There are over 20 new homes for the elderly on the way and the CEO of one of Malta’s largest residential care groups has warned that many are being designed with the minimum standards, rather than with excellence in mind.
CareMalta’s head, Natalie Briffa Farrugia, said that when the standards were being drawn up some years ago, they had to be pragmatic given that existing facilities had been around for a considerable time.
“We certainly could not have had a situation where a large number of the facilities did not meet the standards. What would have happened? Would you have closed them all down?” she asked.
“However, minimum standards are just that: the basic level. It does not mean that facilities should not have better ones if possible.”
One of the standards that she gave as an example is the ratio of one bath to no more than five patients – which means this is what many of the current applications seem to have in mind, even though the clause was only meant to be transitional.
The law, which came into force in 2016, laid down that all new homes would provide single and double rooms with accessible ensuite showers and toilets – but left the ratio for baths at one per five residents.
It provided a proviso for existing homes that did not meet the requirements, giving them up to 10 years to upgrade their premises – as long as structural parameters permitted.
Ms Briffa Farrugia felt that the spirit of this transitional proviso was being ignored.
Minimum standards are just that: the basic level
“We have one or two patients per bathroom, and the only exceptions are where patients are not mobile or require special care for bathing and toilets,” she explained, adding that some of the existing homes were simply finding it was not feasible to upgrade since they did not have the back-up provided by economies of scale.
At the moment, there is considerable demand for places in nursing and residential care, but with around 20 homes in the pipeline, Ms Briffa Farrugia said it was only a matter of years until the supply actually overtook demand.
There are currently 2,800 beds available in Church or private homes, with 1,834 for which permits are already issued (including the St Vincent de Paul’s extension), as well as others in ODZ areas for which no permits have yet been issued.
There were some factors which the entrants to the market were simply not taking into account, she said, such as the optimum size – around 150 residents – and the economies of scale that come from having multiple facilities, ranging from recruitment to management.
“There are a number of applications for facilities taking 300 residents. How can you provide a home-life setting?” she asked, urging the Homes for Older Persons (Care Quality Standards) Authority to opt for the best possible standards for new facilities,” she said.
“Most of our own facilities have around 200 residents, and I can assure you that this requires a considerable level of expertise. How would someone manage with 300 highly-dependent residents if they have no experience in this area? Let alone when they have five people sharing one bathroom!
“Although the daily tariffs have improved and there is more demand, I would strongly urge those coming into the market to really do their homework as, unless you have experienced people who know how to run a facility with maximum efficiency, then it can be very challenging.
“From a business perspective, the situation is very attractive, but from a care perspective, it is very worrying.”
The CareGroup was founded 25 years ago and now has nine facilities with 1,200 employees and 1,600 patients – most of whom are handled through a private/public partnership with the government. It had a turnover of nearly €27 million in 2017.