Council cost-cutting on care a threat to human rights of elderly – watchdog

Councils are abusing elderly people’s human rights by forcing down the price they pay agencies to provide care in their homes, the UK’s official equalities watchdog has warned.
In a scathing report, it accused local authorities of actively creating “incentives” for private contractors for care to get worse rather than better.

The Commission found that in many cases councils are not even paying a rate which covers the “actual cost” of providing care.

As a result, it says, care workers are routinely being paid below the legal minimum wage when travel costs and time between appointments are included.

In turn morale in the industry is now so low that elderly people who rely on help simply to get out of bed or wash are faced with a constant turnover of staff, rushed appointments and basic tasks left undone.

It concluded that constant squeeze on care spending could amount to a breach of international anti-torture rules as well as UK anti-ageism laws.

In an inquiry two years ago the Commission found cases of rushed, demoralised carers putting elderly people to bed at 2.45pm because there was no one available later, leaving them unwashed or in soiled bedding or even without food and water.

Often the level of care is so minimal that people are effectively being trapped in their homes, which itself could be a breach of anti-ageism laws.

The Commission said that, despite some progress since it raised its concerns, in many cases the situation was likely to be getting worse.

“The way home care is commissioned by local authorities may be increasing the risks of older people suffering human rights abuses,” it said.

“In particular, the rates that some local authorities pay care providers do not always appear to cover the actual costs of delivering care, a significant proportion of which is workers’ wages which should include travel time.

“Poor working conditions may lead to a high turnover of staff and increase the risks to the human rights of older people.”

The findings come just a day after a report by the Leonard Cheshire Disability charity found that more than half of councils now book carers in 15-minute blocks, a practice widely condemned as inhumane.

The Commission contacted all councils in England with caring responsibilities to ask them what changes they had made since its last report. Only seven out of 10 responded on time, two did not replay at all and many those who did were unable to provide proper examples of changes they had made.

While recognising that councils have had their budgets cut severely in recent years, it voiced alarm that only one in five had made any increase to the amount they pay care agencies, even in line with inflation, in the last two years.

A third of councils set a maximum on the amount they are willing to pay agencies to provide care, which can be as low as £8.98 an hour and from which they have to cover all of their running costs and pay their staff a legal wage.

“While local authorities may think setting a maximum price allows providers to quickly assess whether or not they should submit a tender, unless the maximum price reflects the actual costs of care, this may constitute a risk to the human rights of service users by creating incentives to reduce the quality of care provided,” the Commission said.

“The maximum hourly contract rates set by some local authorities were at a level that could make this risk a reality.”

The report found that the relentless squeeze on fees was driving forms to “call cramming” – or overbooking themselves and loading carers with unmanageable rotas just to break even.

It said that poor care could breach Article Three of the European Convention on Human Rights, which prohibits “inhuman or degrading treatment”, and Article Eight which protects family life, as well as domestic law requiring public bodies to promote equality including age equality

Caroline Abrahams, Charity Director of Age UK, said: “For local authorities to continue to meet their human rights obligations the rates paid to care providers must cover the true cost of care.

“For older people to be assured of dignified and respectful care at home, those caring for them must also be treated fairly.”

Mike Padgham, chairman of the United Kingdom Homecare Association, the trade body, said: “Too often, cash-strapped councils dictate prices based on what they can afford to pay, rather than what the service costs to deliver safely and effectively.”

But Cllr Katie Hall, the Local Government Association’s care chief, said: “Sustainable solutions around all aspects of pay and reward cannot be delivered in isolation from the other competing pressures on local government.”

And Sandie Keene, president of Association of Directors of Adult Social Services, said it took a “massive leap” to say that people’s human rights are not being respected.

Trevor Brocklebank, chief executive of Home Instead, a care company, said: “We could save millions across the health and care systems if we supported people properly in their own homes.”