Social public services: The Kufstein, Schwoich and Thiersee community-care district
The Kufstein, Schwoich and Thiersee community-care district
The creation of a Land-wide community care district in the mid-80s in Tyrol has led to the introduction of decentralised mobile assistance and advice services principally for elderly people in order to strengthen self-help, autonomy and a sense of community within a district. It includes nursing care and rehabilitation, child and family services, counselling and other activities. There is a good degree of coordination of services with a particular emphasis on training.
- Older people living alone
- Public sector
- Coordinated/integrated service
- User orientated service
- Training and staff development
- Volunteers
The aims of the community-care district are to create and develop suitable mobile assistance and advice services; to improve access to professional assistance and advice services outside the district; to motivate and guide people within the district so that they can assume responsibility for themselves and accept a share of responsibility for their environment; to encourage and support self-help and the provision of assistance by ordinary citizens; and to strengthen the sense of community within the district. Sixty-two of these districts have now been established within the federal state of the Tyrol, covering almost the entire population. The community-care district described here has been offering its services in the communes of Kufstein, Schwoich and Thiersee since 1986. The budget is financed by block grants from the Land and the Gemeinden and from income from the range of services.
The staffing structure has changed significantly in recent years. While most of the community-care work used to be performed by volunteers and casual workers, in recent years there has been an increase of full-time paid staff. The district employs 15 full-time staff and 22 casual workers. Since an ever-increasing number of women without specialised training are seeking employment, the district also recently recruited two home helps, for each of whom it is receiving a twelve-month employment grant from the Labour Market Service. The number of voluntary workers has fallen rapidly over the last few years. There is now only 13 voluntary staff, who are chiefly employed in the meals-on-wheels service. Apart from the voluntary workers, most of the district's employees are women.
The services provided by the community-care district are divided into three categories: nursing care and rehabilitation measures, Children and family care facilities; and counselling and other activities.
Despite the hierachical nature of the District, the coordination of services is achieved through a compact organisational structure, with team meetings held twice weekly. There are good contacts with other providers who offer complementary services. Moreover, coordination is one of the tasks explicitly assigned to the district by the Tyrolean Government.
Services are user orientated and although there is no systematic measurement of customer satisfaction, but the district does try to maintain direct contact with its individual clients. Accordingly, high priority is attached to talks that take place during the provision of care, for which the carer is expected to set aside some time. In order to keep her finger on the operational pulse of the organisation, the head sees it as her duty to visit clients on a regular basis. One of the purposes of these visits is to dispel clients' fears that voicing criticism of the care they receive might result in its withdrawal.
In terms of working conditions too, the compact organisation of the district plays an important role. Staff are able to exercise relatively wide discretion in the way they organise their workload, which would not be possible for members of a larger team. This flexibility in the use of their working hours, however, is something the employees themselves expect. There is an increasing tendency for working hours to be concentrated into a morning and an evening shift, but the actual number of hours to be worked can vary quite considerably, depending on the needs of the clients. It is not unusual for staff not to learn of their working hours on a particular day until the day itself. Staff, however, are made aware of this type of problem during the job interview. All of the women who have to combine their work with their own family responsibilities are employed on a part-time basis. Depending on their own family situation, they either do the early shift or the evening shift. Priority is place on on-going staff training which is facilitated by cooperation with the Tyrolean Government and with the other community-care districts.
The community-care districts in the Tyrol are organised on a decentralised basis, so that they can provide help quickly to the population of their respective areas whenever problems occur. The fact that the staff are few in number, especially by comparison with providers in urban areas, means that the district can respond swiftly to changes in client demand. According to the head of operations, the districts must therefore remain small and easily manageable if their quality is to be maintained. Any further growth will consequently necessitate the creation of new field stations. There is also a priority to develop training for the so-called lay helpers (for example, home helps). This view is increasingly being enshrined in Austrian law. Most of the Länder, for example, are implementing their own laws or guidelines governing the training and qualification of home helps.