Human rights concerns raised over cuts to social care

Disabled and older people have been left to sleep in wheelchairs – or been unable to get out of bed, wash or dress themselves – due to cuts to social care support, reveals a new report by the Scottish Human Rights Commission.

The human rights body says its new monitoring report, published on 6 October, shows the removal of care packages during the Covid-19 pandemic has had “a direct and detrimental effect on people’s human rights”. 

The Scottish Human Rights Commission( SHRC) said it had “deep concerns” and called for social care to be re-instated to pre-covid levels “as a minimum”.

“Distressing” testimony gathered from support organisations, legal representatives and others, includes that of an older man with a learning disability and mental health issues found “catatonic in bed”. He lost a significant amount of weight and is facing a long recovery due to a lack of social care.

Support organisations said some disabled and older people were left to sleep in their wheelchairs because of a lack of care. One man was forced to sit in his wheelchair for long periods of time without being properly dressed, as it was the only way he could access the toilet without support. He reportedly had a physical and mental breakdown due to the stress of the situation.

‘Dire situations’

One user led organisation [not named in the report] told Scottish Human Rights Commission (SHRC) researchers: “[There are] a lot of examples of people left in dire situations…unable to get out of bed, unable to wash and dress themselves, having to move in with family…family members being forced into caring roles that they haven’t done before and some having to give up employment to do that.”

In March The Ferret reported that disabled people felt “abandoned” after being told that essential care packages would be suspended, sometimes with immediate effect, due to staff pressures resulting from the coronavirus epidemic.

The SHRC report found cases where support had either not been reinstated, or reintroduced at a lower level. Disabled people told representative organisations they feared that because they had been forced to rely on family during the pandemic, local authorities would assess them as no longer in need of support.

The SHRC is now calling on the Scottish Government and the Convention of Scottish Local Authorities (COSLA) to jointly commit to the return of care and support at pre-pandemic levels. It is also calling on the Scottish Government to incorporate the United Nations Convention on the Rights of Persons with Disabilities (CRPD) into Scots law.

Judith Robertson, chair of the Commission, said: “Social care is an essential investment in realising people’s rights, particularly those of us who are disabled, older or provide unpaid care. Delivered properly, social care should enable people to access their rights to family life, health, education, employment and independent living in the community, among others.

“That’s why the Commission is deeply concerned about the reduction and withdrawal of social care support to people during Covid-19, and the impact this is having on their rights.”

Valerie Livingstone, 63, who moved from Campbeltown to Glasgow five years ago, has fibromyalgia and arthritis and says she is in constant chronic pain.

Before Covid-19 she had social care visits twice each day, helping her to get up, dressed and have breakfast at 7.30am, and to get ready for bed at 6pm.

In March, with lockdown looming in Scotland, she was persuaded to go to live with her daughter in Largs. The family believed that reducing her contact with carers would also make it less likely she would contract covid-19.

She wrote to Cordia, which provided her social care package, informing them she wished to halt the service while living with her daughter. She received a reply from the manager, seen by The Ferret, confirming it was “fine” to email when she wanted to restart the service, but suggesting she also contact head office so it wasn’t missed.

“I thought I’d only be there for a few weeks, but I was there for three months,” Livingstone said. “By that time I wanted to get back to my own home.” Her daughter’s home had a spare bedroom and downstairs bathroom but lacked the adaptations of her own home such as a walk-in shower, hand rails, reclining chair and handles to help her out of bed.

Most days I’m not really coping. Some days I’m sitting here in tears.

Valerie Livingstone

But when she wrote back to Cordia she was told she did not qualify for a package any more because she had terminated support. An emergency assessment with an occupational therapist was eventually agreed, which found she needed help with showering.

One social care visit per week was agreed, which has since been increased to two visits. Livingstone claims that she lacks the strength in her hands to dress herself, meaning she is only able to change her clothes on the two days the carer comes. Last month her doctor wrote to Glasgow Health and Social Care Partnership (GHSCP) stressing of her need for additional support.

“Most days I’m not really coping,” she said. “Some days I’m sitting here in tears. Her daughters both work full-time and have children, meaning they are not in a position to provide daily care.

A spokeswoman for GHSCP insisted her case was unrelated to the pandemic. However, she later confirmed services were only being provided for “critical needs”, a change explained in a letter to Livingstone as related to the pandemic.

“I do believe it’s because of Covid-19,” Livingstone said. “Every other industry has had to adapt. At the moment I just want out of Glasgow. I feel like the council doesn’t care for its elderly or disabled. Everything I’ve had I’ve had to fight for.”

Pauline Nolan, of disability charity Inclusion Scotland, said Livingstone’s case is far from being an isolated one. “It’s not one particular provider or local authority system,” she added. “The whole system is in crisis. There is a huge level of unmet need. People are assessed, they are asked what their needs are and then services are provided based on the funds made available.”

The pandemic has shown just how fragile and undervalued our social care system has been.

Tressa Burke, GDA

In July an internal survey by Inclusion Scotland suggested almost four out of five of 150 respondents had their social care packages cut or reduced.

“It’s had a huge impact on people’s mental and physical health,” she added. “Social care was in crisis already and so this is having a huge impact on individuals and their families – we’ve heard of family carers having to reduce their hours or give up work. It absolutely breaches human rights.”

Tressa Burke, chief executive of Glasgow Disability Alliance (GDA), agrees the system was “hanging by a thread” even before Covid-19 hit. She added: “The pandemic has shown just how fragile and undervalued our social care system has been.

“While huge emphasis has gone on protecting the NHS, for many disabled people, social care completely collapsed as soon as the virus arrived.”

She claims hundred of GDA members contacted the organisation in the first weeks of lockdown “saying they’d been told their support was stopping immediately, and they’d need to ask family, friends or neighbours for assistance”.

“Many were concerned that if they did ‘cope’ or ‘survive’, they would be reassessed as no longer requiring that care post-lockdown, and for some this seems to be the case.”

Critical needs

A spokeswoman for Glasgow Health and Social Care Partnership (GHSCP) said at the height of the pandemic many people had home care packages reduced temporarily due to staff absences, “to enable resources to be targeted at the most vulnerable people with critical needs”.

She added: “Services in Glasgow have now been scaled back up and are now at 97 percent of that provided prior to the pandemic. A major staff recruitment campaign is also underway to bolster services during the winter months.”

The council claims Livingstone was not eligible when she returned from Largs, as GHSCP’s homecare service was “targeting resources at those who were deemed to have critical care needs”, which she was not deemed to have.

After assessment by an occupational therapist, Livingstone “was found only to required support with showering twice a week therefore the care packages was amended to reflect these needs,” the spokeswoman added.

Councillor Stuart Currie, COSLA’s health and social care spokesperson welcomed the report, which he said provide valuable insight into the experience of social care during the pandemic. 

He added: “When the pandemic hit, local government worked with partners in the third and independent sector to try to ensure that social care support continued to be provided for those who needed it most. 

“However, some people were impacted because social care support could not be delivered in the same way or because that person no longer wanted that support.  It is critical that where this has happened it is reviewed and this work is underway in Health and Social Care Partnerships.”

A Scottish Government spokesperson said it had established an independent review of adult social care with a human rights based approach remained committeed to reform, started pre-pandemic. It has made an additional £150m available for social care.

The government spokesperson added: “We recognise that the COVID-19 pandemic has been incredibly difficult for both those receiving and providing adult social care. It is critical that social care support is maintained as far as possible to ensure the safety, dignity and human rights of people who already receive support, and that of their unpaid carers.”

Image from Istock

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