The Chantefontaine nursing home in Cestas, in Gironde, purchased by the Korian group in 2019, has 42 places but only 34 residents. Reading the final observation report, published this Tuesday by the Regional Court of Auditors (CRC), we understand a little this disaffection. The high turnover of teams, the unsuitable premises and the reception conditions which leave something to be desired contribute to painting a poor portrait of the establishment.
Two complaints were sent, in the spring and summer of 2022, by families of residents to the regional health agency (ARS), the supervisory authority, and to the departmental council for “failure to provide care”.
High risk of “institutional mistreatment”
The premises of this private commercial nursing home “include only 16 individual rooms, only six of which are equipped with showers”, points out the CRC report. Only 35% of residents have easy access to a shower. The monthly prices applied per resident are in the median for other establishments of the same type (between €2,357 to €3,277). “Nevertheless, they can be assessed as being high in relation to the accommodation offered,” supports the report. A rehabilitation project was launched late and should be delivered at the end of 2025.
The number of residents eating their meals in their rooms is considered too high given the number of professionals available to help them eat. “The ARS (which carried out an inspection in August 2022) thus indicates that these findings contribute to a high risk of institutional mistreatment,” points out the report. “Almost 30% of residents are severely undernourished, which deserves great attention, with a rate of around 12% frequently being isolated in a nursing home,” he adds. The objective of monitoring malnutrition is, however, among the objectives of the care project. »
Since the departure of the last facilitator, in May 2022, there are no longer any activities offered to residents and among the nursing staff, there is a high turnover. Families feel it: all satisfaction level indicators are declining. The manager is struggling to recruit and justifies this situation by “the complexity of management since the health and media crises”.
Thirteen days without nursing presence in 2022
Even if a nurse was recruited in the establishment in 2023, the CRC analysis shows that in 2022, there were thirteen days without nursing presence. “Insecurity in nursing care, especially since there is no longer a coordinating doctor present,” underlines the report.
External services are also subject to control: expenses linked to the arrival of physiotherapists are down 17% between 2017 and 2022, “which raises questions about the level and quality of care for residents”. The budget for the fees of private doctors and SOS doctors has also fallen by 41.5% since 2017, a sharp reduction linked to significant payment delays “well beyond the sixty-day deadline”.
Questioning the relevance of the level of public allocations received
The establishment’s financial profitability has improved since the takeover by the Korian group in 2020, even though the occupancy rate is falling. The regional audit chamber identifies a hole of “around €301,451, or almost 7% of the total grants received over the entire period 2018 to 2021” whose use is not identified as required by regulations. This point is disputed by the manager.
“In summary, the regional chamber of accounts highlights the insincere nature of the data concerning the workforce within the statements of revenue and expenditure (ERRD), which prevents the use of allocations from being controlled. » The payroll allocated to care is growing less quickly than allocations: the latter increased by 22% between 2017 and 2022 and by 16.5% between 2020 and 2022 while the workforce linked to care has decreased, according to the manager’s declarations , by 6% between 2017 and 2022, and by 0.04% between 2020 and 2022.
The Regional Court of Auditors issued ten recommendations to the establishment, including the stabilization of staff numbers, the immediate transmission of serious adverse events to the ARS and the updating of the establishment project.