Summary
1. Introduction
2. Mention of the agency’s activities
3. Implementation
4. What audit encompassed
5. Findings
6. Assessment of the control system
7. Regulations
8. Document Stands
9. Participants at the audit
The supervision of Meland municipality 5th, 6th and 8th of April is part of the nationwide inspection of municipal health and care services in 2016.
We investigated whether the municipality by systematic management and leadership has facilitated and came with them that persons with developmental disabilities, 18 and older who live in eigen Housing, getting defensive medical health and care services.
Leader and adding emphasize that the users shall contribute by organizing and carrying out services and activities. With the exception of services for those who cage in bufellesskap, are the services were mainly provided ein for ein. Services are in particular vulnerable to planned absence of permanent personnel in the work team for each of the users.
leadership has self-identified follow needs and improvement area of the services to developing impaired:
- several employees with graduate education
- improving the knowledge by adding the structured and targeted environmental
- Documentation
We do not allow us to conclude that the services being provided, is indefensible.
We fann deficiencies in managing with the services which means that there is a considerable risk of failure in the implementation of personal assistance and health care in the home.
By audit diaper analysis identified violations of requirements in legislation and regulations.
deviation is:
- Systematic measures to ensure that adding has the necessary knowledge to safeguard assignments are inadequate.
- Responsibility for different tasks is not sufficient clarified. The systematic efforts to develop and imple- ment routines and keep abreast of that they are renowned, been followed and eminently suitable, is insufficient.
The deadline for feedback on the introduction of measures to correct deviations is August 15, 2016.
Date 04/25/2016
Anne Grete Robøle
audit owner
Torill Vebenstad
accountant
governor of Hordaland has the authority to oversee the health and care services for supervision Act with health care service § 2.
the report is compiled by an audit of Meland municipality. Authority is a part of the countrywide supervision of health and care services in 2016.
The purpose of the audit is to assess whether the municipality by saying management (internal control) ensured that claims lovgjevinga being lived. Upon audit, we investigated
- what action the municipality has to uncover, correct and preventing breaches of legislation Within the dei inspection program encompassing
- the types of assistance are being followed up in practice and if necessary corrected
- if the measures are currently good enough to ensure that lovgjevinga are been followed
Authority diaper performed as system audit. A system audit being undertaken by examining documents, interviews and other investigations.
The report is about findings of supervision and therefore Inga comprehensive condition assessment of the work the municipality has made Within the dei regions that audit encompassed.
- Variance concerns that requirements imposed by or in accordance with law or regulation, not been met.
Rådmannen govern the services in line to the leader for home and the services department Head of services for mental dis- abilities. The services to mental dis- abilities, age 18 and older who live in eigen Housing, organized by permanent staff in work teams related to each user. Except bufellesskap are the services given ein for ein. Paper will have self-identified follow needs and improvement area of the services to developing impaired:
- several employees with graduate education.
- improving the knowledge by adding the structured and targeted environmental work.
- Documentation.
The audit encompassed follow activities:
Notification supervision framework was sent on 3 February, 2016.
Pre-assessments diaper completed on 25 February 2016.
Answer the survey about drug handling nappy been received on March 18, 2016.
Opening Meeting diaper holding 5 April
Interview: 16 persons diaper interviewed.
conversations with up users diaper completed on 5 and 6 April.
sampling: Journal and brukarpermar, rotation schedule and roster Easter 2016 beskjedbok with more, see Chapter 8.
Final Meeting diaper holding 8 April.
Overview of the contestants at the audit, document that we fekk sent in advance and document what was examined during the audit, is given in Chapter 8.
We have examined whether the municipality by systematic management and leadership has facilitated, came with them and if necessary implements changes so that persons with developmental disabilities receive defense medical health and care services and the requirements of law and regulations are complied with.
the audit encompassed:
- Implementation of personal assistance, restricted to:
– Supervision and help to safeguard eigen care
– Help for activation
– Training in daglege gjeremål, personal care and eigen care - Health services in the home and available for medical examination and treatment, confining to:
– Drug Handling, istandgjering and distribution
– Follow-up after medical visits and follow-up to assess the necessary medical care from a doctor
– Health care by acute condition
– Commune medverknad the user core in contact with and is been followed to a GP or doctor in specialist health
– Help during office visits to convey information that the doctor need to provide health care
– dissemination of information from medical visits back to those who provide health services in the home of user.
In connection with each topic we examined also how the municipality has arranged for and varetek use cleaning right to information and medverknad. We investigated and whether the municipality requested police at an offer for recruiting staff.
The audit encompassed not services being provided by the use of coercion and force, practical assistance households, client-managed personal assistance, medical care at emergency and dental services. About GP and specialist health provides sound professional health care and on the family doctor conducts regular health of the users, were also not part of the audit.
Variance 1: Systematic measures to ensure that adding have the necessary knowledge to safeguard assignments are inadequate.
