Allegations of mistreatment of patients, unqualified caregivers being hired, caregivers doing nurses jobs of giving out medication, and patients nappies not being changed were brought to the attention of Free State World by a concerned careworker working at Vrystaatnasorg, a residential care centre in Bloemfontein, Free State.
The whistleblower, who opted to remain anonymous, told Free State World that some patients at the residential care centre have old bedsores which don’t heal, wear a nappy all day, and are only changed once. Caregivers working without qualifications is one of the major allegations brought to the attention of Free State World.
Free State World saw a picture of the feet of a patient with an undressed wound. There were pictures of patients that Free State World saw in a horrific condition.
Free State World contacted Vrystaatnasorg Management for a comment and right of reply. We put the allegations of illtreatment of patients to them, and Francois Prinsloo, the director and manager at the residential area, replied.
In his response, Prinsloo said the board and management are highly disappointed that they need to defend themselves against an internal person who chose to select a “destructive way” to raise issues while formal internal and external channels do exist. He said this was not value add, but a clear attack on the integrity of the institution.
“These allegations are seen in a serious light and will be investigated further. We sincerely hope that the individual or individuals find peace within themselves and come forward to discuss these issues. The Centre Management and Board support transparent consultation and dialogue on issues that concern the services we render to vulnerable beneficiaries.” Said Prinsloo.
He continues: “All sincere inputs with the aim to improve and add value are welcomed. We are serious to comply with set norms and maintaining a reputation of good standing with our regulators and government partners. It needs to be clearly stated that none of the allegations raised with your publication have been officially raised via the internal and external channels available.”
Free State World put some questions to the Centre which were answered as follows:
- Can you provide specific details addressing the concerns raised regarding the qualifications and training of the caregivers at “Vrystaatnasorg”?
- All vacant positions are advertised in line with the Labour Law and with the assistance of an HR and Labour Consultancy
- Minimum criteria for a Carer Role is a Matric certificate and a recognised Home Care Based certificate with applicable practical experience
- Applicants need to do a technical assessment under the supervision of our Registered Nurse
- Due to historical factors, the ratio of Carers with Carer Qualifications versus Carers who received internal training are, 60% does have a formal Carer Certificate and 40% were upskilled via internal training interventions
- How does the facility justify the allocation of responsibilities, such as administering medication and injections, to carers instead of qualified Sisters, as alleged?
- We follow strict protocol when it comes to the handling storing and administering of medication (this includes injections)
- Only the registered nurse may administer injections accept in the case of Diabetes injections were patients or carers may administer the prepacked injection according to a specified protocol. Tis applies only to two current residents of which Carers may assist.
- All Carers are socialised with the medication policies and protocol and are aware of the sanctions of our disciplinary code should they not adhere to these protocols
- No Carer or Clinic assistant may dispense medication not prescribed by a Medical Docter
- It is common and accepted practice that Care Workers may hand out prepacked (medication in Blister packs) medication to patients
- No medication is handed out if not prescribed by a Medical Professional
- Psychiatrists and a General Practitioner visits the Centre on a regular basis to renew prescriptions
- Prescriptions are also renewed by Medical practitioners at Government clinics
- All medication handed out are prepacked in Blister packs by a qualified Pharmacist (this service is outsourced to a private Pharmacy)
- Carers may only hand out prepacked medication from the Blister packs and need to record it on a register
- The medication registers are checked by the Centre’s Professional Nurse
- What steps is the facility taking to address and rectify concerns about patient care standards, including issues like old bedsores and hygiene practices?
- Continuous training on patient care is provided by the Professional Nurse and external experts
- Patient Care protocols as required by the Department of Health is in place
- Carers are required to complete incident reports if they discover physical symptoms that the professional nurse are not aware of
- Incident reports are evaluated by our Professional Nurse in consultation with Medical Doctors
- Specific treatment protocols are in place
- The Centre is not a Frail Care or medical institution and does not have bedridden patients that remains in bed for extended periods
- The incidences of Bedsores are few and if serious are treated under the supervision of Doctors
- Complaints procedures are in place for families of beneficiaries to bring any treatment failures or service issues to the attention of Management
- Our Clinic was recently inspected by a Specialist in Primary Health Care
- Two of our Board Members are Specialists in the fields of Psychiatric Nursing and Patient Care / One holds a PhD in Nursing
- To date no serious complaints with regards to patient care have been received
- Is it accurate that carers at the facility work without proper papers and receive on-the-job training? If so, what is the rationale behind this practice?
- It is a historical fact that some of the Carers that have been with the organisation for long did not have formal Carer qualifications (40% of the Carer Complement)
- Labour Law prohibits the organisation to dismiss these individuals
- Since 2022 the Centre embarked on an internal Training program presented by Professional Nursing specialists
- The School of Nursing at UFS presented a five week program in patient Care
- Carers work under the supervision of a Professional Nurse
- To ensure professional resident care, the Services of two registered Nursing or Carer Agencies are made use of namely Care Solutions and V&A Placements
- All the agency staff are fully qualified
- Although the institution is not a Health Care facility the Department of Health is in the process of evaluating our facility and do we receive regular visits to check on the standard of service rendered and compliance to acceptable standards.
