Closer to home?

The Equalities and Human Rights Commission today have published ‘Close to Home’, their inquiry into home care and older people’s human rights in England. Overall they found that half of the people that responded to the inquiry expressed satisfaction with the care received at home from paid care workers. However the other half raised issues of significant concern including neglect, abuse, disregard for privacy and dignity amongst others which in the Commission’s view amounted to breaches of their human rights.

This is hard to hear.

There are half a million service users in England and if only half of them are satisfied, there are some real problems out there. Regulators, inspectors, commissioners and providers must act collectively now to address the woefully poor outcomes being delivered on a daily basis for far too many people. This report, as difficult as it is to read, is a really useful contribution to the debate – by laying bare the difficulties associated with delivering home care and the problems that can result for older people in receipt of this care.

So where do we go from here?

Appropriately enough when faced with the compelling conclusions and recommendations of the EHRC report, key stakeholders have sought to respond – for example the Care Quality Commission in England announced that it would be undertaking inspections of home care agencies to help improve quality and standards, with the Care Minister Paul Burstow endorsing this approach on the ‘Today’ programme this morning.

One other option will be to consider what the statutory sector could do to support the much larger unpaid workforce, without whom the demands on social services departments to deliver services to people in need would rise to levels that they could not deal with. These unpaid carers undertake the vast majority of the care that is provided every day across the UK. Research we completed for the Care Council for Wales last year showed that for every one hour of paid care commissioned by a local authority, there are at least 25 hours being provided by unpaid carers – husbands, wives, mothers, fathers, sons, daughters, and other relatives, friends and neighbours – to older people and others every hour of every day of the year.

We know that fewer and fewer people will be eligible to receive home care as the inevitable contraction of eligibility thresholds results in less people receiving paid care at home. Given this, helping the unpaid carers who provide care ‘closer to home’ is now more important than ever despite the inherent difficulties in getting to hear the voices of these individuals. Whilst in places this is happening, investing more of our shrinking resources in focusing on paid workers given that they will be a decreasing part of the workforce as we move forward seems to me unsustainable. It’s time to get serious about supporting those unpaid carers that hold the whole system together by making no demands on it.

Written by Dr Mark Llewellyn · Senior Fellow, WIHSC

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