Call for end to power imbalance in care

The Relatives & Residents Association is supporting an amendment proposed by Lord Hunt to the Health and Care Bill, in its Committee stage in the House of Lords.

The amendment aims to tackle the powerlessness of families prevented from visiting relatives and friends in care homes, not because of Covid restrictions but simply because they have made complaints. At the moment, if families complain about the care their relative is receiving, a care home can simply retaliate by banning them from visiting, and sometimes even threatening the resident with eviction or actually evicting them.

Many callers to our helpline are too afraid to raise issues for fear of such reprisals, even though the law protects their right to family life (Article 8 of the Human Rights Act). Families are frightened into silence by the prospect of reprisals and of being deprived of the very relationships vital to their physical and mental health and wellbeing.

As the regulator, the Care Quality Commission, doesn’t deal with individual complaints, by the time they next inspect a care home, catastrophic damage could have been caused to a resident by punitive isolation.

This was an increasing trend even before the pandemic, but over the past couple of years has been masked by Covid restrictions which are now being gradually relaxed. As far back as 2016, the Victoria Derbyshire programme reported that “hundreds of care homes” were guilty of banning relatives who complained about care standards. In 2019 R&RA warned that the problem was increasing.

One relative found her mother dressed in other people’s clothes, left in her own urine, and with her hair unwashed for weeks. The Local Government and Social Care Ombudsman, who upheld the daughter’s complaint, reported that:

“After raising her concerns with the care home, she – and a doctor – were prevented from seeing her mother when they tried to visit … The care home later told the Ombudsman the ban was because of a previous incident reported to the police because of the daughter and her partner’s behaviour. But it could not provide any evidence that an incident had occurred, or was reported the police”.

The Joint Committee on Human Rights heard of one family who had only asked to discuss their concerns with a care home’s Head Office. In return, they received a threat of eviction. They said:

“We went to see a solicitor. We called CQC. We contacted charity helplines. We visited the local council and our MP. Nobody was shocked. Everyone told us that this was “not uncommon” practice. All said that as the care home was in the private sector, nobody could help us. We asked around and found that other residents had actually been evicted. This care home did carry out their threats. Since then we have not complained”. (Evidence, December 2021, page 12)

Lord Hunt’s amendment would set up an independent review to consider creating a statutory duty of care towards families. He said: “I am urging the Government to tackle this appalling abuse which has been allowed to go on far too long”.

A statutory duty would require care homes to facilitate reasonable contact between people living in care and their relatives. Families banned from visiting would be empowered to apply to the County Court for an emergency injunction restoring contact. Eviction notices would be prohibited while complaints were in progress. The review proposed by Lord Hunt would involve a public consultation, to gather evidence from families and charities familiar with this problem.

Helen Wildbore, Director of the Relatives & Residents Association said:

“There has long been a power imbalance at the heart of our care system but the pandemic response has made this much worse, stripping people of their support networks when they needed them the most. Our helpline hears daily from families who say they feel powerless to raise concerns about care for fear of reprisals. For people already in vulnerable situations, being afraid to speak out even when their legal rights are at stake adds to a sense of loss of control. This has to change to ensure older people’s fundamental rights, like family life, liberty and autonomy, are protected.”