CC BY
12Journal of Siberian Federal University. Humanities & Social Sciences 4 (2011 4) 643-550
УДК 364.075.2
Optimization of the Public Home-Care System: a New Model
Ivan V. Malofeev*
IPK DSZN
10 1-st Basmannyj side st., Moscow, 107078 Russia 1
Received 4.04.2011, received in revised form 11.04.2011, accepted 18.04.2011
The article is devoted to the new model for the optimization of the home care system based on modern organization and information technologies. The article includes the results of the motion and time study ofsocial workers proving the ineffectiveness and disproportionality ofexisting home care system. The article includes the description of an experiment in the introduction of the modern electronic, communicative and logistic technologies for food delivery. The experiment allows raising the quality of home care, reducing motion and time expenses and malversations, sparing more social workers for other in-demand social services.
Keywords: social services, home-care, social responsibility, social assistance, social project.
The given article is dedicated to a new model of the home-care system optimization, based on modern organizational and informational technologies. Here, we present the results of researching of time- and labor-inputs of social workers, which prove that the existing home-care system is inefficient and disproportional. The article includes a description of the experiment on the implementation of modern electronic, communicative and logistic technologies of products delivery. The experiment let us improve the quality of the home-care service, decrease the labor-costs and malversations, disengage a part of the social employers to fulfill some other in-demand social services.
The system of public home-care service has been started to be formed in our country in the last decade of ХХ century. The main target of its activity was to provide assistance, first of all, to
the poor and lonely old and disabled people under the conditions of collapse of the previous social-economical organization of the society.
Social assistance tasks were determined by the necessity to provide a normal social functioning to the serviced people, and that was why the professional activity included provision of hot food in the centers of social public service or in specially-selected institutions of public catering, food delivery at door; medicine delivery; assistance in making payments for utility services and others. Finally, the types of services, which were rendered to the old people and the disabled, were included into the list of social services, being guaranteed by the state -first of all on the federal level, and later into the legislation of the subjects of the Russian Federation. Thereat, the following services were included into this guaranteed list: social-living,
* Corresponding author E-mail address: ivan_malofeev@inbox.ru
1 © Siberian Federal University. All rights reserved
social-medical, social-psychological and proper social services (processing and reissuance of documents, maintenance and re-establishment of contacts between relatives, accompanying of the client in the institutions and so on.).
The model of social service realized its appropriation concerning the support of big masses' survival in 90-s of XX century, when the main targets of social activity were one-dimensional and it was necessary to provide support to all the representatives of subsidized households (the old and disabled people), independently on their property, social and family status. Though, at the later stage, when serious social-economical changes took place in our country and especially in some subjects of the Russian Federation, when salvation from hunger stopped being the main target of the social safety net system, the social service continued to develop on its former basis by inertia and at present time it represents quite an archaic branch of activity, having been built mainly on non-market basis and acting practically without any consideration of the modern organizational-managerial knowledge and notions.
Under the conditions of the program of modernization of Russia, which has been formulated by the President of the Russian Federation D.A. Medvedev, bringing of the social service system to correspondence with the requirements of nowadays, wide usage of electronics and informational technologies become a pressing task of development of the system of social public service of the Moscow City.
One of the key tasks of the social service system modernization is a creation of a more powerful branch of home-care service of the old and disabled people.
In order to develop a new model of social service, we have carried out a front research of
organization and maintenance of home-care service of the old and disabled people (on the example of 3 public centers of social service: CSS «Basmanny», CSS «Obruchevsky», CSS «Yaroslavsky»). We have measured the timing of labor costs of social workers, have studied the organization of their activity, and have maintained the control of their work from the part of CSS administration.
Moreover, we have organized a series of «round tables» and the specialists of social home-care service (employers of regional administrations of social service net, chief managers of home-care service branches, social workers) have been telling about the existing problems and about their vision of the problems of social service organization in the process of these round tables work.
As our research work has shown: in spite of a long list of the Territorial bead-roll of the state guaranteed social services, the biggest amount of time and efforts in social service of citizens are taken by the food stuff delivery at door. Daily, social workers buy and deliver themselves more than 400 tons of products to the home-cared citizens of Moscow. That is why, there is left only not more 15 minutes per person to work directly with (Table 1).
As it is seen from the table, two thirds of all the time of social workers is spent for ordering, purchasing and delivering of food products. If we add here ordering and purchasing of industrial products, ordering and purchasing of medicine, then we shall see that almost 80 % of time of the social worker is spent for shopping and delivery of various products, having been ordered by the client.
