Commissioning for human rights
in home care for older people
Main presentation for
elected members in England –
training resource 2
Aim of the presentation
To provide an introduction to the Human Rights Act 1998
for elected members in England with particular relevance
to the commissioning and provision of home care
services for older people.
Outcomes:
• An improved understanding of obligations under the
Human Rights Act and how they relate to provision of
home care for older people.
• An opportunity to consider human rights obligations in
relation to policy and decision making, scrutiny and
community leadership.
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Learning agreement
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Confidentiality, but…
Respect
No such thing as a ‘silly’ question
Timekeeping
Responsibility for own learning
Taking action!
Anything else?
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The Human Rights Act –
750 years in the making!
1215: Magna Carta
1689: Bill of Rights
1948: Universal Declaration of Human Rights
1950: The European Convention on Human Rights –
containing the ‘Convention rights’
1998: The Human Rights Act – which brought Convention
rights into UK law
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Myths and minefields
• Myth: The Human Rights Act only protects the
rights of minority groups, illegal immigrants and
criminals. Fact: The HRA protects everyone in
the UK equally, from birth and regardless of
their citizenship or immigration status.
• Myth: The Human Rights Act is imposed from
Europe and undermines the British way of life,
including the right to make our own decisions.
Fact: The HRA was introduced by the UK
Parliament. It incorporates the European
Convention of Human Rights which the UK
played a major role in negotiating and
drafting.
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Myths and minefields cont’d
• Myth: We have plenty of other laws to protect
older people so the Human Rights Act isn’t
needed. Fact: The HRA is more than just a
legal framework that gives people arguments
to use in court. It was designed to promote a
culture of human rights, so public services
routinely consider human rights when they
design and deliver services. Older people
who depend on home care services may be
exposed to particular risk of human rights
breaches.
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What are our Convention rights?
• Article 2: Right to life
• Article 3: Prohibition of torture, inhuman and
degrading treatment
• Article 4: Prohibition of slavery and forced labour
• Article 5: Right to liberty and security
• Article 6: Right to a fair trial
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• Article 7: No punishment without law
• Article 8: Right to respect for private and family
life
• Article 9: Freedom of thought, conscience and
religion
• Article 10: Freedom of expression
• Article 11: Freedom of assembly and association
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• Article 12: The right to marry and found a family
• Article 14: Prohibition of discrimination – in
relation to other human rights
• Article 1 of Protocol 1: Right to peaceful
enjoyment of possessions
• Article 2 of Protocol 1: Right to education
• Article 1 of Protocol 13: Abolition of the death
penalty
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Absolute, Limited or Qualified?
absolute rights can never be limited
or restricted, whatever the
circumstances – even in a state of
war or emergency
limited rights can be limited in
specific and finite circumstances.
These circumstances are set out in full
in the Human Rights Act
qualified rights can be restricted under more
general circumstances – they can be balanced
against the rights of others or the interests of the
wider community
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Duties of public authorities
under the HRA
All those who work in public authorities,
whether devising policy or procedures or
delivering services directly to the public,
must act in a way that’s compatible with
Convention rights.
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Positive human rights obligations –
actively promoting and protecting
human rights
Public authorities must act to:
• deter conduct that would breach human rights
• prevent human rights breaches – including
protecting individuals from the actions of others
• respond to human rights breaches, which may
include carrying out an investigation.
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HRA 1998 and
Equality Act 2010
• HRA – domestic expression of the European
Convention on Human Rights. Also public
authorities have positive obligations to
promote and protect human rights.
• Equality Act – protects everyone from
discrimination because of nine Protected
Characteristics. Public bodies must comply with
the Public Sector Equality Duty.
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World of social care
Local Authorities have a duty to assess:
• if someone appears to the local authority
to be in need of a community care
service or if someone is disabled – NHS
and Community Care Act 1990
• if someone helps to care for someone else
– Carers (Equal Opportunities) Act 2004.
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What is community care?
• Defined in section 46 of the NHS and Community Care
Act 1990 (by reference to other legislation).
• It includes:
assistance in the home – home help/care or a personal
assistant
provision of aids and equipment to help with daily
living tasks and for home safety
services to meet psychological, social and cultural
needs.
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Older people and home care
• Around 20 per cent of older people living at home
receive domiciliary care services.
• In 2009-10 about 453,000 older people received home
care through their local authority.
• People aged 85 and over are the fastest growing group –
numbers have doubled since 1985.
Equality and Human Rights Commission, 2011
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Examples
‘Most of the girls were nasty... they’d push
me back into the chair, that kind of thing’
Woman, 78, lives alone with local authority and selffunded care
‘For several weeks Mum was not bathed or
had her hair washed’
Daughter of woman in her 80s receiving home care
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Examples
‘Some staff talk down to/shout
at my mother… She is an
intelligent woman and isn’t hard
of hearing’
Daughter of older woman partfunded by local authority
‘There is a constant parade of new
staff passing through the house.
Trainees turn up unannounced and
the agency fails to contact us
beforehand to ask permission’
Man, aged over 65, self-funded care
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Further examples
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Not being given support to eat or drink
‘Rough’ handling or unnecessary physical force
Ageist or patronising attitudes and comments
Individuals viewed as ‘tasks’
Chatting on mobile phones whilst delivering care
Theft of money and possessions
No control over when visits take place
Lack of respect for sexual orientation and transgendered
individuals
• Impact of poorly delivered home care on family life
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Positive experiences
‘Both my parents have been enabled to stay independent as long as
they can due to the adult social care they have been provided with
… [They] are able to enjoy a dignified life, in their communities, at
little cost to the state, and remain in control and as independent as
they can be.’
Daughter whose parents receive home care, Midlands
‘The Council home care service is ultrareliable, even in bad weather,
and they are always cheerful… I have tremendous respect for the
work they do.’
Husband of older woman, North of England
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Actively promoting human rights
• Leadership and follow through
• Encourage sharing of experiences
• Involve all stakeholders in the
commissioning process
• Provide accessible information for services
users and carers
• Make particular and individual needs
matter
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Specifications –
Market development and
sustainability
Scrutiny
Legislative
obligations
embedded
Planning, delivery
and workforce
Strategic Corporate
vision
Embedding
human rights into
home care
commissioning
Personalisation
/expectations
Contract Monitoring and
Quality
Listening to
people
Risk and
Safeguarding
Budget
Political implications
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Action plan
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Aim of the session
To provide an introduction to the Human Rights Act
(1998) for Elected Members with particular relevance to
the commissioning and provision of home care services
for older people.
Outcomes:
• An improved understanding of obligations under the
Human Rights Act and how they relate to provision of
home care for older people.
• An opportunity to consider human rights obligations in
relation to policy and decision making, scrutiny and
community leadership.
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