TALLINN, 29 November 2023 – Although the state wants to improve the availability of domestic services, the audit of the National Audit Office did not show that people are even now failing to receive the necessary assistance from local governments. At the same time, according to the local governments, the funds for the nursing care reform are not enough in 2023 to even finance nursery service, let alone the development of domestic service.

The National Audit Office analysed the organisation of domestic service and the provision of the service in ten local governments in 2022, among them the four largest local governments in terms of population and did not detect a serious problem with the availability of domestic service, as described in the Social Welfare Act, in the audited local governments. In the cases analysed in the audit, domestic service was provided when the need for it was identified, and people were not left without assistance when they turned to the local government. The same conclusion can be drawn about local governments in general based on the supervision carried out by the Social Insurance Board in recent years.

The National Audit Office finds that the Ministry of Social Affairs should explain the large difference between the current provision of domestic service and the assessed need by the ministry. While in 2022, approximately 8,500 people received domestic service, the Ministry of Social Affairs has inferred from the studies commissioned that the actual need is approximately 20,000 places for the service. This has been repeatedly pointed out when preparing for the nursery care reform and in other policy initiatives in the area.

The National Audit Office has noted in its previous audits that local governments could do more preventive work in the social field and find their own way to those in need. Such a big difference between the alleged demand for the service and today’s provision, however, cannot be explained by possible shortcomings in preventive work. Even though the state has begun to funnel additional funds into the area of domestic services, the Ministry of Social Affairs should clarify the problem to be resolved and its causes in more detail.

The National Audit Office points out that although the requirements for the content of domestic service were specified by the regulation of the Minister of Social Protection in the summer of 2023, the effects of the regulation on the costs incurred by local governments were not properly analysed. If the responsibilities of local governments were to increase, but funding does not come with it due to insufficient analysis of effects, it seems a lot to hope that something would change significantly in the practice of domestic service.

The organisation of the provision of domestic service can be improved in several ways. The National Audit Office finds that it would be reasonable to standardise the methodology for assessing the need for assistance of a person who has turned to the local government. Currently, the methodology for assessing a person’s need for assistance differs in local governments. This does not mean that a person is left without the service, but differences in practice mean that there is a risk that not all needs are noticed everywhere. People’s needs are also constantly changing, and local governments are increasingly faced with the question of whether they should offer more than the minimum required by law. Many local governments are already doing this.

The National Audit Office finds that local governments should formulate specific goals for domestic service to be monitored. This is also presumed by the general quality principles of social services. Currently, the need for developing the service is based too much on the subjective knowledge of a social worker. Paperwork and collection of unnecessary information should be reduced, especially when assessing a person’s need for assistance. In addition to the fact that assessment is different in the comparison of local governments, the link between the information collected during the assessment and the need for service also tends to be weak. The question of why we collect information that is not actually used is justified.

As a result of the audit, the National Audit Office recommended local governments to start checking the quality of the service more thoroughly in order to notice changes in the need for the service in time.

The practice of the audited local governments also showed possibilities of how to approach the elimination of deficiencies in domestic service in terms of different issues. For example, there are local governments that have introduced IT applications in the management of domestic service, which have reduced bureaucracy and enabled them to devote themselves to more meaningful maintenance work.

As a result of the audit, the National Audit Office proposed more detailed recommendations to both the audited local governments and the Minister of Social Protection.

Background Information

Domestic service is one of 13 social services organised by a local government. The target group is people who are unable to cope with everyday tasks at home by themselves. The law lists the activities that the domestic service must include. These include help with heating, cooking, cleaning the housing, washing clothes and buying food and household articles, and running other errands outside the housing.

Good availability of domestic service helps to postpone the need for nursery home service, which is several times more expensive than domestic service. The number of people receiving domestic service has increased by 41% in the last ten years. That is, approximately twice as fast as, for example, the number of elderly people, but at the same time 1.5 times slower than the number of clients in general care homes.

The state has begun to funnel more public funds into the area in order to improve the availability of domestic service. Out of the 39.2-million-euro budget for nursing care reform, about 13 million euros has been allocated in 2023 for the development of services that support living at home. This is approximately twice as much as local governments spent on domestic service in 2022. In 2024, the plan is to allocate 56.7 million euros to local governments to finance long-term care services, including domestic service. Euro funds are also funnelled into the area.

The National Audit Office analysed the problem of availability of domestic service from the point of view of the organisation of work of local governments. Thinking primarily about the increasing costs, the focus was, among other things, on looking for areas where, by improving the activities of local governments, the provision of domestic service could be increased at the expense of available resources.

Audited local governments (10) included Tallinn, city of Tartu, city of Pärnu, city of Narva, city of Maardu, Saaremaa rural municipality, Väike-Maarja rural municipality, Kambja rural municipality, Viru-Nigula rural municipality, and Mulgi rural municipality. They are home to more than 50% of recipients of domestic service.

Priit Simson
Head of Communications of the National Audit Office of Estonia
+372 640 0102
+372 5615 0280
[email protected]
[email protected]
http://www.riigikontroll.ee/

• Posted: 11/29/2023 11:00 AM
• Last Update: 11/29/2023 3:33 PM
• Last Review: 11/29/2023 3:33 PM