Audit finds many problems at Palms

Additionally, food items for the residents of the institution were not properly stored and may be deficient in nutritional value while the institution is understaffed, the report by the Audit Office of Guyana says. Several recommendations were made and the Ministry of Labour, Human Services and Social Security has said that they were able to address many of the identified deficiencies and work will continue to improve the lives of residents and staff members.

The Performance/Value-for-Money Audit report was laid in the National Assembly yesterday having been presented to Speaker of the National Assembly, Ralph Ramkarran on Monday. The report reviewed the period January 1, 2008 to December 31, 2008.

The Report found that the collective nature of budgeting, releasing and expending of funds for the Palms and nine other institutions resulted in the lack of accountability and transparency. Consequently, the Audit Office was unable to determine whether the funding and other support received were adequate to effectively and efficiently manage its operations.  It noted that funds allocated for the Palms could not be identified since collective budgeting was undertaken by the Ministry for all agencies under the Social Services Programme (SSP). For the period under review, the SSP was funded by an annual appropriation.

Total expenditure for the period could not be determined since both the Palms Administration and the Ministry incurred expenditure. “Consequently, the Administrator did not have complete information on expenditure made on behalf of the Palms and could not be held accountable and responsible for the overall expenditure incurred for the Palms”, the report states.

It stated that controls over monetary donations received by the institution were not in place as stipulated by acceptable accounting procedures for the control and reporting of receipts and expenditure. Cash received was kept by the Palms Administration while cheques were deposited into the donations bank account, which was controlled by the Ministry. However, access to the account was restricted by the Ministry and the funds were not used as intended by its donors, the report states. The Ministry in a response said that the recommendations have been noted and the suggestions receiving due consideration.

On the health and well-being of the residents of the home, the report says that they were subjected to initial and regular medical assessments but not optical and dental evaluations. Psychiatric patients were also housed at the Palms even though the nursing staff was not trained to care for such patients. Additionally, leisure time was not adequately utilized due to the lack of social and recreational activities. The Ministry says that upon admission all residents must undergo a medical assessment. It is also exploring other suitable institutions to accommodate those suffering dementia.

On Food and Dietary considerations, the report revealed that the Institution did not have a qualified Dietician/Nutritionist to assess the residents’ dietary needs and therefore, diets supplied may be deficient of nutritional value. The Ministry says that an official has since been hired. In addition, food items were not properly stored, meals not prepared by certified food handlers and transported to the wards in accordance with Public Food Hygiene Standards. The Ministry says that the food storage area now has sufficient lighting, is regularly cleaned and all items are stored according to government regulations.

The report says that the buildings and facilities are in a state of deterioration and disrepair and the City Engineer’s Department has summoned the Ministry to take the necessary action to rectify the problems highlighted.

It said that the Palms did not follow World Health Organization Guidelines on Facilities for Older Persons and Geriatric Standards for the comfort of residents. The facilities were poorly maintained and there were inadequate equipment/aids for residents with special needs, the report highlighted.  The ministry responded that several sections of the Palms are currently undergoing maintenance and walking aids are now kept in stores and therefore no longer exposed to weathering.

According to the report, the Palms was faced with a number of human resource challenges and the absence of the required number of qualified and trained staff impaired its ability to effectively care for the residents. The Report states that staff was dissatisfied with their poor working environment.

It further noted that there was non-compliance with fire Safety Regulations and there was no documented emergency policy. Additionally, the security firm hired to protect the Palms did not fulfill its obligations and the service was unsatisfactory resulting in losses due to theft. The report says that the Palms was understaffed and does not have a formal training plan. These concerns are being addressed, the Ministry said in its response while outlining the actions taken.

The Audit ‘An Assessment of the Living Conditions of the Residents of the Palms Geriatric Institution’ revealed that 213 residents are accommodated at the Palms which was staffed by 126 persons.

The Palms was established in 1874 under British Colonial rule and was known as the ‘Alms-House’. It was subsequently renamed the Palms in 1974. It is the only fully-funded government home for indigent senior citizens and is governed by the Poor Relief Act Chapter 36:02 which was enacted to “make provision for the relief of the poor”.