Audit of Residential Facilities, Final report - Division for Social Policy ...

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CHAPTER 1INTRODUCTION TO THE STUDY1.1 BackgroundThe Department of Social Development is responsible for the development and administration ofthe legislation which impacts on social development services to older persons and residentialfacilities is one of them. The government has a responsibility to ensure that its senior citizens arein environments that maintains or improves the physical, social and psychological well-being ofindividuals who, for a variety of reasons, are not fully able to care for themselves.The Department has realized the need to revisit facilities that are home to some of the elderlypeople with an aim to review the systems adopted to run these facilities and explore the quality ofservices provided to the elderly. The purpose of this Audit is to identify the services provided anddetermine the quality of these services whilst also identifying the management systems which areused to run these facilities. The aim is to provide a national baseline study of the current statusof residential facilities, focusing primarily on where government interventions should be focusedto improve the quality of life of older persons within these establishments.Umhlaba Development Services was appointed as the service provider by the Department ofSocial Development, with the task of auditing the residential facilities for older persons in SouthAfrica. The report will provide the reader with a review and analysis of 426 homes across thecountry in terms of the following: medical services, social / recreational and outreach services,policies and procedures, management and governance, staff and volunteers, as well as anoverview of the building and facilities. The report provides a quantitative analysis of these areasas well as some anecdotal views of all stakeholders.1.2 Objective of the StudyThe main objective of the study was to conduct an audit to assess and analyse the quality ofservices in 426 residential facilities (in the end it was 405 as some homes have become privatewhile others refused to be audited) in respect of the relevant norms and standards in order thatthe DSD may review, plan and implement appropriate management systems for the facilities.16 | D S D A u d i t o f R e s i d e n t i a l F a c i l i t i e s
1.3 Process FollowedA number of other processes were followed, which are listed below:i. Literature review: A review of current legislation, policies, norms and standards wasundertaken as well as a review of studies completed with regard to older personsii. Developing tools for the audit: These included a set of questionnaires for Board andmanagement, staff and volunteers, residents, and where possible family membersand community members. These tools were discussed and reviewed by a ReferenceGroup in the Department after which it was finalised and acceptediii. Training and appointment of fieldworkers: Three teams were trained to conductthe field work over the duration of the audit process. The first team was made up oftwelve (12) fieldworkers from Gauteng. This team conducted the audit in Gauteng,Mpumalanga, North West, Free State, Limpopo, and the Northern Cape. The secondteam was also made up of nine (9) fieldworkers and these fieldworkers were based inKwaZulu Natal. This team conducted the audit in KwaZulu Natal and Eastern Cape.The third team conducted the audit in the outlying areas of the Western Cape andconsisted of seven (7) fieldworkers.iv. Database: Once the lists were received from the Department or provincialcoordinator, follow up was done with each home to verify the identifying and contactdetails. This will ensure that there is an updated list of all homes that have beenvisited.v. Appointments made with homes: This was a challenging process as it involvedmaking telephonic contact with each home, agreeing on 2 consecutive days for theaudit in each home, faxing a letter to confirm the dates as well as the requirements forthe 2-day visit. In a number of homes, especially in outlying areas, discussions withfamily and community members did not take place either because the homes were along distance away from where families lived or because there was no contact withthe older person. Community members and volunteers were often part of the samegroup, and would consist of the local priests, a few NGOs and people who providedsome service to the homes on a voluntary basis.vi. Verification of Audit: Once the visits were completed, the field worker returned allthe completed questionnaires as well as other documentation received such asattendance registers, staff and resident registers. The following process was thenfollowed:17 | D S D A u d i t o f R e s i d e n t i a l F a c i l i t i e s
Page 1 and 2: Final ReportAudit of Residential Fa
Page 3 and 4: 4.5 Sustainability / Funding ......
Page 5 and 6: towards their conditions of employm
Page 7 and 8: The M&E role of the Department (whe
Page 9 and 10: 6. With regard to management capaci
Page 11 and 12: 14. Sharing, Learning and Networkin
Page 13 and 14: Director-General means the Director
Page 15: office-bearers except as reasonable
Page 19 and 20: This was recorded and submitted to
Page 21 and 22: The Population Reference Bureau est
Page 23 and 24: 2.4.2 Proportion of women versus me
Page 25 and 26: Africans comprise 67, 7% of the pop
Page 27 and 28: Where homes are situatedFormer Whit
Page 29 and 30: While the guideline for frail care
Page 31 and 32: The breakdown of these homes is as
Page 33 and 34: Just over a half (51%) of homes off
Page 35 and 36: that “…The Department of Health
Page 37 and 38: Cultural and recreational activitie
Page 39 and 40: one bed should be set aside for sho
Page 41 and 42: a. Although there were a few homes
Page 43 and 44: 100%90%80%70%60%50%40%30%20%10%0%81
Page 45 and 46: While in the majority of homes (62%
Page 47 and 48: The graph indicates that staff for
Page 49 and 50: The norms and standards indicate th
Page 51 and 52: Are there staff records and Perform
Page 53 and 54: In 92% of the homes the residents d
Page 55 and 56: ooIn addition, emergency exits were
Page 57: v. In some provinces, the coordinat
Page 60 and 61: egards to the Mangers carrying out
Page 62 and 63: some senior staff that were black.
Page 64 and 65: 4.6 Intersectoral CollaborationThe
Page 66 and 67:
In terms of the Transformation Char
Page 68 and 69:
from Alzheimer‟s disease, dementi
Page 70 and 71:
the home as very poor, Umhlaba sugg
Page 72 and 73:
Home Requiring InterventionHome Con
Page 74 and 75:
Free StateFree State ResultsPoor /
Page 76 and 77:
Vosloorus Society Care of the AgedL
Page 78 and 79:
Beaconvale Poor YesFairHome for the
Page 80 and 81:
Where a more positive relationship
Page 82 and 83:
The shortage of nursing staff could
Page 84 and 85:
major breakages and faulty equipmen
Page 86 and 87:
. Meetings / Interviews with:1. Dor
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