An important and worrying survey by the UK Home Care Association highlighting the risks to older people's human rights of ever-shorter home care visits confirms the interim findings of the Equality and Human Rights Commission's formal inquiry into the human rights of older people receiving care at home.   

The survey found that home care clients were receiving shorter visits and losing access to services such as safety checks.  82% of 111 UK Councils and health and social care trusts had cut the visiting time allocated for at least some clients. 

What this and other evidence shows is that decisions made by government and public authorities, including spending decisions, do have a direct bearing upon the levels of risk to human rights even if it is often difficult or impossible to attribute actual breaches of human rights to such decisions.  This is contrary to Justice Minister Ken Clarke's assertion to the Joint Committee on Human Rights when asked about proposed reforms to Disability Living Allowance that human rights bore no relation to departmental spending decisions.   

Diagnosing the factors which place human rights at risk in different sectors is the pre-requisite for the development of a culture of respect for human rights in both the everyday practices of public services and in the context of decision-making and accountability.  Only by understanding the real factors which positively or negatively human rights protection can we offer meaningful guidance and measure the performance of public bodies.  Many of these factors are systemic rather than the product of individual 'bad apples' or one-off abuses.

For example, poorly managed, motivated and remunerated staff providing care is not itself a human rights problem, but it is very likely to present a major risk to the human rights of those receiving care. Likewise, commissioning care in 15 minute slots presents a risk to human rights, but would not necessarily be identified or answered by a 'human rights based approach'.  

Risks to human rights are often the manifestation of other problems, not a failure to address human rights explicitly.  A half day course on the human rights of care users may sometimes be transformational, but its impact is likely to be diminished where the staff themselves do not feel respected, or where the time they have to deliver care does not allow them to put such principles into practice.   

For 'human rights based approaches' to be truly successful they have to be able to diagnose and offer solutions to the structural and systemic factors which create risk.   In the case of home care, local authority commissioners need to think seriously about the effects of their decisions.  

The work being led by the Scottish Human Rights Commission on human rights impact assessment is going to be extremely important in this regard.