Key points to note from the Guidance on a Human Rights-based Approach in Health and Social Care Services

Introduction

On the 13^th November 2019, the Health Information and Quality Authority (HIQA) and Safeguarding Ireland published the Guidance on a Human Rights-based Approach in Health and Social Care Services.

HIQA and Safeguarding Ireland published the guidance document to aid in the promotion of a human rights-based approach to care and support for adults in health and social care services. The guidance document provides a practical and accessible introduction to human rights-based approach to care and support and applies to all health and social care organisations.

Key Points to Note

Upon completion of a literature review, HIQA and Safeguarding Ireland used the FREDA Principles for the purpose of the guidance as they provide a globally recognised framework. There are five FREDA Principles, and these are as follows:

1. Fairness – Decisions are made with a resident about their care and support, and the resident must be at the centre of the decision-making process.
2. Respect – Respect must be objective, unbiased and has regard for the rights, values, beliefs and property of others. In the health and social care setting, respect must be shown in the actions towards a resident by others and must be demonstrated through communication in a courteous manner.
3. Equality – Health and social care services must ensure that residents are not discriminated against due to their status or characteristics. Equity in health and social care means recognising that some residents, because of their needs or circumstances, require additional help and support to achieve the best possible outcome. Providers have a duty of care to ensure fairness and equity for all residents.
4. Dignity – Dignity is central to the idea of human rights and all human rights are connected to human dignity. In the health and social care setting, dignity supports residents to feel safe and improve their outcomes while also improving working relationships amongst staff. Lack of dignity is a common theme in examples of abuse and neglect in health and social care settings, including:
   • Malnutrition and dehydration.
   • Physical, psychological or sexual abuse.
   • Ignoring calls for help.
   • Unchanged bed sheets.
   • Not feeding people properly.
   • Pressure ulcers.
   • Poor personal care.
   • Being made to wear incontinence wear when unnecessary.
   • Restrictive practices.
   • Bullying, patronising and condescending attitudes.
5. Autonomy – In the health and social care setting, residents may require different levels of support to assert their autonomy and make their own decisions. Staff must have a key role in the process. In order to respect a resident’s autonomy, meaningful communication must be utilised, and it must involve negotiation and compromise when a resident’s will and preferences impact on the rights, care and safety of others. Residents’ autonomy may also be impacted when there is a legal basis for it not to be upheld.

The guidance document details how staff of health and social care organisations must incorporate the FREDA Principles in their day to day work. Also, the guidance document provides examples that illustrate situations in which the principle was upheld and not upheld.

For information on the care tools provided by HCI, contact HCI at +353 (0)93 36126 or info@hci.care or visit the hcicaretools.com.

References

Health Information and Quality Authority and Safeguarding Ireland (2019). Guidance on a Human Rights-based Approach in Health and Social Care Services. Dublin: Health Information and Quality Authority and Safeguarding Ireland.

Health Information and Quality Authority and Safeguarding Ireland (2019b). Frequently asked questions (FAQ) about the Guidance on a Human Rights-based Approach in Health and Social Care Services.