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

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66% nursing assistants = 9 (50% can be replaced with care givers)It was quite alarming therefore, that in at least 21% of homes they never had access to a nurse,with some provinces much higher such as Eastern Cape (49%), Free State (33%) and NorthWest Province (65%). This means that these homes probably rely on nursing assistants andcaregivers.Public hospital services:In the majority of homes the residents had to access medical services such as a doctor,medicines, a physiotherapist and occupational therapist at their nearest hospital. While in 81% ofhomes there was a hospital available within a 1-10km radius, in some provinces the hospitalswere more than 50km away from the home. In the Free State out of 33 homes, 11 were morethan 50km away from the home making access to medical care very difficult. The lack oftransport was a problem in many of the homes so in the case where homes did not haveappropriate transport for the residents, they relied on family members who were easy to access,or on an ambulance from the Department of Health that was very unreliable. In almost all thehomes they indicated that even where an ambulance fetched the resident, they would not returnthen to the home when they were discharged.Information received from all respondents across the provinces, there were numerous complaintsreceived by older persons who are forced to use the services of government hospitals. They arereportedly not treated with dignity and respect; have to wait for many hours to be assisted. Manycomplained that they waited long hours and often returned from a full day at the hospital withouthaving been attended to by a doctor, or receiving medication.In the SA Policy for Older Persons it notes that “…A Ministerial Committee was appointed in2000 to investigate the neglect, ill-treatment and abuse of older persons. It found services for theelderly in hospitals and clinics to be less than adequate and heard many complaints about theattitude of staff to older patients, the shortage of medicines and assistive devices, the lack oftransport and long out-patient waiting times…”It is therefore very concerning that since 2000 the situation for older persons using the publichealth system remains the same and in some cases might have worsened. Since this provisionof frail care for those in need of twenty-four hour care is official policy the division of responsibilitybetween Social Development and Health Departments needs to be clarified. The Policy states34 | 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
that “…The Department of Health, through partnerships should provide free transport to stateheldfacilities with community-based organisations and service centres. Community HealthCentres (CHCs) should provide Primary Health Care Services. Hospitals should rendersecondary services, including specialist geriatric services, to older persons at a specific user fee.Specialist geriatric services should be provided for in-patients (diagnostic and therapeutic care)and outpatients (referral, continuity and condition specific care). Tertiary centres for olderpersons should provide additional care for complex or rare conditions. Laboratory services,radiography services and other diagnostic support services should be provided at districthospitals…”Medical services offered to the CommunityServices Offered to the Community48.00%Yes25.00%10.00% 9.00%15.00% 16.00%Occupational Therapist Nurses DoctorGiven the lack of adequate medical care and resources for the residents it is not surprising that inonly about 10% of the homes (40) are medical services offered to the neighbouring community;within this the majority (48%) is the provision of nurses to the community.35 | 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 and 16: office-bearers except as reasonable
Page 17 and 18: 1.3 Process FollowedA number of oth
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: Just over a half (51%) of homes off
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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