docBUSINESS PLAN 2012 / 2013 HUIS GENOT HOME FOR FRAIL
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BUSINESS PLAN 2012 / 2013 HUIS GENOT HOME FOR FRAIL
BUSINESS PLAN 2012 / 2013 HUIS GENOT HOME FOR FRAIL OLDER PERSONS AND KLEINSKOOL / KWANAXOLO OUTREACH PROJECT 1. BACKGROUND / PREAMBLE 1.1. Origins & Reasons for Existence HuisGenot is situated in the suburb of Algoa Park Port Elizabeth, a lower income area and surrounded by previous disadvantaged- and industrial areas. It opened its doors during 1975 after a needs assessment by volunteers and started, with the support of the Department of Social Development, to provide older persons in the Eastern Cape with holistic Physical, Psychological and Social Services to ensure their optimal functioning in a safe and secure environment. HuisGenot is now focusing on caring for frail persons older than 60 years residing within the Nelson Mandela Metro pole. Especially those from the lower income groups living in Kwanaxolo and Kleinskool 1 1.2. FEATURES OF AREA OPERATION Nelson Mandela Bay with new stadium 1.2.2. Leadership / Community set-up structures in the area Except for HuisGenot Old Age Home, there are two retirement villages situated in the suburb of AlgoaPark. There are also three churches, a high school, two primary schools and a clinic. Two of the three mager hospitals, Dora Nginza and Livingston, are in the vicinity. Dora Nginza – One of the two major hospitals in the area 2 1.2.3.Number of People, Ages & Gender distribution in the facility. 2011 Age 60-64 65-69 70-74 75-79 80+ TOTAL Male 7 2 4 4 10 27 Female 2 1 10 10 60 83 Total 9 3 14 14 70 110 HuisGenot houses 110frail persons older than 60 years Some of HuisGenot’sAlzheimer Residents 1.2.4. Education & Literacy within the area 1.2.4.1.Schooling 20 yrs& older No Some primary Completed schooling education Primary Education 27.7% 21% 9% Some secondary Matric education 33% 3 11% Tertiary Qualification 5% 1.2.5. Major Health issues within the area and the standard of health services Available 1.2.5.1. Major health issues within the area • Living in informal dwellings • No piped water inside dwellings • No toilet facilities • No refuse removal • Lack of pest control • Lack of health education • Lack of knowledge on prevention of communicable diseases • Lack of food security • HIV / AIDS and lack of ART • Tuberculoses • Waitingin long queues when visiting hospitals • Unable to receive medicines on the same day Clinic Services at Kleinskool / Kwanaxolo Clinic 4 1.2.5.2. Standard of Health Services Available The following services are available in Nelson Mandela Bay • 3 major Provincial Hospitals • 3 Private Hospitals • 2 TB Hospitals • 1 Private Psychiatric Hospital • There are many clinics in Nelson Mandela bay of which one is in the area of Algoa Park All these facilities are and / or may be utilized by all people, including the elderly, but the standard of Health Services available are not always sufficient. 1.2.6.Social Problems facing the Community Older persons are vulnerable in the community as a result of a lifetime of hardship, high susceptibility to chronic diseases and the ageing process itself. Some are dependent on carers for survival. An increasing number of people above the age of 60 need support / and or admission. • High unemployment and therefore older persons are abused by their families demanding their pension. • Old Age Pension is sometimes the family’s only source of income. • Violation of Human Rights • Underdevelopment • Poor Health • Loneliness • Malnutrition • Absent family structure • Limited income which lead to poverty • The money lenders (loan sharks ) challenge • Inability to manage own life. Kwanaxolo Older Persons Feeding Scheme 5 Due to the high cost of living the lower income groups can no longer afford to pay for their own housing and basic needs. As a result frail older persons are forced to live in overcrowded housing where their needs are not always taken care of. Their income is being abused, they areoften neglected and a high prevalence of malnutrition and disease is experienced. 