A aftershock of the earthquake. Barely two months after the release of Victor Castanet’s book on Orpea (The Gravediggers, Fayard, 400 p., 22.90 euros), the General Inspectorates of Finance (IGF) and Social Affairs (IGAS) should submit to the government, Wednesday March 23, a report which sheds light on the practices – revealed in the work – from the private group, which has nearly 230 nursing homes in France. Their conclusions should be overwhelming if we judge by the preliminary report sent to Orpea in early March so that it can respond to the inspectors’ findings.
The world had access to the synthesis of this first version. Its content, detailed in six chapters – from the organization to the internal and external controls of the group, through the support of residents and the use of public money, corroborates, with a few exceptions, the facts brought to light. by M. Castanet: the IGF and the IGAS consider that Orpea pursues as a priority a budgetary performance objective which contributes to the poor quality of life of residents and the care provided to them.
Lack of staff
The first chapter of the preliminary report reviews the organization of the group, which leaves very little autonomy to the directors of establishments. The second chapter is a very critical picture of the care of residents: negligence in oral care, lack of reliability in the distribution circuit of drugs, difficulties in dealing with emergency situations. Respect for hygiene, toileting time, monitoring of bedsores, prevention of falls are affected by the staff’s lack of time.
Unlike the book, the preliminary report does not find any rationing of incontinence pads. On the other hand, he notes shortcomings in the menus, which are deemed too lacking in quantity. The grammage of certain foods is insufficient, the periods of nocturnal fasting sometimes too long. The protocol to fight against undernutrition is debatable. Due to a lack of personnel at their side, the most dependent residents hardly have time to eat well.
Added to the excessively high pace is the lack of staff training and the instability of the teams. One in five Orpea nursing homes (18%) does not have a coordinating doctor. On this point, Orpea is rather above the average: this concerned at least 20% of nursing homes in 2019, according to the National Performance Support Agency. The preliminary report notes, however, that the number of employees per hundred residents, all staff combined, is lower at Orpea than the average for lucrative private nursing homes.
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