When we rely on others to care for us, it can often be at some of the most vulnerable times in our lives. In these moments ensuring our most basic human rights are met takes on even greater importance – rights safeguarded through our Human Rights Act such as protection from harm, negligence and discrimination. Sadly, our human rights are not always respected when we are in the hands of care services, and it was recently reported that the Care Quality Commission had taken enforcement action against Admiral Court Care Home in Hartlepool, found to be breaching the human rights of its residents.

Human rights in care settings: quality and accountability

At BIHR we have over ten years' experience working to support both care providers and advocates in putting human rights at the heart of service development and delivery. Our work shows that when services are supported to properly understand the Human Rights Act and how it’s relevant to their work, that the law, far from being bureaucratic or difficult, is in fact the very tool that ensures the kind of dignified, compassionate and quality of care we all expect. The Difference it Makes, showcases our work to show the value of a human rights approach to health and social care.

Just as importantly, when things go wrong the Human Rights Act makes sure that there is accountability. This could be by allowing individuals to take court action. Equally, though much less discussed, is the legal duty the Human Rights Act places on public officials to make sure that human rights are respected and protected. This includes taking positive steps to prevent abuses. This duty is not simply on service providers, it also extends to others such as regulators, and that includes the Care Quality Commission (CQC), which regulates health and social care in England.

In Autumn last year the CQC launched its new human rights approach to regulation, and in April BIHR was delighted to start the delivery of a new human rights and equality training programme for all CQC staff, including inspectors (supported by a partnership between the CQC and EHRC). We’re receiving highly positive feedback with CQC staff really engaging with how human rights are a practical part of doing their job.

“Joined the dots very smartly between human rights and equalities legislation and the specific legal framework I use” Mark, Inspection Staff

“Educative training that had clear links to my day to day practice” Jonathon, Inspection Staff 

How did human rights help in Hartlepool?

It was found that Admiral Court Care Home in Hartlepool had been depriving some of the residents of the care home of their liberty without invoking the proper safeguards as set out in the Deprivation of Liberty Safeguards under the Mental Capacity Act. Such action breaches the right to liberty, protected by the Human Rights Act (Article 5).

Additionally, the residents' human right to not be discriminated against (under Article 14 of the HRA) had also been breached. This right prevents services from discriminating in how they protect human rights for any reason, such as age, disability or mental health. This could include denying people their right to liberty because they think that the person is too old to want or need their liberty.

As well as breaching its residents’ human rights, the CQC found that the home had breached Regulations used by the CQC to inspect care homes (as set out in the Health and Social Care Act 2008). As the CQC’s human rights approach and our new learning programme makes clear, the Regulations are built upon human rights principles. For example:

Regulation 9: Person-centred care

Putting the person at the centre of their own care is a key part of human rights principles. A person should be involved in all decisions about their care and medication that they are able to understand.

Regulation 10: Dignity and respect

This is protected by the Human Rights Act in several ways including through the right to respect for private and family life (Article 8). Dignity and personal autonomy (the right to choose what you do with your own body) are vital parts of private life because being able to live a dignified life is central to our understanding of ourselves. In a care home setting, a care home where the residents had nothing to do and where staff did not interact with them or treat them like people would not be respecting their dignity. 

Regulation 11: Need for consent

The right to consent to medical treatment is part of the right to choose what happens with your own body included in respect for private life (Article 8, HRA). The CQC found that Admiral Court Care Home had Do Not Resuscitate orders (DNR) in place without consulting with residents or their families or finding out whether the resident is able to consent to such an order. This raises significant questions under the Human Rights Act, you can read more about why DNR orders can breach human rights in our blog.  

Regulation 12: Safe care and treatment

Unsafe care can be, at its very worst, a risk to the right to life of care home residents (Article 2, HRA). Examples of dangers to residents at the Admiral Court Care Home included improper handling of medication (which was also a risk to staff) and insufficient staff to provide safe care or deal with emergencies. 

Regulation 13: Safeguarding service users from abuse and improper treatment

This can include unnecessary physical and medical restraint, which can breach the right to be free from inhuman and degrading treatment, if it is very serious (Article 3, HRA). A human rights approach to restraint requires that it should be used as a last resort and should always be properly assessed. BIHR contributed to a series of videos on safe restraint in health and social care, created by the Social Care Institute for Excellence (SCIE) which you can watch here

This is why the Human Rights Act matters

This example is another powerful reminder of why the Human Rights Act matters to us all. Whilst the human rights in the HRA are drawn from the European Convention on Human Rights, it is the HRA which contains the legal duties that make these rights accessible and work for each of us here at home. From this legal basis we see innovative work such as the CQC’s new approach and the broader work BIHR does with health and social care providers (available here and here) to ensure our human rights are respected and protected.

The thing with human rights is that they belong to humans, to every one of us. The very essence of human rights is about setting minimum standards that protect us all, no matter who we are or what we have done. That is why debates about picking and choosing who has human rights isn’t really a debate about human rights. Human rights belong to us all, including when we are receiving care services.

Our human rights protections are currently under question and there is much work to be done to make sure that universal human rights are protected and respected here in the UK. BIHR's mission to bring human rights to life here at home by empowering people to know what human rights are, and to speak up, will be vital. Now is the time to stand Together for Human Rights, you can sign up to join in here: www.bihr.org.uk/together