1.2.7. Environmental Issues facing the Community Nelson Mandela Bay Metropolitan Municipality – 2011 Living in Electricity Electricity for Electricity Piped Water No toilet No Refuse Informal for lighting cooking for heating inside facilities Removal dwellings dwelling 13,7% 90,1% 85,3% 74,9% 71% 1,5% 4,7% Although there are a notable improvement in the above between 2010 and 2011, there are still many poor households without the necessary and much needed infrastructure. There is also no quality, sustainable waste management in Nelson Mandela Bay – not on the domestic side and none on medical waste. All the above are contributing factors to poor health and especially the vulnerable group of persons older than 60yrs. Waste flowing in a street at Kleinskool 6 1.2.8. Sources of income in the community Old Age Pensions and Grants Private Pensions Mostly blue collar employment 1.2.9. Availability of other Social Services Health: • Mental Health • Alzheimer’s Eastern Cape • Arthritis Foundation • Retina SA Home Affairs High Court and Regional Court Department of Labour Police Service Fire Brigade Transport – Rail, Road, Sea and Air Kwanaxolo / Kleinskool Office 7 The population of the Nelson Mandela Bay is made up of diverse cultural groups of which the Xhosa culture is the majority. The Christian religion as well as religions related to culture is mostly practised. The constitution guarantees complete freedom of worship to all and reflectthe diversity of South Africa’s Communities. 1.2.10. Dominant community values / support systems / cooperation / partnerships Diversity in the area regarding community values is apparent anddiffers according to culture, religion, income, education and area of living. Family life and -support is still one of the community values which is visible and being practiced irrespective of culture. Poverty, lack ofemployment and resulting lack of positive and constructive value systems, violence and crime, have a definite impact on the moral-development ofthe youth in the Eastern Cape. Traditional Xhosa Ladies 8 Happy Birthday – I’m 84 today 1.3 PROBLEMS TO BE ADDRESSED / PROBLEM STATEMENT 1.3.1. Problem Statement Due to very specific reasons the frail elderly are vulnerable and should be cared for whether through admission to frail a care facilities or Home Based Care. The reasons being as follow: • Neglect • Abuse • Cannot function independently any more • Hospitals cannot accommodate them indefinitely when in need of care • Alzheimer’s Disease 1.3.1.1. Problems to be addressed in the area Eradication of poverty through • Provision of free home based care by Nursing Staff • Provision of Wheel Chairs, walking aids, commodes and all necessary to render a top class service • Provision of adequate Health and Nursing Care especially to concur HIV / AIDS • Provision of Social Workers to attend to specific social needs • Provision of Nutritious Meals 9 • • • • • • Provision of transport to and from clinics and hospitals Provision of occupational therapy Provision of very pricy electricity Provision of regular refuse removal Provision of well built, tarred streets so that transport can reach the elderly. Enough policing to eradicate crime 1.3.1.2. Problems to be addressed in the facility • Provision of more trained Nursing Staff • Provision of one Social Worker • Structural Difficulties. Two of the wards have no showers or toilets. • Inability to finance lower income residents • Inability to provide Adult Napkins to Incontinent Residents. (Estimate Cost: R 400 000.00 per year) 1.3.2. How the needs of the community have been identified and by whom • By Members of Management who represent the specific community. • The staff at the HuisGenot facility and Kwanaxolo / Kleinskool Outreach Project • The ACVV Social Worker and other organizations involved with frail older persons • Through telephone calls from family and hospitals 1.4.Beneficiaries and Parties involved 1.4.1. Target Groups and other stakeholders 1.4.1.1. Target Groups All frail persons older than 60 yrs of all races and gender living in the Nelson Mandela Metropolitan and who need 24 hour special care. Christmas Lunch HuisGenot 10 1.4.1.2. Stakeholders Dept of Social Development Dept of Health Lotto Churches Community Leaders Business Sector Political Parties Sickbay PetTherapy Oldest Resident – 107yrs 11 1. INTERVENSION / PLANNING12. 