RIGHTS IN COMMUNITY CARE

Rights in Community Care (RICC) is an umbrella grouping of organisations including Law Centre (NI), Carers NI, Age NI, UNISON, Disability Action and Alzheimer’s Society.

RICC support an equality and human rights-based approach to the delivery of community care services and support. One which will demonstrate an understanding of and focus on needs, voice, choice and control in the provision of good quality care and support services for all individuals and carers. This should be delivered in an equitable way, including upholding and protecting the rights of workers who provide services and support. 

THE CONTEXT

There are over 300,000 people of retirement age (women over 60 and men over 65) living in Northern Ireland. They make up 17% of the population.  By 2030, it is expected that this percentage of older people will increase to almost one fourth of the total population (24%).[1]  The largest increase will be in the older old. By 2030 it is projected that there will be more than 130,000 people over the age of eighty living in Northern Ireland, a 103% increase on estimates for 2010, making up about 7% of the population. As life expectancy has increased a growing number of older people may be living longer with conditions that can seriously reduce their quality of life.

In addition, the level of disability in Northern Ireland is one of the highest in the United Kingdom with 21% of adults and 6% of children living in private households having a disability. Many will therefore rely on health and social care services to maintain and support their independence.

WHAT IS COMMUNITY CARE?

Community care consists of both health and social care. It includes such things as support offered to people at home, access to respite, day care, family placements, sheltered housing, group homes and hostels and residential and nursing homes. It can also include services such as befriending schemes and activity clubs for people with dementia, which provide opportunities to engage in pleasurable and stimulating leisure activities, and family and learning support which underpin and sustain general health and wellbeing.

PROVIDING COMMUNITY CARE SERVICES

Community care services are provided through public services, as well as by the independent and voluntary and community sectors.  In addition, individuals are financed to purchase the services they need from a variety of sources.

Community care is carried out by a range of carers from medical professionals, paid formal carers and informal carers or family carers. It is vital therefore that the needs of carers, particularly informal carers, are taken into account as well as the needs of the person requiring care.

The defining factor, which determines any person's entitlement to community care services is her/his individual and particular need for care and support.  Each individual will have different requirements and will not necessarily require all the services which the Trusts are under a duty to provide. Services may include; domiciliary care services; home help services; respite care; aids and adaptations; residential and nursing care and assessment of care needs.  It is expected that the Health and Social Care Board/Trusts will make a full range of services available and resources to meet the needs of persons requiring care services and their carers.

RICC RECOMMENDATIONS

A number of overarching themes are important in delivering a care system that focuses on entitlements, rights and fairness for all individuals. With effective treatment, fair and equal access to services, appropriate levels of funding and prevention strategies, RICC believe that individuals can continue to experience good health.

• RICC recommend that it is important to broaden the debate about funding care services to address our future lives and life chances.  This may ultimately lead to a different model of social care that involves significant cultural as well as structural change.

• RICC recommend a greater focus on prevention strategies to enable people to live independent and fulfilled lives. 

• RICC recommend mainstreaming equality and human rights into the regulatory regimes to tackle the age and disability related assumptions that are embedded in decisions about treatment and services.

• RICC recommends priority should be given to increased investment in community care as an evidence based, long term cost effective means of delivering better health outcomes for individuals, rather than the current focus on care provided automatically in acute care settings.

WHERE TO NEXT?

We are realistic about the funding constraints facing Government Departments at this time.  Given, however, the vulnerability of those in need of community care services, RICC calls on the NI Departments, the Assembly and the Executive to ensure that those requiring community care have equality of access to the services and support they require. In light of compelling evidence that investment in preventative community care services will improve health outcomes and be cost effective in the long run, this is not only a fundamental equality and human rights issue but makes good financial sense.[2]

RICC

October 2010