Inquiry reveals failure to protect the rights of older people receiving care at home

20 June 2011

Older people’s basic human rights are being overlooked in the provision of care at home, according to emerging findings released today by the Equality and Human Rights Commission.

The Commission is conducting a major inquiry into home care, which is investigating how well the home based care and support system in England is protecting the rights of people over 65. The full report will be published in November 2011.

In gathering evidence, it has uncovered many worrying cases, for example:

  • people being left in bed for 17 hours or more between care visits;
  • failure to wash people regularly and provide people with the support they need to eat and drink;
  • people being left in soiled beds and clothes for long periods;
  • a high staff turnover meaning some people have a huge number of different carers performing intimate tasks such as washing and dressing. In one case a woman recorded having 32 different carers over a two week period.

Major problems in the home care system that have been brought to the Commission’s attention through this inquiry include:

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. 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. Older people and care staff alike have expressed dissatisfaction and frustration about this issue.

Lack of control over timing of care visits
Many older people have little or no control over what time the homecare visit happens. 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. For example we have been told about an older person being regularly undressed by care staff in front of his bungalow window, and another person in front of family members, instead of in privacy. A thorough training process would make sure staff took the simple steps required to avoid these basic mistakes. This would have a huge impact on the day to day lives of those they care for.

High staff turnover
The high staff turnover rate impacts on older people. 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. We will be exploring further the experiences of care workers themselves, together with the reasons for high staff turnover.

Lack of complaints and low expectations
The full extent of the potential human rights breaches is likely to be masked by the fear of complaining and the low expectations about the quality of homecare that many older people believe they are entitled to. 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. In addition, we are exploring what protection and support is in place for whistleblowers who want to expose poor or abusive practices.

Our evidence

The evidence for the inquiry is drawn from several sources including a general call for evidence from older people, families, care workers and NGOs; a targeted call for evidence from government (in progress), regulators and other key organisations; and surveys undertaken with local authorities and primary care trusts, and home care providers. Fifty four per cent of local authorities and 250 home care providers in England participated in the surveys. We received a total of 503 written submissions to our call for evidence.

  • 344 responses from individuals (older people, their friends and family)
  • 58 from organisations; and
  • 101 from home care staff.

Baroness Greengross, a commissioner for the Equality and Human Rights Commission, said:

'Many older people up and down the country receive good quality care from committed, respectful care workers. But our evidence suggests that in some places care workers are faced with too much to do, in too little time, sometimes without proper training. This is causing standards to slip and is placing older people's human rights to privacy, autonomy and dignity at risk, sometimes in very serious ways.'

Ends

For more press information contact the Commission’s media office on 020 3117 0255, out of hours 07767 272 818.

For general enquiries please contact the Commission’s national helpline: England 0845 604 6610, Scotland 0845 604 5510 or Wales 0845 604 8810.

Notes to Editors

The Commission is undertaking an inquiry into the protection and promotion of human rights of older people in England who require or receive home-based care and support. This was launched in November 2010 and is expected to be reporting before the end of 2011. View our inquiry into home care for older people.

The Commission is a statutory body established under the Equality Act 2006, which took over the responsibilities of Commission for Racial Equality, Disability Rights Commission and Equal Opportunities Commission. It is the independent advocate for equality and human rights in Britain. It aims to reduce inequality, eliminate discrimination, strengthen good relations between people, and promote and protect human rights. The Commission enforces equality legislation on age, disability, gender, race, religion or belief, sexual orientation or transgender status, and encourages compliance with the Human Rights Act. It also gives advice and guidance to businesses, the voluntary and public sectors, and to individuals.