5 September 2012
Dear
There are a number of local authorities throughout Wales that are making decisions about care homes in their area. It is important that decisions such as this, which directly affect the lives of older people and their homes, are made in a way that puts older people at the heart of the decision-making process.
The Welsh Government has produced statutory guidance about the closure of care homes where there are concerns about financial viability or abuse, but there is no guidance that specifically outlines good practice when closing care homes as a result of a policy decision. I will, in the very near future, be chairing a working group that will advise the Welsh Government as it develops statutory guidance on this matter. In the meantime, I would like to outline my expectations of Councils when they are considering the possibility of closing or transferring care homes.
Securing the human rights of residents
Councils must act in a way that protects the human rights of those they serve. Older people in care homes have a right to be treated fairly and to have their voices heard. The care home is their only home and this should not be forgotten. Their dignity, beliefs, needs and privacy should berespected, as well as their right to make informed and effective decisions about their care and wellbeing.
Meaningful consultation and engagement
Older people and their families should be consulted with in a meaningful way at a time when proposals are still at a formative stage. The consultation should give enough information, in plain language and in various formats, to allow people to be fully informed. There should be sufficient timeto weigh up the information and respond to it. The responses thatolder people and their families give should be carefully and open-mindedly analysed by the Council, and the results should be made widely available. The Council should publish the views expressed and the reasons for the decisions it has finally taken. The responses should also be fed into an ongoing impact assessment process (see below).
The various stages of the consultation process must be made clear to older people and their families and there must be a key point of contact available who can be contacted to answer any questions about the consultation.
Provision of advocacy
Some older people will not be able to express their own wishes or concerns without the help of an advocate. Where an older person lacks capacity and there is no relative or friend to represent them, an Independent Mental Capacity Advocate must be appointed since it is a legal requirement to appoint one when decisions are being made that could result in them being moved to a different care home.
At the earliest stage, residents should be made aware of advocacy services available to them; even though a person has capacity, he or she may feel they need the support of an independent person to represent their wishes or concerns. The voluntary sector can play a key role in providing such support and should be used to do so.
Social workers and care home staff are not independent advocates.
Ongoing impact assessment
The specific duties under the Equality Act general public sector equality duty require Councils to assess the impact of policies and proposed policies on those with protected characteristics. When considering care home closure, Councils should assess the impact of the options it proposes in the consultation document and should publish the findings as part of that document. The impact assessment process should not be carried out just once – it should be repeated wherever there is a proposed change of direction or a change of circumstances.
Councils should consider the findings thoroughly and act upon them to ensure that no-one with a protected characteristic is treated unfairly as a result of a policy or decision.
I fully understand that Councils have difficult decisions to make at these times of financial restraint and uncertainty. However, I have been contacted by several older people who are concerned about the proposed changes. The expectations I have outlined address some of the concerns they have expressed to me. I hope they will give you some guidance until more formal guidance is issued.
I will be taking a close interest in the way that care home closures across Wales are managed so that older people’s rights are upheld.
Yours sincerely,
Sarah Rochira
Older People’s Commissioner for Wales