CQC’s Human Rights Approach: What Rights-Respecting Care Looks Like in Practice

CQC’s Human Rights Approach: What Rights-Respecting Care Looks Like in Practice

CQC says care that does not respect human rights is neither safe nor high quality. Here is what that means for your service and how to evidence rights-respecting care.

CQC’s human rights approach treats respect for people’s rights as part of safe, high-quality care, and looks for “rights-respecting cultures” in services, including dignity, respect, choice, minimal restrictive practice and fair balancing of conflicting rights. CQC says it describes human rights-related risks and issues rather than formal legal thresholds, and it will use its regulatory powers, from sharing good practice to enforcement, where it finds failures.

Human rights can sound legal and remote, but CQC says people rarely use the formal language: they talk about dignity, respect and fairness. CQC’s updated human rights approach (last updated December 2023) explains why it matters to inspection and what it expects of providers.

This guide translates it into practice for registered managers. It links to dignity in care, restrictive practice, visiting and consent, and supports your CQC compliance evidence for the caring and well-led key questions.

What Is CQC’s Human Rights Approach?

CQC says its role is to make sure people have safe, high-quality care, and that a focus on human rights helps it meet its legal duties under the Health and Social Care Act 2008 and prevent failures in care, which usually relate to risks to human rights. It points to Winterbourne View, Mid Staffordshire, Whorlton Hall and the Edenfield Centre as examples of failures with profound effects on people’s lives.

CQC clarifies that when it talks about human rights it is describing risks and issues, not formal legal thresholds for breaches. It wants conversations about human rights to be commonplace in health and care so that discrimination, inequality and power imbalances can be challenged.

Rights-Respecting and Rights-Rejecting Cultures

CQC says care that respects people’s rights is good care, and good care has a “rights-respecting culture”. Poor care is the opposite, a “rights-rejecting culture”. In practice, a rights-respecting service tends to show:

• respectful, dignified care where people’s needs are fully understood, especially for people most likely to have a poorer experience of care;
• restrictive practices used only as a last resort, when there is no other way to keep people safe;
• conflicting rights balanced thoughtfully, especially around positive risk taking; and
• support for staff, whose rights also matter.

Those are the common themes CQC heard when it reviewed its approach with people who use services, carers, advocates, providers and experts.

Which Rights Come Up Most in Care?

CQC’s page lists human rights articles relevant to health and social care. In adult social care, the rights most often engaged are those in the Human Rights Act 1998: the right to life (Article 2), freedom from inhuman or degrading treatment (Article 3), liberty and security (Article 5), private and family life (Article 8), freedom of thought, conscience and religion (Article 9) and non-discrimination (Article 14). Read CQC’s list for its full framing.

Applying a Human Rights Lens to Decisions

CQC’s Regulation 9A guidance asks providers to consider whether any restriction is lawful, legitimate and proportionate, balancing private and family life, independence, choice and control against risk and safety. You can use the same questions for any decision that limits someone’s freedom:

1. Is it lawful? Is there a legal basis, such as consent, a best interests decision or DoLS authorisation?
2. Is it legitimate? Is there a genuine aim, such as protecting someone from serious harm?
3. Is it proportionate? Is it the least restrictive option, and have alternatives been tried?
4. Who was involved? Did the person, their family or advocates take part, with reasonable adjustments to help them?
5. When will it be reviewed and ended?

See MCA and DoLS in practice and CCTV in care homes.

Building a Rights-Respecting Culture

• Put dignity, choice and respect at the centre of induction, supervision and team meetings.
• Teach staff to recognise restrictions, including subtle ones such as rules, routines and locked areas.
• Record restrictions, the reasons, who agreed and review dates.
• Support positive risk taking with clear risk assessments that balance safety and choice.
• Listen to residents, relatives and staff, and act on concerns. A speak-up route matters. See whistleblowing policy.
• Check equality: are some people, for example those with dementia, a learning disability or from minority groups, experiencing poorer care? See culturally appropriate care.

Evidence an Inspector Can Verify

• Care plans reflecting preferences, with signs of involvement.
• A restrictive practice log and review records.
• MCA assessments and best interests decisions, and DoLS tracking.
• Staff training and supervision on rights, dignity and restraint reduction.
• Feedback from residents, relatives and staff, and what changed as a result.
• Governance reviews of restrictions and incidents. See Regulation 17.

CQCLogic’s DoLS/MCA tracker, safeguarding log, incident log, supervision log and policy register help you hold the evidence. It does not hold restraint-specific forms, so keep your restrictive practice monitoring in a format that suits your service and link it through tasks.