Home supervision

Home supervision is the supervision of homes for elderly people who are of legal age or are disabled by a government agency to determine whether the home meets the requirements of the Home Act or its national succession regulations for the operation of a home (e.g. retirement home , nursing home) ). Colloquially, the authority carrying out the home supervision itself is usually referred to as the home supervision .

Responsibilities, structure, equipment

Which authority is responsible for carrying out home supervision varies from state to state. While there are a total of 96 home supervisory authorities in Bavaria, namely the district offices in the districts and the city administrations in the independent cities, responsibility in Saarland and Berlin lies with only one authority.

In general, two ways of organizing the authorities can be distinguished nationwide, a type of country model in ten federal states and district and community-based models (local government) in six federal states.

A) Country model
Home supervision is based directly at the highest state authority, the Ministry of Social Affairs (Saarland and Bremen ).
Home supervision belongs to a higher state authority, e.g. B. Landesversorgungsamt , so in Brandenburg , Hesse , Rhineland-Palatinate , Saxony-Anhalt and Thuringia . In Berlin it is the State Office for Health and Social Affairs .
In Hamburg, the district offices are the implementing authorities, similar to the regional councils in Saxony .

B) District and community-based models of Baden-Württemberg , Bavaria , Mecklenburg-Western Pomerania , Lower Saxony , North Rhine-Westphalia and Schleswig-Holstein have district offices examined. In Lower Saxony there is a special feature that the inpatient facilities for the disabled are also separately subject to the supervision of the state authority, State Office for Social Affairs, Youth and Family .

The staffing of the home supervisors also varies greatly. It would probably make sense to collect indicators per thousand inhabitants or per 1000 people cared for in the institutions as a benchmark. So far this has not been the case. In a comparison per 100 institutions to be examined (which can be very different in size), Lower Saxony, with 13.7 full-time positions in the offices, was ahead of all federal states up to Saxony with only 1.5 positions (FfG survey 2003).

Type of exams

The home supervisory authority checks every home at least once a year. It can check at longer intervals if certificates from independent experts are available. Around two thirds of the "visits" were such recurring inspections and one third were event-related inspections (figures from the first nationwide survey on the working methods of the authorities (2002; see literature)).

Exams can be registered or unregistered at any time.

To improve cooperation, home supervision, the medical service of the health insurance (MDK), long-term care insurance funds and social welfare providers form working groups in which they coordinate their work as much as possible.

The most frequent deficiencies found during home visits in nursing homes concern care documentation, staff deficits, deficiencies in the organization of the facilities (management problems, duty roster and internal communication). Hygiene, structural and maintenance deficiencies such as problems in the supply of medication, poor handling of residents, neglect and deficits in nutrition and fluid supply were mentioned somewhat less frequently. Legal irregularities that are criticized often relate to home contracts (e.g. fee regulations, void contractual clauses).

If deficiencies are found, the home supervisor has various regulatory intervention options. These are first the orders to change something within a period, then the fines according to ( § 21 HeimG). In addition, the authorities have the option of prohibiting the establishment or employment of individual employees who appear unsuitable. According to the 1st Federal Report of August 15, 2006, there were less than 1,000 orders in the reporting period, employment bans in 19 cases, prohibitions in 91 cases and approx. 200 penalties for administrative offenses (bmfsfj).

Changes, state legal provisions

As a result of the transition from home law to the legislative competence of the federal states as part of the federalism reform since August 2007 according to Article 74, Paragraph 1, No. 7 of the Basic Law, changes in responsibilities and tasks may be expected.

literature

Böning, Fickus u. a .: Practical guidelines for inpatient care for the elderly. Checklists - forms - text modules. Loose-leaf work to continue. Remagen, AOK-Verlag, 2007. 412 pages, 1 CD-ROM. ISBN 978-3553-38300-4

M Getta, E. Schnabel: Nursing problems in fully inpatient facilities . In the State Care Committee of North Rhine-Westphalia (ed.), “Care needs and service structure in fully inpatient facilities”. A study on behalf of the state maintenance committee of North Rhine-Westphalia (Part II / project report) (pp. 45–60). Dusseldorf

Klaus Schmitz, Eckart Schnabel: State home supervision and quality in inpatient care . In: Intelligence Service of the German Association (NDV) 4/2006, pages 170–178. Online at socialnet.de

B. Klein: Future of Home Supervision? How must future-oriented advanced training for home supervision be designed? IAO (Fraunhofer Institute for Industrial Engineering and Organization), self-published in 2003

North Rhine-Westphalia, Ministry for Health, Labor and Social Affairs (MAGS): Home supervision in North Rhine-Westphalia. Inventory and perspectives , Düsseldorf, self-published, 1995.

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