gave them quite an in-depth idea of what care was needed for mum - a lot of it would have been prompting and support - but unfortunately because of time restraints on them they were task orientated."

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One of the common complaints was a lack of help the elderly were given eating and drinking.

The report highlighted cases where people unable to feed themselves were given no help or where uneaten meals were left for days.

In one incident a carer watched as a 76-year-old cancer patient struggled from her lounge to her kitchen to microwave her meal because the worker argued they could not help because of health and safety.

The woman's daughter said: "It is hard to think of a reason or excuse big enough adequately to cover such a fundamental lack of care from one adult to another."

Michelle Mitchell, charity director at Age UK, described the findings as "shameful".

"It is simply unacceptable that care in people's own homes, where they can be at their most vulnerable, is often inadequate, disrespectful and lacking in dignity."

Ministers have already promised the whole social care system - including care homes as well as help at home - will be looked at, with initial plans expected to be published in the spring.

This comes after a recent government-commissioned review recommended costs - the system is means-tested - be capped, while the regulator has promised to toughen its inspections of home care providers.

But councils pointed out such promises have been being made for over a decade.

Councillor John Merry, of the Local Government Association, said: "These results are symptomatic of a social care system that is under-funded and in need of urgent reform. The longer ministers procrastinate, the more our population ages and the worse things will become."

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