Executive summary

Introduction

The Equality and Human Rights Commission is the independent advocate for equality and human rights in Britain, set up by an Act of Parliament and launched in October 2007. We aim to promote and protect human rights, reduce inequality, eliminate discrimination and strengthen good relations between people.

This report concerns the future of care and support1 and the role it can play in promoting human rights, equality and good relations. It has been published in order to influence thinking on the future of care and support in England and it sets out theactions the Commission itself will take to help make its vision for care and support areality. The Government plans to publish its proposals in a Green Paper on care andsupport in spring 2009.

The report draws on a literature review and consultation with stakeholders2. We have examined evidence concerning the current performance of care and support in protecting and promoting human rights and equality and have assessed the implications of predicted social and economic developments and challenges incoming decades. This includes the economy, our ageing population and changing social expectations. Our understanding of what it is to be a disabled or older person, our perception of the role and position of women in society are all changing rapidly. There is also much new thinking concerning the relationship between citizens and public services and our approach to promoting human rights and equality.

The Commission’s role is not to oversee the social care system itself. That role is to be carried out by the Care Quality Commission (CQC) which replaces the Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Act Commission in April this year. We will aim to work alongside the CQC to ensure that our collective equality and human rights remit is effectively discharged. This report sets out a detailed programme of work through which we will engage our partners as well as making recommendations for reform to achieve the role we believe care and support can play in promoting equality and human rights. We do not make detailed recommendations about future funding that is predominantly the role of government but we do highlight the key principles that in our view should affect future decisions and strategic choices about long-term investment in social care.

  1. Care and support helps people to be independent, active and healthy throughout their lives. It is about helping people to do day-to-day things like living in their home, working, cooking, shopping and caring for their family. The care and support system includes a wide range of services such as meals on wheels, home adaptations, housing support services, support to help disabled people live independently, benefits for disabled people, occupational therapy, day care, carehomes and support for carers. www.careandsupport.direct.gov.uk/background/
  2. The consultation was carried out by Cordis Bright Consultants. Details of the methodology used can be found in the introduction, and a list of those consulted is included in the Appendix. Read the Consultation report.

From safety net to springboard

The challenges are profound and far-reaching. The Commission’s view is that without fundamentally re-designing care and support for the future, there is a grave danger that we will undermine individual opportunity, the strength of family life and our future national prosperity. It is our belief that the Government must consider modernising the basic approach to care and support to achieve three key aims: promote the capabilities and autonomy of each individual regardless of means; encourage co-production and partnership to create a sustainable infrastructure of care and support; and identify and communicate the cost-benefits of reform to society as a whole. These ideas are explained in detail in Chapter 3 of the report.

In doing so, care and support has the potential to become a springboard, not simply a safety net, focused on helping people to maximise control over their own lives, to make social and economic contributions and to stay safe and well. The benefits of this approach will accrue to society as a whole.

Care and support should be everyone’s concern. It should engage individuals, families and communities, business and employers, planners, house builders and all providers of public services, from local authorities to schools, from arts and culture to sport. Success relies as much on nurturing reliable and sustainable networks of informal support as it does on reforming public support services. We all have a contribution to make and a benefit to reap.

The Commission believes our proposals will help optimise the role of care and support in promoting economic prosperity and growth in the future, including providing opportunities for job creation and supporting more individuals to enter or remain in paid employment, including in old age. Effective care and support could also help us to avoid the negative social and economic costs associated with poverty, benefit dependency and long-term unemployment, ill-health, family breakdown, abuse and institutionalisation.

The Commission in accordance with its statutory remit has developed a series of proposals and actions under seven broad principles. We want to engage and work with our stakeholders on these proposals, including the Government, local authorities and non-governmental organisations with a commitment to equality and human rights. The principles are:

  1. Care and support based on clear outcomes and founded on human rights and equality.
  2. Access to publicly funded care and support based on clear, fair and consistent criteria.
  3. Individuals and families in control of their care and support.
  4. The right balance between safety and risk to promote choice and independence.
  5. Local strategic partnerships that play a central role in developing and maintaining local care and support.
  6. Funding that balances affordability and sustainability with fairness.
  7. Equality and human rights law and practice re-calibrated to respond to our ageing society.

We make a number of proposals in this report that we believe ought to be considered in the light of the Government’s forthcoming Green Paper on the future of social care. The Commission believes the following to be particular priorities:

  • Action to instil an equality and human rights culture across care and support, including a national rights-focused framework of outcomes and action by the Equality and Human Rights Commission in partnership with the Care Quality Commission to ensure compliance with the law.
  • Identifying and rooting out ageist policy and practice for example in inspection, charging policies or the exclusion of older people from schemes which support independent living.
  • Ensuring everyone requiring care and support is empowered by information, advice and, for those who require it, independent advocacy.
  • Building a detailed and robust evidence base concerning the cost-benefits of reform and of investment targeted to preventing avoidable ill-health and dependency.

The Commission’s actions

The Commission itself can also make a major contribution to progress in how we focus our resources and powers in pursuit of improved equality and human rights outcomes. Our strategic approach is to work with others, particularly statutory public bodies, to extend our reach and make maximum use of our powers to change policy and practice in social care, improving key outcomes for people requiring care and support and their families. In summary the Commission will:

  • Work with the Government, the statutory sector and others to develop a national outcomes framework for care and support founded upon equality and human rights principles.
  • Work closely with the Care Quality Commission to build upon the innovative user-led and human rights approaches developed by its legacy Commissions, to monitor, inspect and ensure compliance across the social care sector including enforcement where necessary.
  • Promote compliance with equality and human rights law, including action to empower local organisations and individuals to understand and to use the law in order to seek redress and to ensure that they have greater power and control over their lives.
  • Collate and disseminate good practice concerning the promotion of human rights and equality through care and support.
  • Enforce the public sector equality duties and intervene in human rights cases relating to care and support.
  • Research and gather evidence to inform future activity, including research into the prevalence and nature of ageism in care and support policy and practice.
  • Grant funding for pathway projects to evaluate the benefits of independent advocacy and to develop informal networks of support in local communities.
  • Work with partners to commission credible and robust cost benefit analysis concerning the benefits of reform to inform the public debate about the future of social care.
  • Carry out further analysis and consultation to develop the proposals in this paper and to develop detailed proposals for implementation.
  • Report on progress via our own annual report and triennial ‘state of the nation report’ as well as via other publications.

Details of the Commission’s planned actions and activities are included alongside our proposals.

Download the full report:

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