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NTA audit of a Psychosocial Rehabilitation Unit (a residential facility in the Region of Western Greece) for individuals with organic mental disorders, Alzheimer’s disease, and related conditions.
Following a named complaint (from a former employee) submitted to the Ministry of Health and forwarded to the NTA, a team of Inspectors-Auditors from the Patras Regional Health Authority, with the assistance of expert consultants, carried out an audit at a residential care facility in the Region of Western Greece to verify its lawful and proper operation, the quality and adequacy of the services provided, as well as to determine whether the residents’ income was being managed correctly.
Key Findings:
Based on the data collected, the statements taken during the questioning of individuals, and the expert assessments conducted, the following was established:
- Regarding the alleged physical and psychological abuse of a tenant, it was confirmed that the tenant had been restrained; furthermore, during the interviews, other instances of restraint came to light that were not recorded in the official logbook. The medical director was not present and did not supervise the aforementioned restraints, as he resides on a Greek island, performs his duties only partially, and provides medical instructions over the phone, which he signs in the logbook at a later time.
- The residential facility incurred significant expenses using residents’ funds (pensions and benefits) despite the fact that these were eligible for funding from the state budget. To cover the needs of all residents, such as supermarket items, meals, and other expenses, the practice of “rotating” charges per resident was adopted. It should be noted that the majority of residents are characterized by severe cognitive impairment.
- Residents’ funds, which was delivered to the residential facility by the mail carrier, was received by facility staff who signed with the beneficiaries’ initials, without proper legal documents (authorization, notarial deed, power of attorney), a procedure that was also followed in the case of a deceased tenant whose pension was collected fifteen (15) days after his death.
- The medical expert conducted a further investigation regarding the circumstances of the deaths of two (2) residents as well as the actions of the nursing and medical staff. Specifically, although the nursing staff was aware of the symptoms exhibited by one of the deceased residents during the night, they did not inform the facility’s doctor. Furthermore, the doctor in question issued a certificate stating the hospital as the place of death, while the National Ambulance Service (EKAV) confirmed in writing that it had received the resident from the nursing home already deceased.
- Following notification by the inspection team, the competent Public Prosecutor initiated proceedings to place one (1) resident of the nursing home under judicial guardianship. Specifically, the inspectors found that the nursing home staff, acting on their own initiative, had moved part of the household goods belonging to the elderly resident (who had no family) to the nursing home premises, claiming that they constituted permanent equipment of the facility.
- Disciplinary liability was sought regarding the actions and/or omissions of two (2) first-level local government employees (a sociologist and a social worker) who had been involved in the process of admitting residents to the nursing home.
- The existing Internal Operating Regulations require immediate updating.
- The goals of psychosocial rehabilitation are partially achieved.
- The staff lacks the required professional experience in the field of mental health.
- At the time of their hiring, the employees had not submitted the necessary documentation to prove a clean criminal record.
Proposals-Recommendations:
- To the Ministry of Health
- To enact legislation ensuring that every facility operating in the field of mental health is included within the scope of the provisions of Law 4837/2021, as currently in force.
- To issue clarifying circulars regarding the management of the income of beneficiaries residing in Psychosocial Rehabilitation Units, as well as the procedure and authorized persons for the delivery/receipt of personal belongings, private documents, and financial information upon residents’ admission.
- To the Company’s Management
To take specific actions aimed at ensuring the dignity and respect for the residents’ personal integrity and improving the quality of the services provided.
The audit report was forwarded to the Athens Public Prosecutor’s Office for criminal evaluation of the matters contained therein.