Any new residences for the elderly and disabled, regardless of whether they are public or private, must be small and have almost all individual rooms. They must also have permanent quality control. The staff ratio must increase by at least 60%. Residents will have their own shared spaces and caregivers. Inmates will decide how to live and decorate their stay. The new centers will look very similar to the existing ones, although they will also be identical. They will only have seven years to adjust to the new model (until 2029).
Today, the Ministry of Social Rights, headed by Ione Belarra and regional authorities, has closed for the minimum. This agreement, which was reached after intense and difficult negotiations, could be called revolutionary in a country with an aging population. They voted by ten to nine in favor of the Territorial Council of Social Services the new document of minimum requirements that will allow centers and services to be accredited and controlled for quality. The new document includes a new model of residential facilities for the elderly and disabled. There have been significant changes in home care and telecare. Belarra says it is "one of the most important agreements in the legislature."
The agreement was voted against by four PP autonomies (Madrid Murcia Andalusia, Andalusia, Galicia, and Andalusia), and socialist Castilla La Mancha who see it as maximum and without funding, and Catalonia, Euskadi who believe it invades competitions. After having joined the veto of the popular ones a month before, the Socialists from Extremadura voted yes today after learning that the Treasury is currently negotiating for some 4,000 million European funds to be used between 2023-2026 to finance reforms and specific adaptations in the old residences.
This change is related to the social scandal that was unleashed by learning about the horrible conditions in which many people lived in nursing homes across the country. It was brought to light because of the horrendous mortality in these facilities by the coronavirus pandemic. Overcrowding and a lack of qualified caregivers, disconnection from public health services, neglect and lack of quality control were all common problems that led to closures of several residences.
New minimums aim to end the notion of asylum and to create a collective home where family size and personal attention will be the norm. These are the most significant changes.
It is the closest thing to a house. This will form the basis of every residence's organizational structure. It will be the basic organizational structure of each residence. This group of cohabitants is composed of stable individuals with the same educators and caregivers. They also have their own facilities (living, dining, and kitchen), as well as internet access and personalized rooms. This model decreases anxiety and depression, lowers psychotropic drug use, and improves mobility and relationships.
New residences should have at least 65% single rooms and at least 2/3 double rooms. You can personalize them with your own furniture and objects. This requirement is not mandatory for residents with less than 35 beds. In cities, the minimum number of rooms cannot exceed 25%. Rural areas can have 10%.
The progressive schedule for increasing the number of direct care staff for residents is set. By 2029, there should be a 60% increase in the elderly centers and 20% for the disabled centers. This is a significant improvement on the current situation. In seven years, the ratio of nursing homes to residents will increase from 0.27 to 0.43. This means that one caregiver is needed for every two inmates.
New residences will be smaller. The macrocenters have been eliminated. There will be 120 places for elderly in cities, and 50 for disabled in facilities. Rural retirement centers may have no more than 75 residents, while those located in towns can house up to 90.
No center for the elderly and disabled can use physical, medical, or pharmacological restraints in order to control or immobilize its residents within a maximum of three years. If the situation is urgent and residents, caregivers, or third parties are in danger, then exceptions may be made.
New centers should be located near spaces for community and social activity. There is no need to isolate the elderly. Urban land is preferred. The inmates will have the same access to public hospitals and health centers as the rest of their neighbors.
In order to provide the best care and support, the centers should create personalized coexistence plans that take into account the lifestyle and interests of each resident. You can also get assistance with creating a living will or collecting your last wishes.
Management of the center will establish an advisory, consultative body that can make improvements proposals. It will be composed of representatives selected by residents and, where appropriate, family members.
The agreement requires the inspection services of the Autonomies to assess the quality of operation in all centers and comply with the minimum parameters. These evaluations will be made public and will impact the renewal or signing of concerts.
In the adaptation process to the center, family members and close friends will be given prominence. There will be permanent communication channels, meetings and periodic exchanges of information, and visitors will be welcome whenever they wish.
All staff will need to be accredited professionals. They will also receive training plans. More funding will go to centers that offer part-time and temporary work. All employees will need to be registered in Social Security and the self-employment system.
The agreement's main focus is on residential care, but it also provides many measures to strengthen home care for dependents. This is because the home of most older Spaniards is their preferred place to live. Smaller teams will provide assistance in the local area. This will reduce displacements and rotations, and allow for more personal and familiar care. According to the agreement, there will be enough workers to provide a minimum of 7.20 workers per 1,000 hours of assistance monthly. This service will require that the coordinators make at least one home-visit to each beneficiary every year. Caregivers will be allowed to use 5% of the time to arrange the service.
Before December 31, 2023, the staff at day centers for the elderly or for the disabled will see a significant increase. The first will result in a 31% increase in staff to clients (upto 0.25), while the second will result in a 36% increase in workforce (upto 0.30), or three professionals per ten users.
New telecare will place the same importance on the relationship with customers and their emotional state as assistance aspects. It will leave behind the fixed telephone line and evolve towards the 'internet of things’ devices and sensors that are either already present in many homes every day or will soon be. For example, there may be activity detectors and falls detectors as well as door opening detectors and medication dispensers. The application of artificial intelligence and large-scale data control will allow for personalized and proactive care.