Info franceinfo How the government wants to fight against mistreatment of vulnerable adults, two years after the scandal in nursing homes

Two years after the Orpea nursing home scandal, the tremors are still being felt. On Monday March 25, the government presented a national strategy to combat abuse, focusing primarily on dependent elderly or disabled adults. This three-year plan marks “a general mobilization, which must continue and expand”assures franceinfo Fadila Khattabi, the Minister for Health in charge of the elderly and people with disabilities.

“Mistreatment is an invisible subject”Who “has not yet found a public response established”, had alerted, last year, the actors brought together by the executive within the States General of mistreatment. This lack of support “is perceived as an abandonment of public authorities”at home as well as in nursing homes and establishments for people with disabilities, they emphasized.

A first response was provided in the proposed “aging well” law, which could be definitively adopted by Parliament on Wednesday, with the support of the executive. The strategy unveiled Monday on franceinfo integrates certain measures of the future law and “seals our desire to make the fight against this scourge a priority object of our policies”, assures Fadila Khattabi. Here are the main axes of the plan.

Inspect all places welcoming disabled people

In March 2022, after the revelations of journalist Victor Castanet on the Orpea group, the government promised to control each of the 7,500 nursing homes in France in two years. The executive intends to replicate the operation, this time targeting some 9,300 social and medico-social establishments welcoming people with disabilities. Medical-educational institutes, specialized reception centers or even accommodation centers for disabled workers will thus be subject to a “unannounced visit” or another type of control from 2025 to 2030.

For the moment, almost half of accommodation establishments for dependent elderly people still need to be inspected. “The objective is of course to complete this operation, with all nursing homes controlled by the end of the year 2024″, promises the delegate minister. The executive then intends to maintain this monitoring of nursing homes over the long term, while extending it to establishments dedicated to disability. For this, ten additional inspector positions must be created, in addition to the 120 post-Orpea recruits, or barely more than one hire per department for two years.

Extend checks on professionals’ criminal records

Until now, unlike employees and volunteers in nursing homes and other reception structures, personal service professionals (home helpers, home cleaning employees, etc.) were not subject to a ban on working in the event of final conviction for a crime or misdemeanor. The government intends to integrate them into this framework, as provided for in the proposed “aging well” law.

“We are resolutely giving ourselves the means to achieve ‘zero tolerance’ in the face of abuse.”

Fadila Khattabi, Minister Delegate for Elderly and Disabled People

at franceinfo

To reduce the risk of contact between vulnerable people and people suspected of sexual or violent offenses, the sharing of information on indictments and non-final convictions will be facilitated. A “certificate of good repute” can be given to anyone who requests it. She will thus be able to guarantee her employer that she is not implicated in a sexual or violent affair. Presentation of this certificate will not be obligatory. On the other hand, an employer alerted to an indictment or conviction contested on appeal may suspend or even dismiss the worker concerned.

Facilitate the freedom of victims to speak out

“This strategy aims to strengthen people’s ‘power to act’ in the face of situations of mistreatment”, underlines Fadila Khattabi. The effort begins with better information and better listening to the most vulnerable, often those most reluctant to denounce poor treatment. By the end of 2025, all social and medico-social establishments will have to offer their residents with expression difficulties tools of expression. “alternative and improved communication”. With this use of pictograms, Falc notebooks (easy to read and understand) or specialized software, the executive hopes to facilitate the reporting of abuse, for example by non-verbal autistic people.

To help victims record events and store possible evidence, the Mémo de vie digital platform developed by the France Victimes federation will be made more accessible to people with disabilities. Usable on computer, tablet and smartphone, this free and secure tool can facilitate the creation of a possible complaint file.

“The most vulnerable litigants are also those who are most reluctant to file a complaint”, points out the Minister for the Elderly and People with Disabilities. For “facilitate and encourage their path towards complaint and legal action”a training plan for law enforcement officers in ill-treatment and “specificities” vulnerable adults will be initiated. It should enable police officers and gendarmes to better adapt to this public, but also to better identify weak signals of mistreatment (defined in law as any “gesture, word, action or lack of action” harming a fragile person in the context of a “relationship of trust, dependence, care or support”).

Create an “abuse” unit in each department

As provided for in the “aging well” bill, a cell “responsible for collecting, monitoring and processing reports of mistreatment” will be implemented in each department. Led by regional health agencies, this body “will constitute a single entry point so that anyone can easily report a risky situation”, explains Fadila Khattabi. It will be specifically aimed at vulnerable adults, in parallel with the “cells for collecting concerning information” which already exist for children in danger.

Another new feature: people subject to professional secrecy (caregivers, legal representatives, bankers, etc.) will be able to report acts of mistreatment without risk of disciplinary sanction. Actors in the medico-social sector will be made aware by law enforcement of the importance of reporting crimes. The departmental unit may be contacted by professionals who witness mistreatment, but also by relatives of a resident or hospitalized patient, whose visiting rights will now be strengthened in the law.

On the other hand, faced with the lack of manpower in the sector of care and assistance for people, the proposal of the States General aimed at “define a minimum supervision ratio” in social and medico-social establishments was not included in the strategy. “Mistreatment is not just a question of numbersdefends the ministry. By imposing a ratio, we should have closed all places that were short of staff at one time or another. We can’t afford it.”