The Commission's inquiry into the home care system in England reveals disturbing evidence that the poor treatment of many older people is breaching their human rights and too many are struggling to voice their concerns about their care or be listened to about what kind of support they want.
The final report of the Commission’s inquiry, 'Close to home: older people and human rights in home care', says hundreds of thousands of older people lack protection under the Human Rights Act and calls for this legal loophole to be closed. It questions commissioning practices that focus on a rigid list of tasks, rather than what older people actually want, and that give more weight to cost than to an acceptable quality of care.
Around half of the older people, friends and family members who gave evidence to the inquiry expressed real satisfaction with their home care. They most valued having a small number of familiar and reliable staff who took the time to talk to them and complied with their requests to do specific tasks. Home care workers said their job satisfaction came from improving the quality of older people’s lives.
But the inquiry also revealed many examples of older people’s human rights being breached, including physical or financial abuse, disregarding their privacy and dignity, failing to support them with eating or drinking, treating them as if they were invisible, and paying little attention to what they want. Some were surprised that they had any choice at all as they thought they had little say in how their care was arranged.
For example, evidence given to the Commission included a woman being left stuck on the toilet in her bathroom, as the care worker said she was too busy completing the list of care tasks to help her; and people with dementia not being prompted to eat or their food ‘hidden’ in the fridge, so they go hungry; and a woman who asked for help with her washing up and to be assisted to walk out into her garden but was given help washing herself instead.
Ways for older people to complain about their home care are either insufficient or not working effectively. Reasons for their reluctance to make a complaint about their treatment included not wanting to get their care workers into trouble, fearing repercussions such as a worse standard of care or no care at all and preferring to make do rather than make a fuss.
The inquiry reveals the pervasive social isolation and loneliness experienced by many older people confined to their homes who lack support to get out and take part in community life. Yet evidence from the home care industry indicates that social activities are some of the first support services to be withdrawn when local authorities cut back their spending on care services.
Alarmingly, one in three local authorities had already cut back on home care spending and a further one in five planned to do so within the next year.