Last year the Equality and Human Rights Commission (EHRC) published ‘Close to Home: An inquiry into older people and human rights in home care’.
It should have been a wakeup call published in the wake of the collapse of care homes for the elderly, most notoriously Southern Cross.
The EHRC seeks to put human rights at the centre of adult care with a strong emphasis on enabling older people to live independently whenever possible within their own home.
It is a thorough piece of work with insight from service users and providers, exposing the human cost of aggressive commissioning that puts price before quality.
Many of the workers interviewed said how much they valued the fact that their work helped people retain their independence in their own homes. They want to provide high quality, respectful care.
Yet numerous factors frustrate this ambition. Not least is the practice known as ’time and task’, which requires carers to undertake a list of tasks within minuted slots. The impact on clients is devastating and removes their ability to decide what care they want and need.
On average carers are paid £7.81 an hour , but about a third are paid £6.86 or less.
Increasingly aggressive commissioning by local authorities reduces still further access to training. The result is a high turnover of staff and ironically the use of more expensive agency workers who do not usually have the opportunity to provide continuity of care.
No wonder then that the EHRC reported some service users feel dehumanised, humiliated and wanted to die.
Faced with 28% front-loaded cuts to government funding, many local authorities have tightened their eligibility for care making it even more restrictive. Now most only provide publicly funded care for those deemed to have critical or substantial needs.
Last week the Joseph Rowntree Foundation published their research into disabled people’s views of the future for adult social care. Overwhelmingly those surveyed expressed a concern that their voices are not being heard. The impact of spending cuts and the level of funding are key among their concerns.
Many users recommended that the social care workforce should have access to better training, support and supervision; better terms, conditions and career progression; more support for the role of personal assistants; effective user involvement and social work based on a social model of disability.
The reality is a race to the bottom pushing down pay, pensions and quality. Research into social care shows greater satisfaction levels where services are provided by local authority employed workers.
Marketisation, privatisation and contestability combined have resulted in 84 per cent of publicly funded homecare being contracted from the private or not-for-profit sectors.
With cuts to advice, information and advocacy it remains to be seen whether individual challenges using human rights legislation will be levelled against care that breaches human rights guarantees.
The capacity of the EHRC to step in is severely reduced as it also faces drastic scaling back that may even compromise its status as a human rights watchdog.
The majority of us will at some time in our life need social care. Such scant regard for the welfare of so many is a measure how out of touch the coalition government’s policy gurus are.
Across the UK anti-cuts campaigners are petitioning, rallying and forming alliances with some successes. Many are setting in for a long haul as they know that there is an alternative worth fighting for.