News broke this weekend of investigations into the deaths of 12 people and potential other failings in care homes in West Sussex run by Sussex Health Care. Police are investigating for misconduct and potential criminal activity in regard to the deaths, including that of an older woman living with dementia, Valerie, who died after a second fall at one of the care homes. Her family said, 'We want to know what measures were put in place to protect Valerie after her first fall.'

 

The Care Quality Commission (CQC) are conducting their own investigation after ‘unannounced inspections’  and are working alongside the police, the NHS and West Sussex County Council to ensure all available evidence is considered and appropriate action is taken. Debbie Ivanova, Deputy Chief Inspector of the CQC  ;

 

“Although CQC inspections are separate to West Sussex County Council’s own review of these safeguarding matters, we do take all information we hold into account - including concerns from family members, professional bodies and other stakeholders…

In respect of our latest inspections - we will publish full reports, detailing our findings and any enforcement action against the provider, as soon as we can.”

 

This comes after one of the care homes under investigation was previously rated by the CQC as ‘Good’ overall (one below the highest rating of ‘Outstanding’) but it was told ‘Required Improvement’ on the area of safety.

 

What has been absent from a lot of the commentary around the care home scandal is human rights. Failings like this are about failing to protect people’s legally protected human rights. In the Human Rights Act the right to be free from inhuman and degrading treatment means protection from abuse and neglect. The right to respect for private and family life means protection of physical and mental wellbeing, of choice and involvement in decisions about your life. The right to liberty means only having lawful restrictions placed on your movements in line with safeguards that protect you. Finally, the right to life means ensuring protection from deliberate taking of life and to safeguard from known risks. Sadly, accountability for many of these rights, appear to be at issue in the recent care home situation.

 

As well as empowering people to seek justice when things have gone wrong, human rights also have a strong preventative element, which services can be using to ensure the care and treatment they provide is lawful and appropriate.  Services providing care regulated by the CQC, which is arranged or paid for in whole or part by a local authority or under the NHS, have direct legal duties under the Human Rights Act to respect, protect and fulfil people’s human rights.

 

More than this, the CQC as a public authority has these same duties, and they are in the process of implementing an explicit human rights approach to regulation:

 

"Our human rights approach will apply whether we are regulating adult social care services, hospitals, primary medical services or carrying out other regulatory functions – such as joint inspections of children's services, prison health services or themed work that crosses organisational boundaries. It applies whether we are registering services or inspecting services." Care Quality Commission (2017)

BIHR has worked with the CQC to implement their human rights approach across the whole organisation. This learning programme included training inspection and registration staff across England in using human rights and equality in their regulatory work. As Caroline, an inspection manager noted about BIHR’s session:

 

“The value of being able to measure good quality care and support against human rights adds another tool to my kit during inspection”

 

Now, more than ever care providers need to become better at understanding why human rights matter to their service provision and how to ensure they are meeting their regulatory and legal requirements. To support this, BIHR is now running a training course for registered providers on ‘The CQC’s human rights approach to regulation’.  This course will enable providers to better understand the CQC's human rights approach, explore unconscious bias in health and social care, get to grips with the relevance of human rights in health and social care for all staff, with tips and tools for practice. Book before 1st October to receive an early bird discount by following this link: https://www.bihr.org.uk/Event/cqc-course

 

Used effectively, and before the need for courts, the preventative power of human rights can transform services and reduce incidents that put those in care into harm’s way.  Taking human rights seriously means ensuring your service and staff are prepared to not only pass inspections properly but reduce the risk of the terrible failings in this week’s news. As one of the services we have work with note:

 

"Using a human rights approach has revolutionised decision-making. Staff are thinking differently and making decisions differently. It needs to be rights based, not just risk based." Paul Hill, North Essex Partnership NHS Foundation Trust