Melanie Field: Valuing the rights of people living in residential care
Melanie Field is the Executive Director of Strategy and Policy, and Wales, at the Equality and Human Rights Commission. Further information can be found on their website.
COVID-19 has affected everyone’s lives, but the impact on older and disabled people living in residential care has been disproportionate. Many of the decisions in the coronavirus response have raised serious questions about the value we place on older and disabled people’s lives.
The Equality and Human Right’s Commission is Britain’s national equality body and the National Human Rights Institution for England and Wales. From the early days of the pandemic response, we’ve been vocal when we’ve seen threats to equality and potential breaches of human rights.
In October we published a briefing advising Government, regulators, local authorities and care providers to take urgent action to put equality and human rights laws at the heart of the COVID response. Decision-makers could use this framework to embed good practice and help prevent some of the serious issues care home residents faced in the first stage of the pandemic – like the lack of PPE and testing, restrictions on visits and inappropriate ‘do not resuscitate’ orders.
Nearly a year into the pandemic, the coronavirus vaccine offers a sense of hope, but we’re still facing significant challenges. More than 10,000 care home residents have died with COVID-19 this year.
A person’s right to life is absolute and cannot be limited, even in times of national emergency. Decisions on withholding access to medical treatment must not violate people’s right to life and to be free from ill treatment. That’s why we said ‘do not attempt resuscitation’ orders (which may have been issued en-masse last spring) must be urgently revisited, discussed with residents or their family members and, if appropriate, removed from files. We are very concerned by reports from Mencap that ‘do not resuscitate’ orders have been issued to people with learning disabilities in the second wave of the pandemic.
We continue to ask the UK Government to urgently undertake or commission a review into the experience in care homes during the pandemic, so that lessons can be learned and the loved ones of those who were lost can get answers.
We have said clearly and repeatedly that blanket bans on visits to care homes should be replaced by individual risk assessments, which consider the full range of human rights of care home residents and take account of differing circumstances.
We are very concerned that this advice has not been heeded and that many care home residents remain isolated from family and loved ones. Decisions about visits must consider the different risks and carefully balance the right to life, health and a private and family life. There should be measures in place – such as regular testing – to facilitate visits wherever possible.
We have now produced short videos to share with the public, raising awareness of the importance of upholding the human rights of those living in care and sharing the powerful stories of some families who have been separated during the pandemic. The videos show not only the heart-wrenching impact of visiting bans but also the innovative ways some care homes have enabled residents to continue seeing their loved ones.
We’re aware that the pandemic has had a specific impact not only on those who reside in care homes, but also on those who work in the sector. We’re particularly concerned about the disproportionate impact on health and care workers from ethnic minority backgrounds.
Our inquiry into racial inequality for workers in the health and social care sectors is looking at how the experiences of lower paid ethnic minority workers have been influenced by factors such as race, working conditions, employment status and immigration status. There’s more information on our website, and we would really encourage people to participate in the inquiry and provide evidence if they can.
The pandemic has exposed and exacerbated the inequalities older and disabled people face, and the longstanding pressures on the social care sector. We are now considering how we can use our unique statutory powers to examine how the social care system can better uphold human rights and equality for everyone who needs to use it.
Comment articles may not reflect the views of the APPG on Adult Social Care.