The body was in January: whether nursing home oversight is sufficient
On January 3, the body of an elderly resident was found in the V.P. Reshetnikov Republican Residential Home for the Elderly and Disabled in Yakutia. The corpse had been lying in a closed room since the end of December, but he was found only a few days later. After the incident was verified, the director and several employees were fired from the boarding home. However, experts in the industry believe that this can only exacerbate the situation, as one of the main problems of state nursing homes - in the shortage of staff. Read more - in the material "Izvestia".
Why the death of a man was not noticed
Died an elderly man with a heart disease lived in an individual room of the Republican nursing home. Since December 31, he had not opened the door to the staff of the boarding house during rounds. According to other information, the man died back on December 28. He was 68 years old.
The Ministry of Labor of the region conducted an official check, which showed that the staff used "unconfirmed information about the departure of the recipient of social services outside the boarding house for the New Year holidays." It was this, apparently, that the staff explained the fact that for so long no one tried to enter the room, which was not opened by the guest.
"As a result of the inspection, the director of the Republican residential home for the elderly and disabled Fokina N.P. was dismissed," the ministry said.-Also left their posts five employees from among the management staff and responsible employees. Disciplinary penalties were imposed for improper performance of official duties".
Verification of the death of a resident in a 24-hour social service institution
"Izvestia" in the Ministry of Labor of the region reported that law enforcement agencies continue to check on the incident, until then the ministry will refrain from additional comments.
Sergei Agapov, a member of the Moscow Region Bar Association, when asked whether the employees of the nursing home had the right to violate the personal boundaries of the man who had locked himself in his room, notes that the relationship between the residents and the nursing home should be strictly formalized in the contract on the provision of social services. Yuri Mitin, managing partner of the law firm "Intellectual Defense", emphasizes that the law "On Social Services" and sanitary rules prescribe the obligations of institutions to ensure safety, including the protection of personal space of residents.
- "However, the boundary between security and privacy is largely determined by internal rules and relations in each particular institution," he noted in a conversation with Izvestia.
"There are simply not enough people."
The Ministry of Labor told Izvestia that there are 539 residential homes for the elderly and gerontological centers in the regions.
The absolute majority of social institutions are under regional jurisdiction. Rostrud can also control these organizations.
-Control alone will not solve the problem, because these institutions are very understaffed ," Elena Topoleva-Soldunova, chairwoman of the RF OP commission on the development of the non-profit sector, told Izvestia. - This is probably one of the biggest problems. We can endlessly monitor institutions, but what can be done if there simply aren't enough people to take care of the residents?
From this point of view, the decision to fire the workers at the Yakutsk boarding home is ambiguous, she says. If they are really at fault, nothing can be done, but it only exacerbates the problem, because it is very difficult to find workers in nursing homes. By the way, on the website "Work in Russia" in the republican boarding school for the elderly there are seven vacancies open, including three positions for a nursing assistant.
Charitable Foundation "Help for the Elderly" in 2021 conducted a study: a survey of managers of residential social care institutions for elderly citizens. The results showed that there are few motivated staff in nursing homes, even according to the estimates of their managers. When asked about motivation, only about 16% of directors answered that employees of state boarding houses mostly work by vocation. On the contrary, the majority of employees stay in place because "other work is hard to find" (50% among all respondents and more than half of those who answered this question).
- Working conditions and personnel policy in general do not correspond at all to the needs of elderly people who are on the support of employees with such motivation," Argam Verdiyan, founder and director of the Aid to the Elderly Foundation, told Izvestia.
Elena Topoleva-Soldunova believes that in conditions when the staff shortage cannot be reversed quickly, it is necessary to look for other ways to solve the problem of social stationary institutions.
- Volunteers would be very helpful. Not only because they are extra hands, but also because external people who come to such institutions on a regular basis mobilize the staff more, " the expert said. - However, involving volunteers is also a big job, and it needs to be expanded.
All the problems that exist in state boarding houses are also present in the private sector, but the trend of people seeking to enter private homes for the elderly continues, said Ulyana Baskleeva-Billinger, founder and head of the NGO "Help for the Elderly.
- The private sector benefits from the fact that the staff and management are more interested in accepting residents: the attitude to the client and the payer is at a different level than in a state-run boarding house, which already has a waiting list, " she told Izvestia. - Nevertheless, these institutions fulfill their state function. Properly or improperly - it all depends on the head and it does not matter whether it is a private or state boarding house.
"A question covered by darkness"
The press service of Rostrud reported that they check the accessibility of social institutions for people with disabilities, compliance with the number of employees, the norms for the area of living quarters, providing residents with clothes, shoes, bedding, the order of charging for services, etc. Last year there were 55 inspections of social service organizations and more than 2 thousand preventive visits. In 2025 there should be more inspections - 76.
- Planned inspections of state social service institutions are carried out on the basis of a risk-oriented approach," the agency explained to Izvestia. - Since 2025, the criteria for assigning organizations to risk categories depending on the number of citizens living there have been changed. Taking into account the new criteria, the boarding home in question has been categorized as high-risk since this year.
However, Ramaz Akhmeteli, a member of the Public Council at the Ministry of Labor and chairman of the board of the National Association of Social Services (NASS), believes that state nursing homes are a closed system with little access for inspections, especially by the public. Federal services such as the Ministry of Emergency Situations, Rospotrebnadzor, and Rostrud can get in.
- They have a kind of checklist," he explained to Izvestia. - But situations like the one in Yakutia point to systemic problems in state institutions.
Ramaz Akhmeteli explains that state boarding houses are part of the system of regional labor ministries, and control over them often turns out to be routine and meaningless. As a result, the quality of inpatient social services is an issue "covered by darkness", the expert believes. Moreover, each region has, in fact, its own standards, and instead of the declared "human-centeredness" the management of institutions often performs other tasks set by the executive branch, emphasizes Ramaz Ahmeteli.
-There should be some general rules, at least minimal, developed at the level of the federal ministry," he believes.
However, the Ministry of Labor emphasizes that public control is "an important element in building the work of social institutions". And there are already general recommendations for the regions in this regard.
- The Ministry of Labor of Russia together with the Ministry of Education, the Ministry of Health, and Rospotrebnadzor prepared and sent to the heads of regions recommendations for the organization of visits to citizens living in social hospitals by representatives of NGOs and volunteers," the ministry told Izvestia. - Maintaining stable contacts with non-profit organizations, volunteers, as a rule, works to improve the quality of services provided.
Elena Topoleva-Soldunova notes that it is important to understand what kind of control will be able to detect serious violations: what is needed is not work with documents, but a deep dive into how life is organized in a particular nursing home. At the same time, public control has become less in recent years, she believes. The reasons are different: at least public organizations also need resources to engage in control. In addition, the authorities should understand its importance and help the public. "Unfortunately, this is not always the case," the expert states.
Svetlana Bessarab, a member of the State Duma Committee on Labor, Social Policy, and Veterans' Affairs, noted in a conversation with Izvestia that inspections, especially given the moratorium, now take place mostly after such high-profile events. According to her, so far state boarding houses are not absolutely open institutions, and the expansion of public control "still needs to be substantially worked on".
- But there are enough open and "controlled" institutions. And it seems to me that the main problem is still illegal nursing homes. They are not under state control at all," the deputy said, adding that the issue of licensing this activity should not be pushed back.
Elena Topoleva-Soldunova adds that at the same time it is necessary to strengthen work with the reason why people end up in nursing homes. According to her, many problems will be solved by building a system of long-term care.
- Now it is being implemented, but so far it is very expensive and not implemented as quickly as we would like," the expert said.
