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

4.9 TransformationWhile the issue of transformation, or the lack thereof, is addressed in some sections of thisreport, a few additional issues need to be addressed. The Transformation Guidelines indicatesthat the critical elements of transformation in relation to governance are as follows:- Management structures that reflect the demographic profile of the region and the provincethey serve- There needs to be a balance between demographics and effective management- Demographic profiles of communities to be reflected in management structures oforganisations (skills transfer, capacity building, transparent processes etc.)If one were to take the above literally, it is easy to assume that transformation is happeningespecially as many communities have remained intact since 1994 with few areas reflectingchanges in the demographic profile of the community. Hence, on the surface it would appear thatthese homes are transforming as they reflect the demographic profiles of the communities inwhich they are based and which they still largely serve.It was also clear that some homes used cost as a way to exclude different groups of people. TheGuidelines notes that “…the same quality and standard of service is provided to all, irrespectiveof race, gender and ability to pay…” While this implies that a home cannot refuse someone whocannot afford the prescribed fees, in practice homes do not accept those who cannot afford thefees. Although some white families also battled to pay the monthly fees, sometimes as much asR8 000 – R15 000 per month, they were still however able to afford it, probably at the expense ofother priorities. Many indicated that they had no option but to pay it because they couldn‟t takecare of their relative.As the social construct of black families start to change and they continue to choose the option ofinstitutional care for their frail residents, the urgency to address transformation at various levels inthe homes must be addressed. Rather than using the reasons of culture and social norms as anexcuse to exclude people there has to be some incentive for homes to embrace diversity and tobe held accountable for transformation. While transformation is not going to be easy there has tobe an intention, a plan and an effective monitoring system to ensure that while there isconsideration for the "more advantaged" older people who might not be able to easily adjust, sotoo should we be mindful of those pensioners who are adversely affected by a continuation of thesystem.65 | 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