Woman in care home

The rights of older people in care homes have been neglected for too long. Now is the time for change

The focus on care homes throughout the pandemic must lead to action on long-standing issues that COVID-19 has exposed so ruthlessly, writes Heléna Herklots, Older People’s Commissioner for Wales 

The pandemic has been an incredibly difficult time for care homes across the UK. Not only have thousands of older people living in care homes lost their lives, thousands more have seen a decline in their mental and physical health, and/or are grieving the loss of their friends and peers. Thankfully, the vaccine roll-out and improving situation we are seeing throughout the country offers some hope for them and their loved ones.

So while, rightly, there has been a significant focus on care homes throughout the pandemic, as we begin to look to the future it is crucial this translates into action across a number of key areas.

What urgent action is needed?

We need to see immediate investment in rehabilitation programmes targeted at older people, including those living in care homes, to ensure the right support is available to prevent any further decline in people’s mental and physical health, and to help them recover from the impact of the pandemic. This must include bereavement support, given the unprecedented levels of loss we have seen within our care homes over the past year, and support to rebuild people’s confidence to re-engage with their communities.

It is also crucial that the voices and experiences of older people living in care homes – as well as those of their loved ones, care home managers and care staff – are used to guide policy and practice. In the early stages of the pandemic, I was concerned these voices were not being sufficiently heard, meaning that crucial knowledge and expertise about the ways people living and working in care homes could be supported and protected were often missing when key decisions were being made.

Many of those who provided evidence for my Care Home Voices report – which was published last year to give a voice to people living and working in care homes – felt that many of the issues and challenges care homes faced could have potentially been avoided through more effective planning and engagement with care homes and older people, and that there was limited understanding among some public bodies about the support care homes needed to keep older people safe and well.

Older people, and the people who care for and care about them, must be provided with ongoing, meaningful opportunities to share their views and experiences with policy- and decision-makers to ensure the things that matter most to residents are properly understood, and that their voices shape policy relating to care homes at both a national and local level.

We must strengthen the rights of people living in care homes

Another key priority as we move forward must be strengthening the rights of older people living in care homes. During times of crisis, it is vital that people’s rights are protected and upheld, but throughout the pandemic there have been many examples regarding people in care homes where this does not appear to have been the case.

In addition to concerns about potential breaches of the Human Rights Act linked to care homes being locked down – specifically Article 2 (right to life), Article 8 (right to family life) and Article 5 (right to liberty) – we have also seen issues relating to blanket policies on access to treatment and ‘do not attempt CPR’ notices, which caused significant worry among older people and their families.

In addition, many older people have been unable to access key services and support, such as healthcare or social care assessments, as external professionals have been unable (or in some cases unwilling) to enter care homes to undertake what are often statutory duties.

Furthermore, concerns have been raised about how the rights of older people without capacity may have been affected during the pandemic – in particular, whether decisions have been made in people’s ‘best interests’ and whether proper legal safeguards have been complied with.

And while these issues have occurred within the context of the pandemic, they reflect similar long-standing issues relating to rights in care homes. Despite legislation, regulations and guidance having been put in place throughout the UK to protect our rights, there has been a significant disconnect between policy and the experiences of many older people living in care homes.

This cannot go on: regardless of where an individual happens to live, and regardless of their age, their rights must be respected and protected. 

My response to these issues

This is why I am bringing together key organisations from across the UK – representing older people and their families, care home providers, regulators and experts in human rights – for a series of roundtable sessions to examine these issues.

Working in partnership, we will identify current gaps relating to rights that may impact the lives of older people living in care homes, and areas where residents’ rights may need to be extended. We will also examine the practical changes that are needed to better protect and promote the rights of care home residents, and the most effective ways these changes can be implemented, drawing upon good practice in different parts of the UK and internationally.

Using our collective voice, we will make a powerful case for change, supported by robust evidence, including the voices and lived experiences of older people.

Life has changed drastically for us all during the past year, but the progress being made in tackling COVID-19 means we are now, slowly, seeing parts of society opening up again. As we move forward, it is crucial that older people living in care homes are not left behind, and that their rights do not remain disproportionately restricted compared with the wider population. We also cannot allow the current restrictions in place – such as limits on who can visit, or leaving the home – to establish themselves as the ‘new normal’.

Instead we must work together, building on the collaboration and new partnerships that have been established throughout the pandemic, to ensure that older people living in care homes get the support they need to keep them safe and well, and that care homes ‘re-open’ safely. Crucially, we must also tackle the structural issues that have put people in care homes’ fundamental rights at risk.

For more information about the work of the Older People’s Commissioner for Wales, visit www.olderpeoplewales.com