Unexpected visitors

A dark cloud hangs over the St. Theresienstift nursing home in Berlin where Roman Catholic nuns care for 18 elderly sisters. A funeral is planned today for a nun who has recently died. The residence manager, Sister Agnes, plans to attend the ceremony with the others, but little does she know who is just around the corner – two women with a very different agenda in mind.

At 9 o'clock sharp, the women enter the bright and spacious building, located in a quiet, residential neighborhood. "Hello, my name is Birgit Freimuth from Medical Services," says one of the women. "We are here today to carry out a surprise evaluation of the nursing home. I would like to speak to the head nurse and manager please."

Ready for inspection

The nurse at the front desk immediately rings up Sister Agnes who promptly appears before the inspectors. Despite their inconvenient timing, Birgit Freimuth and Simone Rusch explain that they cannot delay the inspection. For the rest of the day, Sister Agnes will be subjected to a 100-page evaluation by her uninvited guests, who are equipped with a long and detailed catalog of questions, including: How satisfied are the residents? Is their privacy respected? Is the home kept clean? What kinds of facilities are available?

Without complaint, Sister Agnes complies with the surprise evaluation.

Birgit Freimuth pulls out her laptop and scans through a long list of questions, calling out for one document after another. Each time, Sister Agnes jumps to her feet and obediently flips through her files. She wants everything to go smoothly, and for good reason. In a few weeks, the results of the evaluation will be made available online; then everyone will be able to see how their nursing home ranks, and in which areas they are especially good – or especially bad.

Concern over care

More than half of seniors in need of care in Germany are looked after by outpatient services and nursing homes. However, a series of treatment scandals has caused the public concern, especially since elderly residents are often not in a position to express their grievances.

In order to avoid mistreatment and to improve the quality of nursing homes, insurance companies are carrying out periodic inspections. By the end of 2010, they plan to inspect all of Germany's approximately 11,000 nursing homes.

Although publication of such data has long been requested by nursing home residents and their families, the move has attracted its fair share of critics too - who say the scoring system is unsatisfactory. For example, if one document is missing from the nursing home's records, it can drastically affect its overall score. And, some questions - they say - are too restrictive, only allowing for "yes" and "no" answers.

As Birgit Freimuth continued to probe Sister Agnes for more paperwork ("Do you keep records of complaints? I have to see these as well"). The other inspector, Simone Rusch, spoke with Sister Editha, a slight woman of 90 who has lived at the home for the past seven years. In her sparsely decorated room, she appears to be very content with her stay as she answers "yes" to every question. "Are the employees always polite and friendly?" Yes. "Does the nursing staff take enough time for you?" Yes.

"Yes, there's nothing more to say other than that the staff is excellent," Sister Editha insists.

Excellent conditions

Sister Carola, a 67-year-old resident agrees. "The Sisters make such an effort – they read to us; they sing with us."

Although it has been a tiresome day for Sister Agnes, she feels positive about the inspection. "This was a big surprise for us today," she says. "But I think we scored well."

Furthermore, she believes the evaluation is as useful to nursing home employees as to the residents. "I think this inspection is a good thing, because then we can also find out what we can improve."

Dennis Stute / dpa (vj)
Editor: Trinity Hartman