2.1. Intervention Logic OVERALL OBJECTIVE / DEVELOPMENT GOAL: Frail persons older than 60 years functioning in an environment that makes provision for their optimal wellbeing and care by March 2013 Immediate Objective 1 To manage and maintain a 24 hour residential facility that provides optimal care to 110 frail older persons in need of care in the Nelson Mandela Metropolitan by 2013 Objective Verifiable Indicators 110 frail older persons are accommodated in a facility that provide 24 hour physical, psychological, social and cultural care Means of Verification DQ 98 Screenings Admission forms Health Records through Nursing Process; Incident Records; Evaluation Reports; In Service Training; Manuals & Attendance Registers Complaints Policy 12 Activities Responsible Party 24 Hour Nursing / Health, Board of physical, hygiene, Management Psychological & ACVV Regional Alzheimer care Consultant Admission Observations Manager Daily Flow chart 3 Registered observations Nurses; 4 Vital Signs Enrolled Nurses Intake & Output 5 Enrolled Prevention of Pressure Nursing sores Auxiliaries Nursing Interventions 21 Care Workers; Problem-Orientated 1 Laundry / Floor Specific Individual Care Manager Plan 21 Domestic Administration of Staff; 1 District Medication Surgeon; Wound Care Resident 3 monthly or as needed Committee urine tests; Hb’s; HGT’s and Weight Daily Record Keeping & Report Writing Daily Laundry Service 3 Balanced Meals and or special meals per day Weekly District Surgeon Visits’ Daily Cleaning Budget Immediate Objective 1 Objective Verifiable Indicators Means of Verification Weekly Program Formats Process Reports Progress Reports Attendance Registers Statistics Resident Service Agreement Resident House Rules Immediate Objective 1 Objective Verifiable Indicators Means of Verification Strategic Planning; Constitution; Financial control through: Budget Control; Monthly Financial Statements (income & expenditure control) Electronic Accounting system, three signatories, petty cash control; Monthly Management Board Meetings and minutes; Yearly AGM; Progress 13 Daily Transport Daily Exercise Program Foot & Nail Care Activities Reality Orientation Program through psychological, social, cultural and spiritual activities Church Services 5 times per week Evening prayer Meetings by 4 volunteers School Visits Music Therapy Pet Therapy Games Knitting Book Reading DVD’s Exercises Hairdressing twice a Week Daily Tuck shop Monthly Library Open Visiting Hours Activities Financial & Operational Management Responsible Party Board of Management ACVV Regional Consultant Manager 1 Activity Organiser Nursing Staff 5 Minsters from different denominations 13 Volunteers Resident Committee Budget Responsible Party Board of Management Financial Committee ACVV Regional Consultant Manager Treasurer Admin Officer Registered Auditor Risk Budget Management Resident Committee Reports; Annual audited financial statements submitted to the DSD NPO with proof of admission, ACVV Head Office andDept of Soc Development Procurement Policy Inventory and Asset Register Complaints Policy Register of persons convicted of abuse Immediate Objective 1 Objective Verifiable Indicators Means of Verification Grievance & Disciplinary Procedures Code of Conduct Personnel Rules Staff Contract; Job Description; Basic conditions of employment Performance Appraisals of all staff quarterly Employment Equity Policy Harassment & Abuse Policy Employee Wellness Policy Receiving of gifts policy Uniform Policy Search Policy Staff Registration Certificates and Receipts In house training records Monthly Staff Meetings Activities Human Resource Management through Transparent and open Recruitment, Selection & appointment Abiding with Labour Law and Equity Act Responsible Party Board of Management ACVV Regional Consultant Manager Admin Officer Senior Staff NEHAWU Shop Stewards RESULTS: A residential facility that provides 24 hour holistic care and services to 110 frail persons 60 years and older. 