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.

Learning agreement Confidentiality, but… Respect No such thing as a ‘silly’ question Timekeeping Responsibility for own learning Taking action! Anything else?

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

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.

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.

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

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

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

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

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.

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.

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.

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.

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.

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

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 self- funded care ‘For several weeks Mum was not bathed or had her hair washed’ Daughter of woman in her 80s receiving home care

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 part-funded 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

Further examples 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

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

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

Embedding human rights into home care commissioning Specifications – Planning, delivery and workforce Market development and sustainability Strategic Corporate vision Scrutiny Listening to people Embedding human rights into home care commissioning Legislative obligations embedded Risk and Safeguarding Personalisation /expectations Budget Contract Monitoring and Quality Political implications

Action plan

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.