About
Project Scaffold
How it all started
We in the Care sector of the Retirement Industry are like residents of a particularly important old heritage building. The “heritage” is our current Care paradigm, with all of its laws, norms, standards, history, policies and procedures. Within this heritage, we are caretakers of some of the most vulnerable within our society, but we also hold the hopes and dreams of young people who work in the industry and yearn for development and recognition.
We have become bloated and far too expensive to continue as we are. Should we ignore the warning signs that have been brought into stark relief by the COVID-19 crisis, we run the risk of becoming irrelevant to a society which either cannot afford our services, or which has a deep cultural or other aversion to the way in which we refuse to flex our approach.
As is done in the restoration and renewal of valued old buildings, let us erect a new scaffold around the old Care approach, carefully retaining the most essential, noble and desirable elements, rapidly discarding those that impede our progress towards better service for our customers and better recognition of our excellent human resources and making service a richer, more fulfilling experience for all involved – the older individuals, staff and families.
Project Scaffold provides a restructuring strategy which needs to be applied, tested and evaluated in the total spectrum of Residential care facilities to move towards Person-Centred Care and Person-Directed Support involving all stake holders.
To this end, there are several ways organisations and individuals involved in long- term care, can participate.
The results will be published on a regular basis and sent to DSD to support them in formulating a new approach to care legislation in South Africa.
How you can get involved
Step 1
Please ensure you read the entire guide before applying to join the project . Click the button below and download the guide.
Step 2
Please download the application form, complete and email back. Successful application will be notified.
Step 3
Once you have received the email confirmation please register as a member to access member only library on the website.
Why now?
A number of factors have contributed towards the creation of this project. Some have been around for a very long time, others, joined more recently.
The reform of the care sector is long overdue due to historic political and cultural reasons when DSD and DOH split on 23 February 1994. DSD carried on with the model that was previously set up by the Department of Health.
The care industry has the choice to either wait for the new strategy to materialise or to explore and test care programs, in a bottom-up approach, enabling organisations to survive and residents to afford care.
Residential Care facilities providing frail care are experiencing enormous financial pressure. The number of empty beds are increasing (currently estimated at >50%) and most people cannot afford the care fees that are charged. Many frail care facilities in retirement villages are closing their doors and changing over to primary health, wellness and home-based care options.
The private care sector has been divided for many long years. Again, politics and religion/culture played the main role. Thus, the private care sector runs on “me, me, me”, and “I know better”. During the work to write the norms and standards we held meeting after meeting with the private sector to bring the sector to be united, which proved at the time to be fruitless.
This project is an opportunity for sharing of best practices and for collaboration, for the good of the sector.
The pandemic has put a spotlight on some of the challenges our sector has been facing for many years. It also brought new challenges that need to be accommodated within practices and systems.
The individuals entering the sector, or due to enter the sector in the near future, have a different mindset to the ‘traditional’ residents in care facilities.
Expectations are different and service delivery should change with this changing client group.
It is also worth noting the increase in number of small care homes where up to 10 residents share a converted house. Such homes group together and share a registered nurse to oversee the care plan. Care workers often manage the care service in such places.
The residential care sector/industry both locally and abroad is shifting away from medical/hospital like environments to affordable and person-centred care.
In many instances, care is driven by approaches that lean toward institutional, clinical, hospital-like practices and remedies, for obvious reasons (e.g. as training and history). The focus is often very limited and related to medical problems.
Nursing support in the Care environment is essential to the lives of those in the frail care centre. Some treatments of illnesses (e.g., wound care) are the domain of the nurse, along with a number of other clinical interventions that treat disease and other ailments.
Most Care Centres are run by excellent Nurses who are trained in
a set of practices which they must execute in terms of their Nursing Code of Conduct.
Nursing is a highly specialised field and not required for daily management, nor is it particularly suited to creating a relaxed, homely environment nor suited to the financial management foisted upon many Nurses in these roles.
Medication administration is currently only within the scope of the Registered Nurse in South Africa, while other countries have softened this approach in order to reduce costs, dependent on the schedule of the medication, without compromising on the quality of care or the safety of those receiving care.
Care workers are undervalued, undertrained and have no official recognition system or pathway towards self-betterment other than a nursing career.
Government is adamant that a new strategy to train and deploy care workers is the best possible way forward. Presently, there is no SETA- accredited training (except full qualifications). This process will take time.
None of the present care worker training programmes are aligned with the Older Persons’ Act. This matter will need consultation with the The Quality Council for Trade and Occupation (QCTO) and applicable SETA.
There is presently no central registration system for care workers. Legally, those care workers presently deployed are operating outside the parameters of Act 13/06. Two terms are currently used:
Caregiver(Act 13/06) and
Care worker that is used as defined in some registered programs, for
example Health Care Workers
The Department of Health does not want to address the care worker challenge as they are against the concept of care workers doing more than cleaning, bathing, dressing and socialising and chatting with clients. The Nursing Council also do not want Nurses to supervise care workers as it is against their legislated code of practice, however, this ruling cannot be enforced as it will possibly place all nurses in this sector at employment risk. The same will apply to the total care industry.
Focus
Project Scaffold started with a voluntary pilot programme of participating care centres to pave the way towards a new dispensation. Membership has since been expanded considerably. The main objective remains to develop a home-like environment that is person-directed and more affordable. We, like many countries abroad, believe that hospital-like care needs to make way for person-focused care. Project Scaffold, although not a crisis management tool, hopes to facilitate the sharing of best practices within the sector throughout the duration of the project.
COST REDUCTION: Overall reduction in costs to deliver care at a reduced rate to older persons, both in Care Centre and home environments.
CAREWORKER UPLIFTMENT: Focus on training, recognition, development and advancement of careworkers.
CULTURE ADAPTATIONS: Continued shift away from institutional cultures and environments
Opportunities to participate
Project Scaffold aims to include as many role players within the long-term care sector of South Africa as possible. The more facilities, organisations, service providers and individuals connected to the sector that are involved, the richer the body of best practices collected will be, for eventual presentation to DSD.
All participants who applied for the project and are accepted, irrespective of which category they participate in, will have access to the specific project tools/templates developed.
Pilot Participants
Any facility, that provides residential long-term care (frail care) for older individuals, can apply to be part of the pilot group. All applications will be considered with the selection aimed at having a representative and diverse selection of facilities providing residential frail care services. The facilities in this group are committed to compliance, and agree to obtaining certificates of compliance from a registered social worker (in good standing) for the intervention/s that they integrate.
While there are no compulsory costs involved for participants, social workers and others you engage with may charge for their services.
Applications for current pilot participants closed in January 2022. You can still register as an associate or an affiliate.
Project Associates
This group is for any facility who do not wish to be a pilot participant but still want to engage in the project.
There are no compulsory costs involved for Project Associates.
Project Affiliates
This group is for any individuals or organisations working within the sector of long- term care for older individuals who would like to be part of the change.
This could include service providers such as food service providers, care service providers and any other organisation who works within the sector.
The Project Scaffold team members are facilitators for the purpose of this project. It is vital that a broad spectrum of affiliates contribute with their inputs and opinions in a peer-to-peer manner along with the Scaffold Project team members. An obvious example is the need for those with clinical and nursing expertise to bring their views to bear on these matters.
There are no compulsory costs involved for Project Affiliates.