Deviation from: Regulation on internal Control in health care § 4 a and c, cf. Act on municipal health services § 3- 1, third paragraph, ref. § 4-1 letter c and d and § 4-2.
the discrepancy build upon follow:
- It’s not all employees who have been sufficient information and training about the condition and needs of the bracken source users can make, before they lasted set into rotation. It is stated that in several instances is set too short a time for training.
- It is not everyone who provides services for mental dis- abilities who have been trained in first aid for employment in home services.
- It’s not all primary contacts who know the tasks conferred primary contact, ref. Council font physician routine. The debt for example assignments in connection with the preparation and evaluation of the action plan and individual plans.
- There are different perceptions of what will be documented in the medical records
- It’s not all that familiar routines for reporting any deviation and in what cases it may be appropriate to report. Several states that there is underreporting.
- Random samples show that deviations debt drug handling is recorded in the patient record. It is unclear whether other anomalies that debt intermediation to user must also register with the journal or be reported in other ways.
- Employees who provide services to the users dei Sami, have not always necessary knowledge and common understanding of how the individual facilitator Inga of attraction to the user should be, for example, ADL training. Need for more training is frying up paper will.
Variance 2: Responsibility for different tasks is not sufficient clarified. The systematic efforts to develop and imple- ment routines and keep abreast of that they are renowned, been followed and eminently suitable, is insufficient.
Deviation from: Regulation on Internal Control in Health Care § 4 a, g and h and the law on municipal health services § 3-1 third paragraph, cf.. § 4-1 c and d and § 4-2.
the discrepancy build upon follow:
- it is not sufficient clarified and known sequences that look that there is consistency between decisions regarding health and care services and action plans. Seven out of 16 users can make decisions from 2013 or previously years.
- It is given various information about know who is responsible for developing, evaluating and updating action plans.
- The function system coordinator is not sufficient clarified.
- Goals and measures for the training of user is not clearly seen in action plans.
- It does not go forward of routine for journaling how training of user will / should be documented.
- sampling medical records showed that not all action plans are updated.
- There are big separators candidates in kva, each and how often it will be documented in the medical record. In some journals it is a long time between the note.
- sampling brukarpermar shows that not everyone is up to date.
There is often not enough time to evaluate and conclude on the working methods and measures are eminently suitable for achieving targets in the action plan, possibly about goals and or initiatives should be changed. The debt for example measures to tryggje, develop or maintain holding trained ADL functions. Planlagde meeting being canceled. It is reported to paper will that it is too long between joint meeting of some teams.
Individual plans are not updated. When the audit was six planar is in progress.
The lead opposition not routines for decision-making about, preparation, evaluation and updating of individual plans.
It is not enough just clarified how information should be conveyed back to services when parents / relatives have been followed user to doctor / specialist health.
Practices to document that the user has been given real medicine is being done in different ways depending on what personnel performing task. In summer event will be no documentation.
It is not enough just clarified what information from the services to the development inhibited to report fallen in line from branch owner to councilman.
leadership is aware of conditions here. Where corrective measures are put into effect, have they hitherto not had sufficient impact.
Leader and adding emphasize that the users will get contribute by facilitating and implementing services and various activities. With the exception of services for those who cage in bufellesskap, are the services provided ein for ein. We have not a basis for concluding that the services being provided, is indefensible. With Novera staffing are the services in particular vulnerable to planned absence of permanent personnel in the work team for each of the users.
Chief boards the services to developing impaired in line to the leader for home and the services department owner. By audit there uncovered pervasive deficiencies in the leadership and management of its activities which in our view increases the risk of failure in the services to persons with developmental disabilities. With sound resturants management assumes that there will arbeidd systematically to prevent and detect incidents where it has or can malfunction, correcting and preventing that same happens again. In connection with the paper will its review of resturants and management system, it is insufficiently evaluated on practices and routines are well enough eminently suitable to safeguard its users their needs and comply with requirements in the health and omsorgslovgjevinga.
- law of 30 March 1984 no. 15 supervision of health and care services
- The Act of 24 June 2011 on the municipal health care
- The Act of 2 July 1999. 63 on patient and user rights
- The Act of 2 July 1999 no. 64 relating to health m.v.
