Elderly home nurses will have to speak in English or Maltese

New set of minimum standards that all care homes need to apply by ten years, stipulate that carer old people's homes will have to speak English and Maltese

All nurses and carers at old people’s homes will have to be able to speak in English or Maltese, according to a new set of minimum standards that all homes will have to fully adopt within the next decade.  

Moreover, all potential staff members will have to obtain at least two written references and be in possession of a clean police conduct certificate. Volunteers will also undergo a rigorous selection process that will include police checks and will not be allowed to replace paid staff. All new staff members will receive induction training within six weeks of appointment, as well as documented foundation training within the first six months of employment. All staff will have a minimum of three paid days training per year.

All care staff members will have their own performance plan, which will map out their career development, against which a performance appraisal will be conducted on a biannual basis. 

Following a series of surprise inspections last year, parliamentary secretary for the elderly Justyne Caruana flagged serious concerns about the level of care offered at old people’s homes.

“I was shocked at the apathy and lackadaisical attitude in many old people’s homes and centres,” she had told MaltaToday. A damning national audit report later revealed that chronic understaffing and a lack of rigorous enforcement is leading to inadequate care for elderly residents, in clear breach of homes’ contractual obligations. 

The report claimed that the absence of national minimum requirements for homes was prohibiting robust enforcement of services. 

According to the standards – launched by Caruana earlier this week – the minimum ratio of care staff to residents will be determined by the Barthel 20 index, a scale that measures people’s dependence. On admission of a new resident and following any change in dependence of any one resident, the ratio will be altered accordingly. Night staff will be on duty in numbers that reflect the numbers and needs of the residents. 

Home managers will not be allowed to manage more than one home. Moreover, they must also be experienced professionals, with at least two years’ prior experience in management and a diploma in management or health sciences. Current managers without such qualification have until 2019 to study for and obtain certificates.  

Clampdown on elderly abuse in homes

In August, a St Vincent de Paul nursing aide was charged in court with slapping a dementia patient in the face. A spokesperson for the Foundation for Active Ageing had described abuse cases in MaltaToday – including how dementia patients in a private home were made to stand in a line and held from behind as the same spoon was used to scoop food into all of their mouths. 

In an attempt to crack down on elderly resident abuse, the standards will also ensure that all homes establish clear complaints procedures – that includes the possibility for residents to anonymously whistle-blow on abusive staff. 

Homes will keep a record of all complaints, as well as details of investigation and action taken. 

Every year, homes will have to audit their accounts and come up with a development plan that details their plans to improve their residents’ lives. They will carry out regular professional surveys amongst residents, the results of which will be made publicly available, and encourage residents to form their own associations. 

Residents, their families and their legal representatives will be informed beforehand about planned government inspections and will be allowed to speak to inspectors, anonymously if they wish, about conditions at the home. Their views will be published in inspection reports. 

Homes will develop policies to their staff on how to deal with physical or verbal abuse by residents, that will ensure that physical intervention is only used as a last resort in accordance with the law.