MAYORAL COMMITTEE
11 September 2006
CASA MIA OLD AGE HOME: STATUS REPORT
1. STRATEGIC THRUST
Health and Community Development
2. OBJECTIVE
To inform Council about the current status of Casa Mia Old Age Home following
recent coverage about the conditions at the Home made by the Star newspaper on
01 June 2006 and a 3rd Degree Programme aired by E-TV on 29 August 2006.To
request funding in the amount of R 3 million and possible relocation of
residents.
3. BACKGROUND
On 01 June 2006 The Star published an article depicting unfavourable conditions
at Casa Mia Old Age Home, which at the time was managed by the Social Services
Department in Region 8. It should be noted that the Star did not approach any
officials for comments or verification of the facts before they printed the
article. To this end there was a need to evaluate the situation existing at
Casa Mia.
4. SUMMARY
Historical Perspective:
The City of Johannesburg Region 8 runs 5 homes for Senior Citizens under the
management of the Housing and Social Services Departments.
Casa Mia Villa as it was previously known used to be a hotel belonging to a
private owner before Council bought it with the intention of providing
accommodation for senior citizens. It was managed by the Housing Department of
the erstwhile Eastern Metropolitan Local Council (E M L C). Subsequent to this
evaluation process E- TV did an expose on conditions prevailing at the Casa Mia
Old Age Home.
In 1998 it was transferred to the Social Services Department (E M L C) due to
administrative problems being experienced under the Housing Department at the
time.
In 2001 during the 'EGOLl' restructuring process it was transferred to the
management of Region 8 Social Services.
Having been built in the 1940's and also due to progressive deterioration
through probable lack of maintenance over a long period the facility that
Region 8 took over was in a poor condition.
It is necessary to state that the term "Old Age Home", as Casa Mia
has come to be known is misleading in that it creates an expectation that it
provides facilities, that in terms of the law are a requirement for any old age
home, inter alia, nursing services and frail care facilities.
On the contrary, Casa Mia is a home for senior citizens like the rest of such
Council managed facilities citywide. The only difference is that what may have
been out of good intentions and it having been a hotel with cooking facilities,
meals were provided for residents. Whereas this could have been viable many
years ago, it currently presents problems due to budgetary constraints that
have been experienced in recent years.
Although residents pay an amount of R150.00 p.m. for three meals, Council has
to subsidise this amount so as to maintain a minimum standard of nutrition,
given the varied dietary requirements of the residents.
In 2001 Council was engaged in a process of outsourcing some of its retirement
centres including Casa Mia. However, for reasons currently unknown, this move
was abandoned but should be reinvestigated.
During 2004 the possibility of outsourcing the kitchen was also investigated
but this was not successful as the potential service providers showed no
interest.
4.1 THE ARTICLE IN THE STAR
The comments of the Region were sought in response to the assertions made in
the Star focused mainly on the following areas:
(i) Security
Measures to safeguard residents include the provision of security personnel
hired from a private security company on a 24-hour basis, seven days per week.
Several recent incidents resulted in additional security personnel being posted
at these premises. Further hard measures in the form of razor wire and burglar
proofing have also recently been installed on the ground floor to eliminate
unauthorised entry.
(ii) Condition of building
It is conceded that the Home's electrical and water reticulation systems
constantly fail. In this regard timeous plumbing repairs of an emergency and
planned nature are continually undertaken. These problems are attributable to
the aging of services in a building, which was constructed in the 1940's.
With this in mind the services of a structural engineering group was
commissioned recently to assess the building's infrastructure, which proved the
structure to be sound. That assessment also served to identify issues, which
require remedial work.
As far as the City is aware there has been no harm caused to residents
attributable to the state of the building.
(iii) Safety
Staff and residents are being trained in fire safety and evacuation procedures.
However, difficulty is being experienced in soliciting the support and
co-operation of all residents in their participation of an evacuation exercise.
An evacuation exercise has been re-scheduled for a later date convenient to
most residents.
The emergency staircase, boiler room and water pumps were repaired some time
ago and the Regional Manager: Social Services, Region 8 has been incorrectly
quoted in this regard.
(iv) Frail and Elderly Residents
While the Home is required to accommodate able-bodied residents, residents
reaching frail care status are encouraged to seek appropriate alternate private
accommodation. This has become a major issue of concern as many residents
refuse assistance in this regard and are not willing to leave the facility.
A copy of proposed response to the article by the Regional Director Region 8
is appended hereto for consideration.
4.2 CHALLENGES TO MANAGEMENT AND OPERATIONS:
(i) Upgrading and renovations:
Due to the state of the building and budgetary constraints it is not possible
to make any meaningful impact by doing patchwork emergency repairs. This is
both uneconomical and time consuming. Evidence of this is that to an outsider
it appears that nothing is being done to remedy the situation but the fact is
that over the past 5 years at least R2, 5 million has been spent on this
building but the same problems recur due to inherently aged and deteriorating
infrastructure.
The repairs and maintenance budget is not enough to address the problems
identified. Hence an amount of R3 million was requested on the draft Capital
Budget for 2006/07 as per a structural engineers investigation and report, to
do in phase one (1) which involves major utility service upgrades. This
allocation was not approved in the final budget.
(ii) Purchase of Food:
As has been indicated previously in the report, provision of food for the
residents is a big challenge due to inadequate provision in the budget.
