Human rights – a way to address power imbalances

What this means

Power was a theme underpinning a lot of the Leading The Lives We Want To Live discussions. This could be overt power that professionals hold – such as financial control, or control over access to a particular service or intervention. But it could also be covert and passive, such as a professional being elusive, or an organisation failing to implement co-production. The asymmetry in the social care relationship needs to be acknowledged, as a first step. 

Greater knowledge of, and use of, human rights is a way to address some of this power imbalance. The group believed that the articles of the Human Rights Act (1998) ‘…should be learned like a nursery rhyme’ and, along with the UN Convention on the Rights of Persons with Disabilities, human rights should be linked with every plan and every action.  

We know what good practice looks like. The imbalance of power means that we are not heard.

The research 

Much of the research on power is covered in the Sharing power as equals key change (it may be particularly relevant to read the sections Power has many faces and Power can be subtle and unspoken). 

Human rights legislation is unique because it focuses on humanity - the basic freedoms and protections we should all have because we are human (Elliott, 2017) rather than being contingent on our identity, behaviour, or eligible needs. It is potentially, therefore, a potent way to equalise power relationships when thinking about adult social care. The British Institute of Human Rights (2013) found that increasing a focus on human rights in health and social care would support: 

• More person-centred practice. 
• Reduced risk of complaints and litigation in the longer-term. 
• Improved decision-making. 
• More meaningful engagement. 
• Broader range of minoritised groups having their voices heard. 

The report also said that a human rights approach promoted ‘power not pity’, arguing that accessing public services often inherently involved an imbalance of power but ‘human rights can provide a powerful language for the conversations that need to take place, moving away from needs or charity to fulfilling rights and duties. This can be empowering for all involved’ (p.8). 

However, in practice, there can be a gap between rhetoric and reality. Kinderman et al. (2018) found that staff training in human rights, in itself, did not improve the wellbeing of the people staff worked to support (in this case, people living with dementia). The study suggested that more staff ownership of a human rights approach was needed, rather than a solely top-down approach. In a study concentrating on social workers in an integrated mental health service, Meadows and Moran (2022) found that, while all participants recognised human rights as central to the work they did, there was limited knowledge of human rights legislation, little explicit training, and a lack of human rights discussion in supervision.  

The United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) was adopted by the UN General Assembly in December 2006. The UK ratified the Convention in 2009. By following UN CRPD, the UK agreed to protect and promote the human rights of disabled people, including: 

• Eliminating disability discrimination. 
• Enabling disabled people to live independently in the community. 
• Ensuring an inclusive education system. 
• Ensuring disabled people are protected from all forms of exploitation, violence and abuse. 

(Abreu, 2022) 

Kim (2010) argued that the UNCRPD could be a significant lever to strengthen human rights-based practice and move conversations towards disability rights and inclusion. However, UK-wide progress on UN CRPD has been slow, with Inclusion London finding that the situation for disabled people has worsened since 2017 (which was when the UN last looked at the UK’s progress), including the impact of COVID-19 measures (which discriminated against disabled people). Overall, the report found that there was insufficient monitoring of the UN CRPD, which was also inhibiting progress (Inclusion London, 2022). 

What you can do 

If you are in direct practice: Research in Practice has a Frontline Briefing that can support you in taking a rights-based approach to your assessment work (this briefing is also helpful for people working in social care who don’t assess people). Questions that support a human rights approach in your direct work include: 

Broad questions on dignity and equality 

• What matters most to you? 
• What does a good life look like to you? 

Questions related to Article 2 (freedom from inhuman and degrading treatment) 

• What is stopping you from living your life the way you want to? 
• What has happened to you? (This is a trauma-informed question that allows exploration and growth, and does not undermine someone’s dignity.)  

Questions related to Article 5 (Liberty and security) and Article 8 (Respect for private and family life, home and correspondence) 

• What makes home for you? 
• Who is important to you? 

Questions related to Article 14 (Prohibition of discrimination) 

• Can you tell me a bit about your history? 
• What’s meaningful to you in your life? 

Consider these questions, and think of others that could relate to the Human Rights Act (1998) and the United Nations Convention on the Rights of Persons with Disabilities. How can you include more of these in your practice? Whose support do you need to get in order to do this? 

If you are a supervisor: The research has clearly identified that having a supervisor support learning and development around human rights, and keeping it on the agenda in supervision sessions, is key to getting this approach in practice. You might consider the following: 

• Speaking to those you supervise about how they currently view and use human rights in their practice. 
• Team awareness-raising, including posters, shared links, and discussions. 
• Scheduling agenda items on human rights in team meetings and individual supervision discussions. 

If you are a senior leader: Research in Practice has published a Leaders’ Briefing, on Embedding human rights in adult social care. It contains many reflections and ideas for taking this work forward. The five key steps to take are adapted below:  

1. Consultation Find out what is important to citizens and staff. What do they say are the fundamental things your organisation needs to be doing in order to treat people with dignity and respect? 

2. Identify the rights you should be protecting Translate these views into a list of specific rights that are important to people, and compare this with your legal duties under the Human Rights Act 1998, and with the principles of the UN CRPD. 

3. Create a quality standard Agree a set of staff behaviours that protect and promote human rights, and which can be used to judge the effectiveness of your organisation. 
4. Support your staff They will need to feel supported in adopting this approach (consider the research above that suggests a human rights approach can be impeded by a lack of confidence and little line management support). 
5. Monitor your success And then build on what is working well! 

Linking Human Rights with assessments and plans, and adapting the forms so they explicitly prompt practitioners to consider this, is another positive step (for an example of this, see the Mersey Care Keeping Me Safe And Well manual, co-produced with people with learning disabilities). 

Further information 

Read and watch  

The Equality and Human Rights Commission has clear information and bitesize videos on human rights and the Human Rights Act 1998. 

Read  

The British Institute of Human Rights has a Practitioner's Guide to dementia and human rights.