14 Budget Immediate Objective 2 Objective Verifiable Indicators To manage and maintain Community Based attendance to 300 older supportive services to 300 persons in need of home home based older persons based care in the suburbs of Kleinskool&Kwanoxolo Means of Verification Activities HBC Registration Certificate, Medical Assessment and Screening, Health Care Records, Progress Reports, Budget, Financial Records, Statistics, Stock Control Registers,Attendance Registers, Log Book, Minutes of staff meetings. Daily Clinic Services One Balanced Meal per day Daily Transport to and from clinic and hospitals Social Services and assistance Occupational Therapy Responsible Party Management, ACVV Regional Consultant Manager, 1 Registered Nurse, 3 Care Workers, 1 Administrator / Receptionist 3 Kitchen Staff Budget RESULTS: While still living in a familiar environment, 300 older persons in previous disadvantaged areas live a healthier lifestyle, filled with meaningful interaction, physical activity and increased levels of independence Immediate Objective 3 To manage and maintain attendance to 50frail home bound older persons who cannot and do not want to be accommodated in any residential facility in the Nelson Mandela Metro and who are in desperate need of specialized care. Objective Verifiable Indicators Community Based supportive services to 50 home bound frail older persons by 31 March 2013 Means of Verification HBC Registration Certificate, Application Forms, Medical Assessment and Screening, Personal Medical Assessments Waiting List, Budget, Financial Records, Home Based Care Records, Health Care Records, Progress Reports, Statistics, Stock Control Registers,Attendance Registers & Log Book. 15 Activities Daily Home based Medical, Nursing & Hygiene Care Home visits by a Registered Nurse One Balanced Meal per day Daily Transport to and from clinic and hospitals, Social Services and assistance Responsible Party Management Committee, ACVV Regional Consultant 1 Manager, 1 Registered Nurse, 3 Care Workers, 3 Kitchen Staff Budget RESULTS: 50 older persons live a healthier lifestyle, and increased levels of dignity within their community that are known to them 16 2.2.Assumption / Unforeseen Circumstances • No loss or cuts of Subsidy • Adequate funding and donations by other stakeholders • No staff losses • Adequate professional staff • Enough volunteers to render different services 2.3.What might prevent the service / programme from achieving the improvement that the community seeks • Change in the economy • Change in policy and legislation • Lack of improved and higher subsidies • Lack of Financial assistance from National Lottery • No subsidies for community based projects • The incapacity to raise funds • Lack of donations • Inability to render the necessary and much needed services to disadvantaged residents • Restricted community involvement and lack of volunteers • Lack of trained staff due to inadequate salaries • Increased cost of living • Inadequate building infrastructure due to shortage of funds and high building / renovation cost • Outdated and restrictive technology 2.3.1.Possible solutions to the problems that might arise • Applications for additional financial assistance to cover the loss of income from National Lottery Funds • Approach private donors • Motivate community to get more involved & secure more volunteers • Obtain more funds in order to appoint more Professional Nursing Staff & improvement of salary structure 2.4.Target group participating in the planning 2.4.1. Internal Target Group • Management Board • Residents serving on Residential Committee • Staff 17 2.4.2. External Target Group • Department of Social Development • Department of Health • Registered Builder, Plumber and Electrician. • Community Members / Volunteers • Social Worker • Family 3. IMPLEMENTATION 3.1. Physical & Non Physical Means 3.1.1. Physical Means HuisGenot is in possession of the necessary buildings, but lack the proper Infrastructure, technology, staff and equipment. Volunteers are involved and HuisGenot and the Home is accessible to the community Facilities and resources. HuisGenot is networking with all relevant departments and stakeholders. 