Human rights in small places, close to home

As Eleanor Roosevelt so famously remarked “Where, after all, do universal human rights begin? In small places, close to home so close and so small that they cannot be seen on any map of the world. … Unless these rights have meaning there, they have little meaning anywhere.”

Because home care services are operating in such ‘small places’, out of sight and often out of mind, evidence about how human rights are promoted and protected or otherwise by them can be hard to come by. Shockingly, a previous estimate from the UK Study of Abuse and Neglect of Older People published in 2007 by NatCen and King’s College London, found that 350,000 older people are abused in their own homes (although this figure does not focus solely on abuse carried out by paid carers). Home care services provided by the state are regulated by the Care Quality Commission but it can be difficult for a regulator to shine enough light into these ‘small places’ to illuminate them properly. Earlier this week the Equality and Human Rights Commission (EHRC), issued a call for evidence directly to older people and their carers, which it hopes will build up a much clearer picture of how home care services are impacting on older people’s human rights. 

Home care services, by their very nature, seek to uphold older people’s most basic human rights. Providing an older person living alone with a regular hot meal can, in a very direct way, promote their right to life by preventing them from becoming malnourished.  Or providing access to adapted bathroom facilities can maintain an older person’s dignity.

But the very personal and intimate nature of such services also means that they can, if not carried out in the right way, put older people’s human rights at risk. Upholding someone’s right to privacy and dignity when you are being asked to help them get up, get washed and dressed and have breakfast in a 15-minute window is going to be a challenge, to say the least.

And despite welcome commitment from across the political spectrum to personalise services to better meet the needs of individuals, all too often the experience of older people receiving home care means that their rights to choice and autonomy are squeezed out by the demands of managing a service that is efficient and affordable. For example, what time you go to bed is not a question to be answered by the older person concerned, but by the staff’s rota.

These issues need our urgent attention so the EHRC’s Inquiry is very welcome. Age UK will be urging older people it is in contact with to submit any evidence they have.  It will hopefully also have the added benefit of driving home the message that human rights are not solely the preserve of ‘others’, be they alleged terrorists at risk of being tortured or celebrities whose privacy is threaten by the tabloids; they begin much closer to home and affect us all.

Further care stories on the Age UK blog
Home and Care information and advice on Age UK

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