- The Act of 10 February 1967 relating to procedure in cases concerning public
- Regulation of 21 December 2000 no. 1385 relating to patient
- Regulation of 20 December 2002 no. 1731 on internal control in health and care services
- Regulation of 27 June 2003 nr.792 of quality in nursing and care
- Regulation of 3 April 2008 no. 320 on medication management for businesses and personnel providing health care
- Regulation of 16 December 2012 No.. 1256 on habilitation and rehabilitation, individual plans and coordinator
INFORMATION awards received from Meland Municipality:
E letter 1st March 2016 enclosed
- Organization Chart
- Detailed organizational charts Meland home teneste
- Name of owner and others in staff functions – services for the handicapped
- Information about bufellesskap and Service capitals
- Goals and Strategic Plan 2016 – 2019 for Meland home occupational and Meland nursing
- Meland home teneste – subdelegasjon per 12.16.14
- Subdelegasjon coordinator – sakshandsamar
- Procedural Routine by omgjering of positions
- Strategy Document for recruitment
- Competence Plan for Meland municipality – action plans for eins source occupational area in 2016
- Examples of omgjering of heimehjelp position to vernepleiarheimel
- Examples of omgjering of Health postures to environmental therapist position
- Examples of omgjering of heimehjelp position on health postures
- Competence Plan for Meland municipality 2012 – 2015
- Procedure – information to appointments
- Checklist – training of new appointments in your home The service
- Domination training plan – users with disabilities
- Checklist for training
- Information for new appointments
- Supervisor iplos – registration of information in the connection with decisions about renting
- Mapping Form – user to move to eigen Housing
- Procedure for case processing in home The service
- Procedure primary contact
- Attachments – procedure primary contact – deepening users with disabilities
- Template for meeting structure
- Overview of meetings for employees in home services that work with persons with disabilities
- Procedure – patient documentation and report
- Deviation Form
- Rosters
- Week Planar
- Procedure for drug manageability in caregiving
- Checklist practical training
- Contract Form – delegated greyhound drug manageability
- Procedure – receiving patients by hospitals residence
- Email notification procedure between Plomer and health care businesses
- Individual plan – SAMPRO
- Note – liability groups per March 2016
- Results of the User Survey care 2014
Unknown public, cf. Offline a. § 13 cf. PAA. § 13:
administrative work and decision on the allocation of services
Sampling
- 16 patient
- Eight brukarpermar
- Reported deviations from 1 January 2016
- Minutes from the meeting of the work team, team meeting in bufellesskap and staff meeting
- Rosters Easter weekend and overview actually staffing at Easter 2016
- Beskjedbok
- Work List
- Receipt Lists capable made and distributed medicine
- Individual plans
Document what was submitted
- Eight brukarpermar
- Reported deviations from 1 January 2016
- Minutes from the meeting of the work team, team meeting in bufellesskap and staff meeting
- Rosters Easter weekend and overview actually staffing at Easter 2016
- Beskjedbok
- Work List
- Receipt Lists capable made and distributed medicine
- Individual plans
- Job description coordinator for the handicapped, 20 March 2002
- Proposal for mandate – functional responsibility for coordinating unit in Meland municipality
- Overview of individual plans created in SAMPRO
- Summary of primary contacts for mental dis- abilities who enter for the course of coordinator and individual plan
Correspondence between Meland municipality and governor of Hordaland :
- Notification of Supervision, letter of 3 February 2016 from governor of Hordaland
- E-letter with attachments from Meland municipality 11. February 2016 about know who’s municipal contact
- E-letter with attachments from Meland municipality 15. February 2016 about sequences as contestants on preliminary meeting
- E-letter with attachments from governor of Hordaland on 26 February 2016 survey of drug handling
- E-letter with attachments from Meland Municipality 1st March 2016, documentation which we had requested
- E-letter with attachments from Meland municipality on 8 March 2016 primary contacts in bufellesskap
- E-letter with attachments from governor of Hordaland 9th March 2016, the transmission of the program
- E-letter with attachments from Meland municipality on 18 March 2016 in response to surveys of drug handling
- E-letter with attachments from governor of Hordaland 18 March 2016, the transmission of corrected program
- E-letter with attachments from governor of Hordaland 30 March 2016, the transmission of the program
Other information
- E-letters from local branches owner in Norwegian Order of development inhibited about tenestetilbodet in Meland municipality.
The table below provides an overview of the participants on opening up meeting and final meeting, and over what people who nappy interviewed.
| Name
| Function / position
| Pre-assessments
| Opening Meeting
| Interview
| End Meeting
|
|---|---|---|---|---|---|
| Monica Agledal
| Social educators
| X
| X
| X
| |
| Anne Marit Andresen
| Hjelpepleier
| X
| X
| X
| |
| Rannveig Vats Helle Bovim
| Coordinator for the handicapped
| X
| X
| X
| |
| Marianne Bratshaug
| Social educators
| X
| X
| ||
| Signe E. H. Carlsen
| carer
| X
| X
| ||
| Matilde Bastesen Dale
| Environmental Work
| X
| |||
| Helene Hammer
| Health Work
| X
| |||
| May Linn Hvedding Hansen
| Environmental Work
| X
| |||
| Ingvild Hjelmtveit
| Chief
| X
| X
| X
| |
| Bjorg Haaland
| Heimehjelp
| X
| X
| X
| |
| Christel Knudsen
| Social educators
| X
| |||
| Josefine Kristoffersen
| Social educators
| X
| |||
| Helge Kvam
| Adviser
| X
| X
| X
| |
| Britt Romarheim
| Leader, heim residues residues
| X
| X
| X
| X
|
| Nina Till Fjord
| Department Leader
| X
| X
| X
| X
|
| Janne Vinnes
| Social educators
| X
| X
| X
| |
| Kari Wellbrock
| Førskulelærar
| X
|
From the County attended:
Torill Vebenstad, Senior Adviser
Oliver Moldestad, Adviser
Arne Erstad, Senior Adviser
Anne Grete Robøle, section owner
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