Human rights of care home residents at risk due to misuse of DNACPR notices and slow progress on visits

The human rights of people in care are at risk of being breached by slow progress on enabling visits and the inappropriate use of resuscitation notices, a report has warned.

Restrictions introduced during the pandemic are still keeping loved ones from visiting residents of some care homes in England, the Joint Committee on Human Rights said.

This is despite current Government guidance saying “there should not normally be any restrictions to visits into or out of the care home”.

It also said it is concerned that Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices and Deprivation of Liberty Safeguards (DoLS) are often not applied correctly, meaning someone’s treatment can be wrongfully withheld or their liberty infringed.

In a new report, MPs and peers said concerns have been raised that DNACPR notices are being solely based on someone’s age or condition, without adequate consultation.

The committee said restrictive practices, such as the use of chemical or physical restraints, should only be used where strictly necessary, and it has particular concerns around their use on people with dementia or learning disabilities.

There are also concerns that people are being deprived of their liberty, where they are placed under continuous supervision and not free to leave, without adequate or timely safeguards.

Slamming the existing complaints system as “confusing” and “time consuming”, it recommends more streamlining so all complaints are managed by existing ombudsman bodies, with mental health complaints handling being removed from the remit of the Care Quality Commission (CQC).

The committee also repeated its call for the Government to establish a legal right which would enable people in health and care settings to maintain contact with at least one loved one providing essential support.

It should legislate so care providers must inform the CQC of any changes to visiting, the report recommends, while the CQC should take a greater role in ensuring providers are not “needlessly blocking” relatives from seeing their loved ones.

Committee chairwoman and SNP MP Joanna Cherry said there must be a “careful balance” between protecting human rights and preventing the risk of harm.

She said: “We are concerned that too often safeguards are not being applied correctly.

“Measures that should be tailored to individual needs, whether it concerns the right to a visit from a loved one or the question of whether someone should be resuscitated, are instead applied across a ward or age group.

“This is wrong and should not happen.”

Helen Wildbore (pictured) , director of the Relatives & Residents Association, said: “The committee’s report is a damning indictment of the failure to protect people placed in the most vulnerable of situations.

“From the lack of action of the regulator to the lack of training for care staff, older people are being left at risk of having their fundamental rights breached.”

The CQC said it completed over 13,000 inspections during the pandemic, alongside ongoing monitoring and listening, and said it “will not hesitate to act” where concerns are brought to its attention.

Kate Terroni, CQC chief inspector of adult social care, said: “We welcome the recommendations today from the Joint Committee on Human Rights to ensure that human rights of people in care settings are upheld.

“We have been clear throughout the pandemic that the individual must be at the centre of decisions around visiting.

“Our expectation remains that care homes follow government guidance – which is now to ensure visiting is unrestricted and we will follow up in instances where we are made aware that this may not be happening.”

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