3.1.2. Non Physical Nursing as well as Domestic Staff measures up to the necessary skills to provide holistic care to 110 people with special needs, and services are in line with policies of the Departments of Health & Social Development. However, Professional Nursing Staff are under continuous pressure due to a shortage of Registered / Enrolled Nurses. The inadequate present salary structure could play a significant roll in this. 3.2.Organizational Structure & Staff Capacity 3.2.1. MANAGEMENT BOARD (Volunteers) NAME RACE ADDRESS ID NO. POSITION CHAIRMAN – Bussiness Man VICE-CHAIR ANC Councilor MEMBER Manager Service Centre MEMBER Manager Private Hospital MEMBER Housewife TELEPHONE Mr S Broodryk W 6 Karisma,Tasstreet, Fernglen 072 336 7864 460330 5002088 Ms Belinda Ndidi B 082 303 5660 751201 0671086 MrsRetha van der Merwe W I4 Independence Str 4, Ext 35, Bethelsdorp 24 Avonmouth Lane Summerstrand 082 964 4488 450304 0056086 Mr Walter Kurten W 14 Lilac Lane, Strelitzia Park, Uitenhage 082 338 1138 541004 5120009 Mrs Geswint Joyce C 96 Louis Dubb Kabega Park 041-360 0843 073 802 2621 380410 0417080 18 Mrs Margaret de Andrade MrsRien du Preez W 9, Rowanstraat, Rowallan Park W Frykenhuisstraat 5, S/strand Ronel Bosch W Van der Lindestraat 8, Despatch 3.2.2. Staff at HuisGenot Implement Manager Administration Clerk Maintenance Official Registered Nurses Enrolled Nurses Enrolled Nursing Auxiliaries Health Care Workers Activity Organizer Kitchen Manager Chefs Assistant Chefs Kitchen Staff Floor Manager Domestic Staff Gardener Total 1F 1F 1M 3F 4F 5F 21 F 1F 2F 2F 2F 2F 1F 13 F 1M African 041-3711572 082 5661 897 041-583 2383 072 516 4917 571013 0013088 041-9335358 082 562 3450 641213 0045082 450412 0086086 Coloured Asian 1 1 1 12 1 4 1 2 2 1 8 1 5 MEMBER DA Councilor MEMBER Registered Nurse ACVV Area Representative White 1 1 1 2 3 3 5 1 2 1 HuisGenot is in desperate need of more Nursing staff. According to the new Older Persons Act the following additional staff should be employed • 2 More Registered Nurses (Sisters) • 2 More Enrolled Nurses (Staff Nurses) • 7 more Auxiliary Nurses 3.2.3. Staff attending to Community Outreach Project Implement Registered Nurse ( 3 Days per week) Care Workers Kitchen Staff African Coloured 2 1 2 1F 3F 2F To implement this project efficiently the following staff are needed • At least 3 More Care Workers • A Driver (Currently done by the Sister) • One Social Worker 19 White 1F 4. COST ESTIMATE AND FINANCIAL PLAN See Annexure A 5. FACTORS ENSURING SUSTAINABILITY 5.1. Policy Support • • • • • • • All the relevant acts Evaluation Policy Feedback Meetings Income Generating Program Sustainability Plan Procedure Manuals Statistics 5.2.Appropriate Technology Effective technology is in use, but need to be modernized. 5.3.Environmental Protection • Insurance of buildings, equipment & vehicles • Security inside and outside buildings • Fire & Emergency Evacuation Plan in place • Regular Preventative Maintenance Practise is in place • Efficient use of natural recourses and raw materials • Health and Safety Policy • Control of waste & litter, pollution and noise. • Continuous improvement of our environment through various means. • Environmental Awareness amongst all employees and residents • Recycling 5.4.Socio-cultural Aspects All programmes and projects are planned and conducted in order to encourage the older persons to have pride in their social-cultural traditions and beliefs. Services are rendered to all older persons in the Home and the community irrespective of race, gender, religion or creed. 5.5.Human Recourse Development & Training • Transparent and open Recruitment, Selection & appointment • Grievance & Disciplinary Procedures • Code of Conduct • Personnel Rules • Staff Contracts; Job Descriptions; Basic conditions of employment • 3 Monthly Staff Performance Appraisals • Employment Equity Policy • Harassment & Abuse Policy 20 • • • • • • • • • • • Employee Wellness Policy Receiving of gifts policy Uniform Policy Search Policy Staff Registration Certificates and Receipts In house training with records Orientation with new Staff members. Practical Training to three training schools and one nursing college. Monthly Staff Meetings Monthly Supervisor Meetings Management training through 3 monthly ACVV meetings and annual Head Office