Organization of food stuff and goods delivery is formed on quite a primitive basis: the social worker writes down the order of the client into his scribbling-diary, gets the money, goes shopping (to the stores, chemists shops, and etc.),
Table 1. Distribution of Social Services According to Their Types (on the example of SI RCSS «Basmanny», 2009)
Including the types of the services
The number of cared people The number of services Food products Industrial products Chemistries Policlinics Sberbank Personal work Other services (mail, laundry, dry-cleaning and so on.)
1720 249323 168941 12350 14955 9876 7521 14466 21214
The share of the services ( %)* 100 % 68 % 5 % 6 % 4 % 3 % 5 % 9 %
* The meanings are rounded up to whole numbers
then he delivers all the products to the client, gives an account for the spent money, writes down the purchases into his record-book (note-book), gives the client the register receipts and the change, if it is necessary.
Such an order is rather labor-expensive and difficult in control: trading centers can be disposed at various distances form the client's apartment (especially, in central districts of the city). The employer has to go to the sales point (or even to several points) by municipal transport; himself to carry the bags with the products to each client separately.
Moreover, there have been cases, when social workers have overrated the costs of the purchased products, wangled with the register receipts and so on. The existing system of control, which is used in the institutions, uncovers such crimes, and such workers are dismissed, but the conditions for potential malversations still remains.
To the number of inflicted malversations we also refer collusions between the social workers and owners of the shops and apothecaries: the social worker can get certain rake-off for purchasing goods precisely at that very sales point.
The carried analysis of provision of social home-care service proves that it is necessary to optimize the work organization of the given
element of the social public service system of Moscow.
Pursuing this very aim, we have started organization of our experiment on the basis of social service institutions of two districts of Moscow:theNorthern-Easternand Zelenogradsky districts.
The target of the experiment: probation and introduction of the social service public system, using the modern means of information transfer.
The tasks, being solved in the course of the project realization:
- Optimization of the public home-care service system;
- Improvement of the service effectiveness on the account of the modern informational-logistic technologies;
- Growth of volume of the social-psychological services to the clients due to deeper specialization of the social employers' labor;
- Release of the personnel resources of CSS (CCSS) in order to organize the provision of home nursing or some other necessary public services.
In the course of the project we presuppose to introduce specialization and to deepen the division of labor of social workers, serving clients at home.
The first group (social assistance service branch) provides social and psychological services: accompanying of the client in the public social service institutions, in the state and municipal institutions, in the policlinics, in the institutions of commerce and culture and so on; talking to the client, rendering help in cooking and maintaining order in the apartments.
Each of such social workers can serve 15 clients.
At the same time, the task of provision of services of delivery (food stuff, goods, and medicines) and of payments (housing and public utilities, phone, and other services) will be fulfilled by the second group of social workers, who will use the modern means of communication and logistics.
The social worker visits the client and gets the order in accordance with the project. The given order is transferred with the help of a special electronic device - note-pad, - working in the on-line regime, to AIC «Social Partner», where the information (orders for food, goods, and medicines) is centrally accumulated, processed and distributed. The means of communication (note-pads) are passed by «Social Partner» to the social service public institutions for the social workers to deal with.
Partners of AIC «Social Partner» are suppliers of goods with reliable recommendations, the goods which are in high demand by the social service clients.
The processing program provides an automatic addressing to the supplier, who suggests the best price for the chosen good. The purchased product is packed and delivered in the morning the day after the client's order has been received. Each order is supplied with a detailed invoice, which contains the client's full name, classification, number of goods and their price.
Delivery is realized by the transport means of AIC «Social Partner» to the district, where the clients, who has made the order of the given day, live. Social workers, who provide the delivery, take the corresponding orders from the delivery vehicle driver and spread them to the clients, getting money in accordance with the invoices. Gathered and filed invoices become the means of control instead of the records in the register, which are easy to falsify.
The social worker transfers the cash monetary means, gathered from the clients, to AIC «Social Partner», possibly, by means of the cash machine - notes receiver (either after visiting every client, or at the end of his working day). It is also possible that the monetary means will be gathered at the end of the day by the special representatives of AIC «Social Partner» in the building of CSS, where all the social workers will arrive. The social worker sends all the information on the clients' payments in electronic form to AIC «Social Partner», while the computer center spreads all the gathered money among the suppliers.
It is possible to organize utilities, phone and long-distance calls and other payments on a similar basis: the social worker informs AIC «Social Partner» concerning the effected payments by means of his note-pad, and the money received from clients is transferred to the destination either by means of the cash machine, or is handled to the representative of AIC «Social Partner» for the service suppliers.
Social workers are supposed to visit their clients twice a week; thereat, the day of the products delivery can be also the day of the next order making (Fig. 1-2).
