Older people deserve the best quality of life, with human rights central to their care. At Care Rights UK, we want to see a care sector that protects the dignity of people accessing care, operates and regulates with strength, and that has a supported, robust workforce. Yet every day we hear from people struggling to navigate the care system, facing increasingly complex challenges with care which put their dignity and safety at risk.
Our adviceline supports people facing issues with person-centred care, funding, complaints, evictions and safeguarding concerns, so we see firsthand that there is a way to go. But, with the independent commission into adult social care reform in progress, it is within the Government’s power to get us there.
Care under strain
Pressures on the sector have led to an increase in poor care, our adviceline hears, at its worst leading to neglect. Individuals’ human rights, such as the right to wellbeing, are often neglected, for example by not being supported to keep their dentures/hearing aids safe, clean and in use, or being dressed in someone else’s clothes.
In some instances, the circumstances are bleaker, putting people’s dignity and life at risk, compromising their right to be free from inhuman and degrading treatment and even their right to life under the Human Rights Act. This can include lack of support to eat or drink, lack of medical care, being left in soiled clothes or sheets or withdrawal of fluids at the end of life.
Protecting rights
We consistently support people to understand their rights and to have their rights respected within care settings. Unfortunately, the people reaching out to us for advice are in deeply complex and distressing situations. Often, they are facing a power imbalance, where there can be consequences for trying to report poor care, such as visiting restrictions or evictions.
Our vision is for human rights to be at the centre of good care. Currently we see gaps that need addressing to ensure people in care’s critical rights are not neglected. We are calling for mandatory human rights training for all care staff as currently, with the lack of a consistent, compulsory training framework, too many people fall through the gaps.
From lack of training on managing and identifying bed sores leading to a person developing sores and a skin infection, to lack of training on proper use of essential equipment such as recliner chairs leading to a fall and injury and hospital admission, centring care delivery on human rights allows a path from legislative requirements to positive everyday care.
Supporting people through crisis
The people we support often come to us in a time of crisis – where someone faces an urgent move into care, they have been evicted or they are experiencing a serious safeguarding risk. We aim to empower people with knowledge about their rights and how to use them, because we know how challenging it can be to understand your place in such a complex sector, surrounded by a legislative minefield.
We want to see more transparency and accountability within the sector, with a shift to more proactive, tenacious regulation, so that people are protected by independent bodies like the CQC. This would take the onus off the loved ones of people receiving care, who often must go above and beyond to advocate for care that prioritises dignity and autonomy.
Building a care sector fit for 2025
Social care has been plagued with neglect by successive governments for decades and, at a time of huge structural shake-ups in the world of health and social care, we need to see this opportunity seized to transform care. We have heard the Secretary of State call the CQC not fit for purpose, after years of us calling for recognition of this issue.
Our research found that 56% of those who had witnessed poor care in a care setting did not report it to the CQC. 52% of those people reported that they were worried about negative repercussions. This power imbalance puts people at risk and cannot continue – there must be independent accountability when things go wrong.
With the launch of the 10 Year Health Plan, this could be a turning point for key themes that are fundamental to social care – shifting to community and focusing on prevention. But will we finally get to see social care understood alongside healthcare? The Government should be responsible for ensuring parity between the NHS and social care, but too often fixing social care is seen simply as a way to ease the burden on the NHS.
The narrative on this issue is increasingly disheartening, where people who need care are consistently referred to as ‘bed-blockers’ – like obstacles to be removed rather than people to be supported. We need to see stronger partnerships that ensure people in care settings get specialist healthcare when needed and that care assessments are a fundamental part of the hospital discharge process.
Partners in care
Most of the fundamental shifts we are calling for involve putting the people who receive care at the heart of their experience – making their care personalised, maintaining their dignity and ensuring they are protected – not only from poor care but also the consequences of making complaints in a culture of fear.
Your loved ones know you best – your likes, dislikes, preferences and needs. Without a legal right for every person in health or care to the support of their loved ones, we will continue to see people’s voices lost through lack of contact with their chosen representatives.
Despite the introduction of a new CQC fundamental standard to protect visiting, we still support people who raise concerns about poor care and are then subjected to a visiting ban. This is a critical concern for the person in care. It can be incredibly distressing to suddenly lose contact, especially for people living with dementia. Not only do they lose the personal wellbeing support but they also lose their trusted eyes, ears and voice to raise care concerns.
From vision to reality
In order to enable the transformations that we are calling for in Our Vision for Social Care, we need the Government to own the opportunity provided by the Casey Commission to be radical with social care, and to take the bold steps that are needed to bring people’s rights to the centre of their care.
When people move into residential care, they deserve their care to be delivered by staff who are properly trained and well supported, and for their new environment to feel like it is their home, where their autonomy is respected. Reform is also necessary for the economic health of the country; we cannot have a strong, resilient NHS without a strong, resilient care system.
We are advocating for well-funded safeguarding teams and protected human rights regardless of funding status, with guaranteed access to Care Supporters and care plans. We are calling for unannounced inspections, integration of complaint investigations into regulatory processes and for a fairly funded sector, with stronger integrations with healthcare. We are asking for registered care staff with mandatory, specialist training, who are consistently rewarded and progressed through their career. This is not just a vision but a responsibility for the Government to put rights at the centre of care reform.
Visit the Care Rights UK website to read Our Vision for Social Care. Do your ambitions for the sector align with those of the report? Leave a comment on this feature or join the conversation to share your thoughts.
Lauren Byrne is Policy and Campaigns Lead at Care Rights UK. Email: [email protected] LinkedIn: @Lauren-Byrne-21