1. Commissioning for human rights in home care for older people
Main presentation for
elected members in England – training resource 2

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.

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

4. 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

5. 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.

6. 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.

7. 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

8. 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

9. 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

10. 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

11. 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.

12. 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.

13. 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.

14. 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.

15. 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.

16. Older people and home care
Around 20 per cent of older people living at home receive domiciliary care services.
In 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. Action plan

24. 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.