Out of a total of 128 residents, 42 people eat in the dining hall on a regular
basis. The rest provide their own meals, even though they are required to eat
in the dining hall, as there are no kitchen facilities in the rooms and
therefore they are not permitted to cook in the rooms. The average amount
collected for food from the residents is R5 610-00 p/m.
It is estimated that on average Council subsidises the purchase of food by
between R10 000-00 to R20 000-00 p/m, whereas the actual amount allocated in
the budget is usually in the region of R60 000-00 per annum.
In addition further costs involved for Council include:
Electricity R 32 000 p/m
Gas R 2 000 p/m
Water Not Available
Staff costs (24 staff) R 140000
p/m
The above costs do not include stores and materials for day to day running of
the facility. It is clear from the above that Council is committing sufficient
resources to this facility and its operation.
(iii) Accommodation:
The capacity of the facility is 177 rooms situated on 8 floors. Currently 121
rooms are occupied and 56 are vacant. Rent collections present a big problem.
Rental on average is R227 -00 per month, per room. The projected overall rental
for a month is R22 775-00 but the actual amount collected is :t R8 708.
Another factor that presents a challenge is the type of accommodation that the
old people occupy i.e. high- rise (8 storey) building. The fact that some of
them are frail poses a risk in the event of an emergency, especially fire. The
situation is exacerbated by the poor state of the building.
(iv) Frail Residents:
Although it is expected that
residents are able bodied and self sufficient, a problem arises when they
become frail and in need of constant nursing care which in nor provided at the
Home. This had become a major issue of concern, as many residents refuse
assistance in this regard are not willing to leave the Home.
4.3 ISSUES AND CONCERNS
There are a number of issues and concerns that should be highlighted that will affect the manner in which decisions are made to resolve the current situation.
The estimated cost to upgrade
the services in the facility to an acceptable standard, ensure that it is safe
and refurbished all the rooms and communal areas is estimates to be R12-R14
million. This should be weighed against the following:
(i)
The inhabitants of the building are elderly people numerous of which are
in their seventies and eighties.
(ii)
The facility is a high rising building, which is not really suitable for
the elderly.
(iii)
Only three lifts serve the 177 rooms of the complex.
(iv)
In the times of power failures the elderly will find it inconvenient and
difficult to move between floors and leave the building.
(v)
In case of emergency e.g. fire when the lifts are not operational, the
potential for loss of life exists.
(vi)
The current fittings i.e ceilings, carpets, doors are old and flammable
and could exacerbate a fire. It is the intention if the refurbishment takes
place to replace all this old material.
(vii)
The current occupancy rate of the building is 128 residents. Some 65% of
the rooms are occupied.
5. PROPOSED ACTION
In order to respond positively to the existing situation and also improve
the quality of life of the residents of Casa Mia, the following course of
action is proposed:
(i)
That the R3 million be made available to undertake the essential and
urgently required work for phase one, namely the replacement of water, sewerage
and electrical services. This will make the facility habitable but further
action will be required as a matter of urgency to rehabilitate the building.
Funds for phase two will be placed on the draft Capital Budget for 2007/08.
(ii)
Due to the extensive nature of the structural upgrading works that have
to be undertaken and the fact that the building could be without basic services
for the extended periods while the works are carried out, it is proposed that
where possible where possible the residents be moved to alternative
accommodation while upgrading works take place.
(iii)
That the Housing Department ascertain what other accommodation are there
at old age homes managed by the Council, and transfer the Casa Mia residents to
these vacant facilities on either a temporary or permanent basis.
(iv)
That the Department re-evaluated its continued management and the
commitment to this facility, and investigate possible alternatives as to how to
reduce council commitment, but still ensure that the service can be provided.
5.1 RELOCATION STRATEGY
Community Development Department conducted investigations with regard to
the provisional or permanent relocation of the residents to allow the
refurbishments of the Casa Mia to continue with less distraction to the
residents. Even though the contractors have indicated that they’ll be able to
work whilst the residents are around, it is advisable that they be relocated to
avoid any harm as a result of the contractor’s work.
The option available to the Council is to relocate the residents to other
Council owned Retirement Villages. This relocation should be permanent and no
allocations for the residents should be made available at Casa Mia. This
approach will however take Council a long while until the last resident is
relocated, but its worth the exercise.
The Housing Department has been consulted and is willing to assist in this
regard. A strategy for relocations will be developed between Community
Development and Housing Departments in consultations with the Casa Mia
residents and clear plan will be presented to the next Mayoral Committee.
Community Development will enlist the services of its social workers to debrief
the residents of Casa Mia on the anticipated refurbishments and the relocation
process.
6. POLICY IMPLICATIONS
This processes is informed by the City’s policy imperatives to ensure
that our target groups especially the aged are well taken care of.
7. COMMUNICATIONS IMPLICATIONS
Residents of Casa Mia will be informed of the impending relocations and
refurbishments to the building.
8. LEGAL IMPLICATIONS
Any contractors used for the renovations must be engaged in terms of
council policy. The Council must be weary of relocating these people without
their consent.
9. FINANCIAL IMPLICATIONS
The first phase of the project will require R3 million for the upgrading
of existing services.
10. Other Departments consulted:
-
Housing
-
Corporate Shared Service
-
Johannesburg Housing Company
11. RECOMMENDATIONS
It is recommended:
(X George)
(Lead official)
Community Development)
(Tel: 407 – 6719)
MMC: Community Development
Councillor N Mayathula -Khoza