The Government has launched a proposal in which it proposes limiting the size of nursing homes to a maximum of 50 places. It is one of the criteria that the Ministry of Social Rights and the 2030 Agenda has included in the document with which it intends to reach an agreement with unions, employers, organizations and autonomous communities to promote a new residential model after becoming the most beaten during the first wave of the pandemic and system failures become apparent.
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The document, advance by InfoLibre and to which elDiario.es has had access, establishes the standards that accredited residences must meet, those that serve people recognized by the System of Personal Autonomy and Dependency Care (SAAD). It involves a minimum of human, material and equipment and quality resources, which must be evaluated periodically, for which the communities must have one inspector for every 30 residential centers.
The idea of the ministry is that the draft of the Agreement on common criteria for accreditation and quality of the centers and services of the System for Autonomy and Care for Dependency (SAAD), As the document is called, it can be approved by the communities during the first quarter of 2022, but it is currently a "working" text, so it can still be modified.
The objective is to ensure "the dignity of treatment and the exercise of rights" of residents and "move towards a model in which residences are homes," says Luis Barriga, general director of the Institute for the Elderly and Social Services (IMSERSO) , which insists that it is a proposal pending agreement. In practice, the criteria would affect all residences because it is extremely unusual for there to be centers that are not accredited to serve people recognized by the dependency system.
The proposal obliges the centers to be located on urban land, guaranteeing "access and proximity" of users to "spaces for social and community activity" or if they are centers that are already built today without meeting this requirement , "communication must be guaranteed by public transport or own means of transport" to facilitate access to services.
The document proposes not to accredit newly built centers that exceed 50 places, while those that already are must be adapted: either by "gradually" reducing the number of places by going from rooms for collective use to individual ones or by dividing their facilities.
Residents must have spaces that "duly preserve their privacy", they will be able to customize their rooms "to the maximum" and enjoy "spaces for coexistence in the center" independent of the general ones, shared by "a small group of people" with the objective that "a home-type operation can be guaranteed".
Regarding human resources, it is expected that residences will require a minimum professional ratio of 0.36 workers between "first level" workers, who are caregivers or assistants and "second level" workers, who are physiotherapists. nurses, doctors ... as of January 1, 2023. A minimum that will increase in 2025 to 0.40 and to 0.43 in 2027. In the case of residences with people with disabilities, the figures will be higher: 0.45; 0.48 and 0.55.
The document also addresses the working conditions in the sector, one of the most precarious and feminized. Thus, for residences, a maximum of 20% temporary contracts is foreseen for "first level" workers. And in the case of day centers and home help services, whose conditions are also addressed by the plan, it may not exceed 33%. Neither part-time contracts may exceed a maximum limit of 30% of the total.
Personalized support plans
The proposal also foresees that all residences have personalized support plans, in order to "advance towards a management" of the "people-centered" model: "Each one will have a personal support plan in which they will be planned and monitored. the support they receive for the development and enjoyment of their project and lifestyle ". The plan will collect the "preferences and wishes" of the resident person, specifies the text, which will also have a "reference professional" responsible for promoting this personalized support in their day-to-day life.
The Ministry of Social Rights also suggests that another of the criteria is to guarantee care "free from restraints", in which its use is reduced to exceptional, temporary moments and always in a "documented" procedure with medical care and provided that there is "verified the failure" of other alternative measures. It is also proposed to promote the role of families whenever the resident considers it appropriate and "permanent" communication channels should be implemented, as well as holding "periodic meetings".