Foundation lambasts ‘profit-seeking’ homes for the elderly

An NGO that represents elderly patients has launched a scathing attack on Malta’s care homes for the elderly, arguing that some of them are run according to the logic of profit. 

“Anybody with a MEPA licence can set up a home, admit residents, make a profit and run it on a tight budget,” a spokesperson for the Foundation of Active Ageing (FXAM) who chose to remain anonymous, told MaltaToday. “Some private homes charge their residents up to €75 a day and €1,700 a month for basic services only, without any frills, and yet we have seen elderly residents at these homes exposed to all sorts of abuses – from inadequate carers to humiliation by getting forced into nappies, to living in rooms whose windows overlook pollutant streets.” 

The spokesperson was speaking after the publication of a damning report on care for the elderly, drawn up by the National Audit Office, in which it was revealed that minimum nursing and caring times in four private homes had fallen well short of contractual obligations. 

On average, the elderly in homes in Zejtun, Mellieha, Roseville Home and Casa Leone had to be given, individually, a minimum of 132 minutes caring time on a daily basis, and 24 minutes nursing time daily. 

The Mellieha home was found to have given over 80 hours less caring time during three inspections in 2013 and 2014; the Zejtun home fell short by 178-202 hours; Roseville home fell short by some 40 hours; and Casa Leone fell short by 35 hours on average. 

The Mellieha, Zejtun and Roseville homes are all operated by Nazzareno Vassallo’s CareMalta through public-private agreements with the government. 

“We have all the structures in place to ensure that the standard of care we provide is consistently of the highest level,” CareMalta CEO Natalie Briffa Farrugia said. “Unfortunately, the levels of care required have increased dramatically over the years as government arrangements need to be regularly revised.” 

Indeed, she said that CareMalta provides nursing services to the entire Zejtun home, when it is only contractually obliged to do so for the High Dependency Unit that was opened in 2013.  

Fears government could water down care standards for the elderly 

After the NAO’s damning report, eyes now turn to the upcoming National Minimum Standards for homes for the elderly. Originally drafted by the FXAM upon the request of former social solidarity minister Marie-Louise Coleiro Preca, the proposals suggest that homes have to sign a legally-binding contract with each of their residents, detailing the home’s responsibilities and the fees payable by the resident. 

Homes will have to employ professional staff who speak English or Maltese, provide residents with a varied programme of social activities, and ensure that meals are varied and drawn up by nutritionists. Within ten years, all homes and their grounds will have to be rendered fully accessible, comfortable and homely. 

The parliamentary secretary for the elderly, Justyne Caruana, has said that the Bill is currently being drafted, but the FXAM fear it will be based on a watered-down version of their proposals. 

“Some homes are in a disgraceful state, and it is absolutely shocking that we don’t have any legally-binding standards for them,” the spokesperson said. “Our proposals were the absolute minimum and no group had objected to them during a six-month public consultation process.” 

When questioned, Justyne Caruana’s secretariat refused to disclose preliminary details about the final national standards that will be adopted in the Bill. 

The FXAM are also concerned at a second Bill, that has already been tabled in Parliament and that will see the Prime Ministerial appointment of a Commissioner for the Elderly, who will advise the government on rights for the elderly and investigate any breaches of the human rights of the elderly. 

“It seems as though the new standards will fall under this Commissioner, meaning that the government will be both regulator and a major service provider,” the FXAM spokesperson said. 

The spokesperson also warned that, as it stands, the Commissioner will not be able to investigate conflicts between the elderly and their carers.

“The Bill is simply political propaganda, window dressing with no substance,” the spokesperson said. “It is an un-socialist, un-caring attitude towards elderly people in their most vulnerable state.” 

The government has denied that claim though, insisting that a separate "independent authority" will be set up specifically to enforce these new national standards. 

“While we thank the Foundation for working with the Health Care Standards Directorate to draft these standards, the material was optimized following an extensive public consultation process, in which unions, residents and their relatives took part,” the Parliamentary Secreteriat for the Elderly said in a statement. “While the government will always prioritize the rights and welfare of elderly people, one must understand that such a laborious exercise takes time.”