We have suggested the following algorithm of actions in order to realize the set targets:
1. The specialist accepts an order for delivery of food stuff, household goods, medicines, and utilities payments.
n 79%
n Delivery of food stuff and manufactured products, apothecary
^ Communication with the person
^ Policlinics
□ Sberbank
n Other services (mail, laundry, dry-cleaning and etc.)
Fig. 1. The existing model of social home-care service. The timing
Fig. 2. The new model (time spreading per a client)
2. The specialist sends the information to AIC «Social Partner» with the help of his notepad.
3. AIC «Social Partner» realizes the order of food stuff, household goods and medicines at its suppliers.
4. AIC «Social Partner» sends the information to the partnership trading networks.
5. Trading networks send the products to the Logistic center of «Social Partner».
6. At the beginning of the working day, specialists of the Logistic center of «Social Partner» deliver sorted orders to the districts
according to the logistic scheme and traffic routes.
Specialists of the social home-care service deliver the products at clients' doors and collect orders for the next delivery.
In the course of realization of the experiment, we have worked out the following model (Fig. 3-4):
Our calculations prove that realization of the given project will not result in increase of the number of social workers, but it will bring to release of some of them for realization of other functions and problems solution.
Milk
Bread
Vegetables
Коммунальные платежи, Сбербанк
Apothecary
Industrial products
Work with the client
Shortcomings of the existing model
1. Sometimes, the social worker visits each of the institutions several times according to the client's order. Food stuff, products and services are situated in various places and it can be difficult to get to there.
2. We cannot completely exclude malversations, as far as all the purchases and payments are accounted according to the records in the register.
Fig. 3. Social Worker's Activity Structure (the existing model)
Goods supplier
Goods supplier
Service provider
Service provider
4
'Ч
Organizations of housing and public utilities
Logistics specialist
The ordered goods and services are delivered to the social worker for handing them over to the client
Fig. 4. The suggested model
Thus, if in Moscow there are in average 1100 home-cared people per each CSS (CCSS), and we need 138 salaried social employees in order to provide them home-care services (on the basis 8 clients per 1 social specialist), then realization of the suggested project will lead to that, that the number of employers of the social service branch will become 75 - 80 people per the same number of clients (taking in account their sick leaves, holidays and etc.).
There must be 30 - 35 social workers (taking in account their sick leaves, holidays and etc.) in order to care about the people (payment and delivery of goods and utilities) on condition that they serve 40 clients twice a week. This way, the total number of both groups of social workers of each CSS must be 105 - 115 people.
The released 20 - 25 employees can be redirected to the nursing service department in the social service institution.
The expected results of the project realization
Specialization of social services, computerization of goods ordering and delivery in accordance with the presented social project will result in the following:
- Labor costs for provision of home-cared clients with food-stuff, medicines and utilities payments will be decreased;
- The quality of home -caring will increase, as far as the clients will get precisely those goods, which they will have ordered (not those, which can be bought at the nearest stores);
- The number of inflicted malversations will go down, as far as the automatized system will select the goods suppliers in accordance with the objective criteria;
- The social work will preserve and improve its achieved level of home-care services, but at the same time it will improve the work with each person, providing communicative-psychological support to the citizens.
References
R.I. Yeruslanova. Technologies of Social Home-Care of Old and Disabled People: Educational Book / Yeruslanova R.I. 4-d Edition. Moscow: Publishing-Trading Corporation «Dashkov and Co», 2010.
P.V. Popov, I.V. Malofeev. The Main Tendencies of Innovative Technologies of Organization of Home-Care Service of Old and Disabled People in the Regions of Russian // Social Service. Moscow, 2010, № 7.
L.V. Topchy. Organization of Public Social Service. Moscow, 2002.
N.Y. Uskova. Condition and Perspectives of Implementation of Innovative Technologies in Organization of Home-Care Services of Old and Disabled People // Social Service. Moscow, 2010, № 7
Оптимизация системы надомного обслуживания населения: новая модель
И.В. Малофеев
ИПКДСЗН
Россия 107078, Москва, 1-й Басманный переулок, 10
Статья посвящена новой модели оптимизации надомного обслуживания, основанной на современных организационных и информационных технологиях. Приводятся результаты исследования время- и трудозатрат социальных работников, доказывающие неэффективность и диспропорциональность существующей системы надомного обслуживания. Статья включает описание эксперимента по внедрению современных электронных, коммуникативных и логистических технологий для доставки продуктов. Эксперимент позволяет повысить качество надомного обслуживания, сократить трудозатраты и злоупотребления, высвободить часть социальных работников для других востребованных социальных услуг.
Ключевые слова: социальные услуги, надомное обслуживание, социальная ответственность, социальная помощь, социальный проект.
