Orpea group’s response to Investigate Europe

The average staffing ratio in ORPEA Care homes in France is 0.7 FTE (Full Time Equivalent) per resident in 2021, which is more than in line with the average observed in the sector.

In any case, we do not operate on the basis of a quota but rather by analysing needs to ensure that the overall staffing level is adapted to the needs of the residents in each facility, depending on their autonomy and state of health. The composition of the teams in each facility was also in line with the commitments agreed with the authorities under the tripartite agreements, and is still in line with those facilities that are still governed by such agreements.

82% of the ORPEA Group’s employees in France have permanent contracts and 83% of them are full-time; this reflects a desire to stabilise and secure jobs within the company, in a global context of shortage of qualified healthcare personnel.

Indeed, the health sector (public, private, associative, etc.) is experiencing a chronic shortage of caregivers, particularly among nurses and care assistants. The short-term training and recruitment needs are considerable. Annual needs are estimated at 100,000 people in public and private hospitals, and 200,000 if the needs of the medico-social sector are included.

Generally speaking, our policy is to replace absences; and in any event, the Group does not give instructions not to replace positions. Our desire is to ensure the proper care and safety of residents in all our facilities with the appropriate resources.

It should be noted that we may need to reinforce our teams to deal with a particular situation. In this respect, in the context of the Covid crisis that you mention in your message, we have been led, depending on the epidemic situation in each care home, to increase the time spent by the Coordinating Doctor and/or the care teams, but also the hotel teams (both to ensure the maintenance of the establishment and to serve meals in the rooms or in the living units or to reorganise the sectors). Night staff were also reinforced in many establishments.

In addition, mainly during the first wave of the epidemic, employees from headquarters came to assist the teams in the field: for administrative profiles, to provide secretarial and hotel services, to organize video conferences between residents and their families, or to provide logistics and transport personal protective equipment; and for nursing profiles, depending on their degree. On a very occasional basis, a caregiver from a clinic was able to provide a replacement, for example.

On the other hand, it is certain that when a caregiver is unexpectedly absent from the schedule on the same day, it can sometimes be complicated (or even unsuccessful) to immediately replace the absent staff, given the shortage of health professionals mentioned above, even though the Directors of the Establishment are doing their utmost to find replacement solutions, both to guarantee the care of the residents and to maintain the number of staff enabling our employees to work in the best possible conditions.

In the context of a replacement, there is an access code to the care file for temporary workers, which is relayed by the nursing team in place. In addition, like any employee, the temporary worker must have the care plan for each resident assigned to him or her on the cart, with details for the entire day, in order to ensure that the care offered is secure. In this way, ORPEA provides the necessary resources for each person to carry out their duties.

Furthermore, the Group does not organize a system aimed at paying the salaries of caregivers in one residence by using the funds allocated to another. We are not aware of any such practices.

Furthermore, the Company does not refuse to hire caregivers; on the contrary, we seek to recruit qualified caregivers by all means, and this, on permanent contracts.

And it would make no sense to refuse because these positions are financed within the framework of the “care” (covered by the health insurance) and “dependency” (covered by the departments) allocations issued by the Authorities. Private long-term care facilities are subject to strict controls on their expenditures: each facility produces an annual detailed statement of expenditures, including personnel costs, which makes it possible to assess the compliance of the expenditures incurred with the amounts granted by the authorities.

To this end, each expense is justified, including of course personnel costs, which are declared on the basis of the monthly payroll.

It should be noted that the Authorities may request any supporting documents (including a schedule of names, a copy of the diploma of the nursing staff, pay slips, etc.), whether in the context of a management dialogue or in the context of an inspection; and we keep these elements permanently at their disposal.

As far as the auxiliary employees  are concerned, some of them, depending on their experience, may be asked to act as an “assistant nurse” in tandem with a qualified professional, in order to carry out tasks related to the resident’s living environment (cleaning his or her room and bathroom, assisting the assistant nurse with toileting, distributing meals, etc.). The auxiliaries employed by the Group’s EHPADs (care homes) are regularly trained in the same modules as those given to assistant nursse and educational and social assistants (formerly AMP).

This may be necessary in view of the recruitment difficulties linked to the penurious context mentioned above.

In accordance with the regulations, these auxiliaries are paid from the care and dependency allowances as soon as they enter a nursing assistant diploma program. ORPEA also encourages its employees to develop their skills, in particular through the Validation of Acquired Experience (368 employees registered at the end of 2021). The Group has two accredited schools for nurses assistants (IFAS) that train 250 students a year in France for the professions of nurse and family assistant, thus helping employees to develop their career plans.

The other auxiliaries who have not yet started their training, but who are acting as nurse assistant, are funded concurrently by the care and dependency allocations and are clearly identified in the reports sent to the authorities each year.

All other auxiliaries are paid from the accommodation and dependency package, in accordance with their missions and the regulations in force.

Regarding the tasks assigned to the nursing assistants, given the difficulty in recruiting qualified professionals, it is obvious that they are hired to accomplish the tasks assigned to them.

Regarding the role of a housekeeper in one of our establishments, there must be a simple confusion: every weekend, in each ORPEA care home, a member of the establishment’s management team is present to accompany the teams and receive or respond to visiting families. As part of this on-call duty, the employee on duty ensures that the facility is running smoothly.

Lastly, with regard to management, ORPEA has always encouraged internal promotion by supporting its employees through training courses, including those leading to a diploma, which shows the consideration given to each individual and the desire to value skills, contrary to what seems to be conveyed.

In the Group’s establishments in France, 50% of coordinating nurses are promoted from within, as are 54% of establishment directors and 96% of regional directors.