Audit no. D/24/514
Since 1 January 2004, districts have received state budget subsidies for the maintenance of residents of social care facilities admitted or referred there before that date, under the so-called “old” rules. It means that some issues, such as care home fees or admission principles may differ from entities operation in accordance with the “new” rules. Under the Act on social assistance of 2024, the governor may raise or reduce subsidies for the given district. The responsibility for dividing subsidy funds lies with the district.
The NIK audit revealed irregularities in all provinces concerning calculation of targeted subsidies from the state budget for districts which run or commission the operation of transmunicipal social care facilities.
In most provinces, the amounts of targeted subsidies were not adequate to the changing conditions in which the social care facilities operated. The reason was that the average monthly costs of living of residents in these facilities were going up to a greater extent than the number of residents and the revenues from their stay declined. That was particularly noticeable in 2024.
The consequence of underestimating subsidies for care homes include, among others, low pays in these entities followed by outflow of staff. This, in turn, impacts the service level which is below the standards set out in the Ordinance on social care facilities of 2012.
The method of calculating subsidies for districts, adopted in provincial offices, did not comply with the requirements set out in the Act of 2024 on the revenues of local government units. Irregularities found in the provincial offices were mainly related to establishing subsidies for districts and supervising operations of social care facilities. The governors’ approaches to calculating those subsidies varied significantly. In general, the governors calculated the average monthly subsidy for the province using the “old” method. That method did not reflect the costs incurred by individual care homes. Instead, it protected the provincial offices against exceeding the planned expenditures for this task.
The governors’ supervision over subordinate organisational units carrying out tasks in the field of granting subsidies to local government units was insufficient. The number of full-fledged audits or equivalent problem or ad hoc inspections in social care facilities was too small, which was a breach of the Ordinance on supervision and control in social assistance.
The small number of audits and inspections was related to the small number of inspectors responsible for supervision and control in social assistance. In spite of that, not enough people were recruited for these positions, and vacancies were often left unfilled, mainly due to unattractive remuneration.
The audited district offices were found to have inadequate oversight of social care facilities and errors in calculating and publishing the average monthly costs of resident care. Many entities failed to meet required standards for living, care and support services, particularly due to low staffing levels, insufficient room sizes, and too few bathrooms and toilets. Additionally, they often failed to assess the future resident’s living situation beforehand. Other issues included outdated accounting policies and non-compliance with bookkeeping regulations, contrary to the provisions of the Accounting Act.
Recommendations
In the light of the audit results, NIK made 49 detailed post-audit recommendations, of which the most important were:
to the governors to:
- establish the average monthly subsidies for the province for the maintenance of residents living in the social care facilities in line with old rules, in accordance with Article 53(7) of the Act on the revenues of local government units;
- establish monthly subsidies for districts running or commissioning the operation of social care facilities in which residents lived under old rules, using data on average monthly costs of living in social care facility announced by individual district heads;
- take efforts to hire the required number of inspectors responsible for supervision and control in social assistance;
- carry out comprehensive audits or equivalent problem or ad hoc inspections in accordance with the Ordinance on supervision and control in social assistance, and monitor the implementation of all post-audit recommendations addressed to the social care facility as a result of the said audits and inspections.
to the district heads to:
- properly establish the average monthly cost of living of residents in social care facilities;
- reliably supervise social care facilities by verifying if the average monthly cost of living of their residents was determined correctly,
- verify quarterly and annual reports on public task performance,
- conduct audits of compliance with contractual obligations.
to the directors of the social care facility to:
- ensure the provision of living, care and support services in compliance with the standards defined in the Ordinance on social care facilities, including e.g.: installing an elevator adapted to the needs of disabled people, designating a smoking room in care homes inhabited by smokers, ensuring an adequate number of bathrooms and toilets, providing at least 6 m² of space required for one person in dormitory rooms;
- make sure a social worker of the care home establishes the current social and living situation in the place of his/her residence or stay before the person is admitted to the social care facility;
- take efforts to achieve the required employment rate of employees of the therapeutic and care team;
- providing district family support centres with information on resident maintenance costs based on the costs actually incurred by the social care facility.
Notwithstanding the above recommendations, NIK stands in a position that, it is necessary to strengthen supervision of the Minister of the Interior and Administration over governors in the scope of establishing subsidies for districts to subsidise the stay of residents admitted or referred to social care facilities before 1 January 2004. In addition, it is necessary for the Minister of the Interior and Administration, in consultation with the Minister of Family, Labour and Social Policy, to standardise the method of establishing subsidies for districts or to take a legislative initiative to clarify the provisions of Article 53 of the Act on the revenues of local government units in order to prevent its diverse interpretations.