conferences and Department of Social Development 6. MONITORING & EVALUATION 6.1. Develop Monitoring Framework 6.1.1. Monitoring Information System Management will strive to manage this programme in a meaningful & cost effective manner through the following evaluation methods 6.1.1.1. Management • • • • • • Strategic Planning Monthly Management Meetings Monthly evaluation of programme planning results Annual General Meeting Annual evaluation of strategic planning program Biannual internal audits 6.1.1.2. The Manager • Promoting Active Ageing • Awareness to the rights of Older Persons • Monthly monitoring report of programme planning & target results to Management • Monthly Report to Management • Quarterly Report to all stakeholders • Monthly staff meetings • Monthly evaluation reports of Senior Staff • Screening of applications • Abide with all relevant Acts • Up keep of all Human Resource Policies • Proper record keeping of all residents and staff • Continuous meetings with Residents Committee • Continuous family meetings • Recruit more volunteers to fulfil specific needs • Budget Control 21 • • • • • • • Financial Management Strategic Management and goal setting Risk Management Health and Safety Control Assets value improvement Insurance Portfolio Management ACVV Internal Audit Control 6.1.1.3. The Senior Professional Nurse • Monthly Monitoring reports to Manager • Daily Night & Day Reports to Manager • Monthly meetings with Manager • Monthly performance appraisal reports of new nursing recruitments and there after 3 monthly to Manager • Continuous in service training of nursing staff. • Nursing Process and Reality Orientation Specific Care Plan for each Resident and Home Bound Older Person • Proper record keeping of all residents • Risk Management • Health and Safety Control 6.1.1.4. Kitchen Manager • • • • • • • Monthly Monitoring reports to Manager Monthly performance appraisal reports of new recruitments and there after 3 monthly to Manager Monthly Meetings with Manager Continuous in service training Up keep of proper stock sheets Up keep of nutritious menus and special diets Health and Safety Control 6.1.1.5.The Floor Manager • Monthly Monitoring reports to Manager • Monthly performance appraisal reports of new recruitments and there after 3 monthly to Manager • Monthly Meetings with Manager • Continuous in service training • Up keep of proper cleaning material stock sheets • Up keep of semi sterile environment • Health and Safety Control 6.1.1.6. Activity Organizer 22 • • • • • • • Monthly monitoring report of programme planning & target results to Manager Monthly meetings with manager Daily Activity Program for Residents Proper record keeping of all attending residents Statistics of activities and attendance Recruit more volunteers to fulfil specific needs Assist with fund raising. 6.1.1.7. The Treasurer • • • • • • • • Monthly Financial statements & comparisons to Management Annual Audit of Financial statements Yearly PAYE & Vat Audits GAAP Implementation ACVV Practice Codes Control Assets Control and Maintenance Insurance Portfolio Management ACVV Internal Audit Control CONCLUSION AND PROPOSAL Persons older than 60 years who are physically and/or mentally frail are cared for at HuisGenot. All services comply with the relevant Acts and Amendment Acts on Older persons. Services at HuisGenot are accessible to all frail older persons in the community regardless race, gender, religion or social status. Before admission all older persons undergo screening(DQ 98 ) which is conducted by a professional nurse and social worker. To improve the lives of the previous disadvantaged older persons of the Kleinskool and Kwanoxolo areas, HuisGenot renders special care and free community based services, to the elderly. Home based care are being provided to 50 frail home bound older persons and clinc services, meals and transport to 300 older persons. The need is much bigger ACVV HuisGenot is registered with the Department of Social Development and a NPO caring facility and committed to non-racialism, providing asustainable and efficient service to older persons and frail older persons in need of care. I thank You Mrs V Coetzer (Manager) 23