- The most recent consultative and evaluation meeting with Mr Erasmus of Health was held yesterday (13 November 2023)
5. Can you provide transparency regarding the hiring process, specifically how qualifications are verified, in light of concerns raised about the qualifications of the staff?
- The recruitment of staff are done with the assistance of a reputable HR and Labour Agency (Staff Management Services)
- All applications are screened against acceptable Labour practices and Labour law
- Staff Management has access to sources that assist with the verification of qualifications
- Strict reference checks are in place
- Only one permanent Carer has been replaced in the past 24 months and the individual has an impeccable track record in primary Health Care and Public Health (individual is still on probation only started on 2 Nov 2023)
- Strict probation periods are adhered to before permanent employment
6. If patients are found to have health issues or unhealed bedsores, what investigative measures and interventions are in place to identify and address the root causes?
- Incident reports needs to be written by carers
- Each patient has a patient file where treatment and conditions are recorded in / these files are open to the authorities and Medical Professionals of the Department of Health to audit
- Some of the Bedsores originate in hospital or public Health facilities
- The Centre is not a hospital or medical facility, thus serious cases are referred to Public Hospitals or Wound care specialist where the resident has medical aid
- The Professional Nurse in partnership with a Private GP or Public Health professionals will decide on the treatment protocol
- Carers does not have any diagnostic powers and need to assist with basic care under the supervision of the professional nurse
- The Centre is an NPO and resources are scarce; therefore, we are highly dependent on the support of Public Health services for treatment
- Regarding the recent hiring of a qualified Careworker for supervision, how has this individual impacted the overall quality of care provided to patients, and what changes have been observed?
- The newly appointed Care Worker is not in a supervisory position
- The Carer has only started on 2 November and is still on probation
- The individuals primary expertise are in the area of Primary and Public Health Care with many years of experience in primary health care facilities
- Can you elaborate on the allegations that patients wear one nappy all day and change only once daily, and what measures are being taken to verify or refute these claims?
- We only have three residents currently making use of nappies
- Depending on the level of continency the Professional Nurse signs out 2 to 3 nappies per day per individual
- It is the responsibility of Carers to check on these residents and change nappies when needed
- Where there is family support the families provide the nappies
- Regular two hour rounds are in place to check on residents who are in bed due to illness or other reasons
- How is the facility addressing the specific concerns raised by the anonymous Careworker, and what steps are being taken to ensure the accuracy of the information provided?
- We have internal grievance and complaints procedures in place that the concerned Care Worker can use
- None of these concerns have been raised via the official channels
- In the process of applying for a Mental Health license we work closely with the Department of Health and have had several consultations with the adjudication team
- The Centre can be inspected at any given time by the Department of Health and are open to it as our policies and protocols to ensure proper resident care are in place
- In light of these serious allegations, what internal investigative processes or external audits are being initiated to assess the overall functioning of the facility, and what steps are being taken to improve transparency and accountability?
- Unfortunately the individual did not follow the available and acceptable channels to raise these concerns
- The Management and Board sees the allegations as serious and will investigate it in partnership of our Labour Consultancy
- The Management and Board sees the allegations as serious and will investigate it in partnership of our Labour Consultancy
- The allegations were also discussed yesterday with a senior representative of the Department of Health (Monday 13 November 2023)
- If there is any truth in the allegations the Department of Health will pick it up during their assessment of the Centre for our Mental Health license which has commenced and will be completed early in 2024 via an onsite visit and evaluation of patient protocols and processes (The process is conducted by a Multi professional team from the Department of Health)
- Specialists from the Public Health Sector and Final year students of the UFS Faculty of Health Sciences visits the Centre on a frequent basis and have access to residents and will also identify any irregularities if there are any.
- Unfortunately the individual did not follow the available and acceptable channels to raise these concerns
- The Management and Board sees the allegations as serious and will investigate it in partnership of our Labour Consultancy
- The allegations were also discussed yesterday with a senior representative of the Department of Health (Monday 13 November 2023)
In one of the reply to answers, the Centre mentions the whistleblower who informed Free State World not following the available and “acceptable channels” to raise the concerns and allegation, however, the photos that Free State World has seen paints a picture of alleged negligence of patients that allegedly seems to have been ongoing.
The Centre further says it see’s the allegations as serious and will investigate and acknowledged having incidents of Bedsores saying they are few and if serious are treated by Doctors, however, one wonders why does the centre have to wait for bedsores to be serious in order to be treated and why cant they be totally treated irrespective how few they may be for the health of the patient.
A question arises of the Centre Manager or managers personally making routine checks to check the wellbeing of the patients because the pictures of the patients Free State World has seen paints a different picture.
According to the Centre, the allegations were discussed on Monday, November 13, 2023, with a “senior representative” from the Department of Health. Free State World shall, in a follow-up article, find out from the Department of Health the representative and what actions will be taken by the Department of Health.
