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UKHCA: Human rights of older people using homecare must not be victim to public spending cuts

The leading homecare provider association, UKHCA, welcomed yesterday's report from the Equality and Human Rights Commission (EHRC) as an important contribution to safeguarding the well-being of people who use home-based care.

UKHCA's Chief Executive, Bridget Warr, said:

“Older people must receive safe, dignified and effective homecare which protects and promotes their human rights. Examples of poor practice in the EHRC report are troubling. However, the Commission has rightly concluded that many of the problems are largely caused by inadequate commissioning of home care by local councils, who fund and arrange the majority of social care. (See notes 2 and 3)

“In addition to highlighting unacceptable practice, this report must act as a wake-up call. Aggressive public cost-cutting is damaging the very homecare services essential to support people in their communities. Age discrimination further compounds the problem.”

Research undertaken by UKHCA in August 2011 gathered 206 separate impressions from homecare providers of recent local authority commissioning practice, covering 111 statutory sector bodies, which we believe underlies the Commission’s findings of rushed, hurried and sometimes undignified care (see note 9):

  • 82% of councils were reducing the amount of time they allowed for personal care for at least some people;
  • 76% of councils were reducing the number of visits to some service users’ homes;
  • 58% of councils appeared to have cut the fees they pay independent and voluntary sector providers.

One in four careworkers speaking to EHRC raised the length of time they had with people for whom they care as a concern. This is almost entirely a result of councils reducing the amount of service they fund and the impossibly low rates they pay for very short homecare visits, which do not permit sufficient flexibility when more care is required. Last week UKHCA took the unprecedented move of writing to every council in England and Wales drawing attention to the increasingly difficult conditions imposed on the sector, which are leading providers to consider using the courts as a final resort to address inadequate funding.

UKHCA welcomes EHRC's invitation to join them in producing robust guidance to help older people safeguard their human rights. In the intervening period, UKHCA has today made a series of recommendations for employers and their careworkers, based on the evidence provided to the Commission (see note 8). In addition, we strongly support EHRC’s recommendation that commissioning policies of local authorities should reflect the actual costs of care, including at the very least the National Minimum Wage.

However, the Association has two areas of concern from the report’s recommendations:

The commissioning practices of local authorities in England ceased to be subject to external scrutiny, when Government instructed statutory regulator, the Care Quality Commission (CQC), to end routine monitoring of councils’ commissioning in November 2010. It is regrettable that EHRC fell short of recommending that Government reinstate this function. While the regulator continues to monitor providers’ compliance with regulation, it is now constrained in its ability to identify the substantial issues affecting social care.

EHRC has recommended that the Human Rights Act is extended directly to independent and voluntary sector homecare providers. There is a risk that cash-strapped councils will see this as absolving them of their public sector responsibility: passing duties required of the state onto care agencies, without recognising their need to fund care adequately, or that provider's costs may increase through defending allegations of breach of the Act, even if the allegations eventually prove to be unfounded.

UKHCA will continue to support its member organisations in achieving and maintaining the highest standards of homecare. We commend EHRC for its diligence in running the inquiry and the wide-ranging engagement with ourselves and other interested parties. We look forward to working with the Commission, central and local government and regulators to promote the human rights of older people using home-based care.

Notes for Editors

  1. Homecare encompasses provision of personal care, to people in their own homes. For many, homecare is the alternative choice for people who would otherwise need to move into residential accommodation.
  2. The majority of homecare is funded by the state (usually by local council social services departments, Primary Care Trusts (PCTs) or Health and Social Care Trusts in Northern Ireland). However, homecare services are largely delivered by independent and voluntary sector providers working under contracts with the statutory sector.
  3. There are over 6,880 registered homecare providers across the UK, the majority of which (84%) are in the independent and voluntary sectors. We estimate that these organisations employ over 440,900 homecare workers, who deliver over 6.65 million hours of care per week to around 600,500 service users, valued at £4.8 billion per annum.
  4. Further statistical information about homecare services in all four UK administrations is available from "An Overview of the UK Domiciliary Care Sector" at www.ukhca.co.uk/downloads.aspx?id=109.
  5. United Kingdom Homecare Association (UKHCA) is the professional association for more than 1,900 domiciliary care providers in Great Britain and Northern Ireland.
  6. UKHCA’s mission, as a member-led professional association, is to promote high quality, sustainable care services so that people can continue to live at home and in their local community. We do this by campaigning, and through leadership and support to social care providers.
  7. UKHCA has a vetting procedure for its members, all of whom agree to abide by the Association’s Code of Practice, which can be found at www.ukhca.co.uk/codeofpractice.aspx.
  8. A series of action points for homecare providers and their care workers has been created by UKHCA to help reduce the incidence of unsatisfactory care described in EHRC’s report: www.ukhca.co.uk/downloads.aspx?ID=345
  9. A more detailed briefing on UKHCA’s Commissioning Survey can be found at www.ukhca.co.uk/pdfs/UKHCACommissioningSurvey2011.pdf. Appendix 1 of this report includes a series of anonymised case studies that illustrate the consequences of public-sector cuts on the lives of people who use homecare. To protect the privacy of individual's circumstances, we regret that we are unable to arrange interviews with the people described.
  10. UKHCA’s Chief Executive, Bridget Warr, and Policy Director, Colin Angel, are available for studio interviews in central London, or for telephone interviews, on request.
  11. A high resolution royalty-free image of Bridget Warr, who is quoted in this release, is available from www.ukhca.co.uk/images/highres/bridgetwarr1.jpg.
  12. For further information please contact:

Colin Angel, Policy and Campaigns Director
United Kingdom Homecare Association
Group House, 52 Sutton Court Road, Sutton, SM1 4SL

Direct Line: 020 8288 5297
Mobile: 07920 788993
Website: www.ukhca.co.uk