SOCIAL CARE FACILITIES MANAGEMENT AUDIT AT THE RESIDENTIAL CARE HOME FOR THE ELDERLY IN MALAYSIA: A CASE STUDY OF RUMAH SERI KENANGAN WENDY LIM WEN XIN A Thesis Submitted in Partial Fulfilment of the Requirement for the Award of the Degree of Master of Science in Real Estate and Facilities Management Faculty of Technology Management and Business Universiti Tun Hussein Onn Malaysia (UTHM) SEPTEMBER 2015
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SOCIAL CARE FACILITIES MANAGEMENT AUDIT AT THE
RESIDENTIAL CARE HOME FOR THE ELDERLY IN MALAYSIA:
A CASE STUDY OF RUMAH SERI KENANGAN
WENDY LIM WEN XIN
A Thesis Submitted in Partial Fulfilment of the Requirement for the Award of
the Degree of Master of Science in Real Estate and Facilities Management
Faculty of Technology Management and Business
Universiti Tun Hussein Onn Malaysia (UTHM)
SEPTEMBER 2015
vi
ABSTRACT
By the year 2030, it is expected that 15 per cent of the Malaysian population will be
aged 60 years old and above. Reports show that the elderly in Malaysia for the
coming decades are likely to be living alone or ending up in the welfare homes. The
reliance of elderly on the Care Home for the Elderly (CHfE) has clearly shown an
increase trend over the years. CHfE which provided accommodation, meals and
personal care will be the alternative living arrangement for the elderly in Malaysia
for the coming years. However, the quality of the social care service delivery varied
for each care homes due to the absence of common standards regarding the
establishment and running of CHfE in Malaysia. Hence, the best way to secure the
CHfE in Malaysia from future liability is to conduct an effective Facilities
Management Audit (FMA). However, up to this moment, there are still no FMA
being conducted to audit the standards delivered at the public RCHfE in Malaysia.
Interview sessions have been conducted with the care homes managers of RSK in
Malaysia and officers from Department of Social Welfare (DSW) Malaysia. It aimed
to understand the current social care practices being delivered at the RCHfE in
Malaysia. The findings of the study indicated that there are no official formal
standards being established to guide the operational facilities management at the
RCHfE in Malaysia. Regrettably, the absence of formal standards has led to no
official structured inspection and auditing process available at the RCHfE in
Malaysia. Thus, the researcher had proposed an auditing guideline for the operational
facilities management at the RCHfE in Malaysia based on the elements in National
Minimum Standards (NMS): Care Homes for Older People in United Kingdom.
vii
ABSTRAK
Menjelang tahun 2030, populasi penduduk Malaysia yang berumur 60-an dan ke atas
dijangkakan akan mencecah 15 peratus daripada jumlah populasi negara. Laporan
menunjukkan bahawa golongan besar warga emas di Malaysia akan hidup
bersendirian atau menetap di rumah kebajikan dalam masa 10 tahun yang akan
datang. Warga emas didapati semakin bergantung kepada rumah kebajikan orang tua.
Institusi rumah kebajikan yang menyediakan penginapan, makanan dan kebajikan
orang tua dijangkakan akan menjadi tempat tinggal pilihan alternatif untuk warga
emas di Malaysia pada masa akan datang. Namun begitu, kualiti perkhidmatan
penjagaan sosial yang disediakan untuk warga emas adalah berbeza mengikut
institusi rumah kebajikan kerana tiada piawaian umum yang wujud untuk penubuhan
dan pengurusan rumah kebajikan orang tua di Malaysia. Maka itu, pelaksanaan Audit
Pengurusan Fasiliti yang efektif dapat menjamin rumah kebajikan orang tua daripada
liabiliti. Sehingga kini, masih tiada Audit Pengurusan Fasiliti yang telah
dilaksanakan untuk mengaudit piawaian yang disediakan oleh rumah kebajikan orang
tua di Malaysia. Sesi temu bual telah dijalankan bersama pengurus Rumah Seri
Kenangan di Malaysia dan pegawai di Jabatan Kebajikan Masyarakat Malaysia. Ia
bertujuan untuk memahami amalan semasa penjagaan sosial warga emas di rumah
kebajikan orang tua di Malaysia. Hasil kajian menunjukkan bahawa tiada piawaian
umum yang telah disediakan untuk pengurusan fasiliti (operasi) di rumah kebajikan
orang tua di Malaysia. Oleh itu, pemeriksaan dan pengauditan telah dijalankan secara
tidak formal di rumah kebajikan orang tua di Malaysia. Kesimpulannya, penyelidik
telah mencadangkan satu garis panduan pengauditan untuk pengurusan fasiliti
(operasi) di rumah kebajikan orang tua di Malaysia berdasarkan elemen dalam
National Minimum Standards (NMS): Care Homes for the Older Person di United
Kingdom.
viii
CONTENTS
TITLE i
DECLARATION ii
DEDICATION iii
ACKNOWLEDGEMENTS iv
ABSTRACT vi
CONTENTS viii
LIST OF TABLES xiv
LIST OF FIGURES xvii
LIST OF ABBREVIATIONS AND SYMBOLS xx
LIST OF APPENDICES xxiv
CHAPTER 1 INTRODUCTION
1.1 Preamble 1
1.2 Research Background 3
1.3 Problem Statements 6
1.4 Research Questions 9
1.5 Research Aims 9
1.6 Research Objectives 10
1.7 Research Scope and Limitations of the Study 10
ix
1.8 Importance of the Research 11
1.8.1 The Elderly in Malaysia 11
1.8.2 Government of Malaysia 11
1.8.3 Providers of the Residential Care Home for
the Elderly (RCHfE) in Malaysia 12
1.8.4 Academics 12
1.9 Methodology 12
1.10 Organisation of the Thesis 13
1.10.1 Chapter 1: Introduction to the Research 13
1.10.2 Chapter 2: Literature Review 13
1.10.3 Chapter 3: Research Methodology 13
1.10.4 Chapter 4: Data Analysis and Result 14
1.10.5 Chapter 5: Conclusion and Recommendations 14
1.11 Summary of the Chapter 16
CHAPTER 2 LITERATURE REVIEW
2.1 Introduction to the Chapter 17
2.2 Background of the Elderly 18
2.2.1 Stages of Human Development
(Human Life Cycle) 18
2.2.2 Definition and Context: The Elderly 19
2.2.3 The Elderly in Malaysia 21
2.3 The Elderly Living Arrangements in Malaysia 24
x
2.4 Social Care Delivery for the Elderly 28
2.4.1 Definition and Context: Social Care Services 28
2.4.2 Social Care Delivery Users: The Elderly 29
2.4.3 Social Care Theories on Elderly’s Needs 29
2.5 Social Care Delivery in Malaysia 32
2.5.1 Ministry of Women, Family and Community
Development (MWFCD) 33
2.5.2 Department of Social Welfare (DSW) Malaysia 34
2.6 Policies for Social Care Practice Delivering in Malaysia 36
2.6.1 Law and Regulations 41
2.6.1.1 Care Centres Act 1993 42
2.6.1.2 National Policy for Older Persons 42
2.6.1.3 Plan of Action for Older Persons 43
2.6.1.4 National Health Policy for Older Persons 44
2.6.2 Sources of Social Care Practices 45
2.6.3 Standards 46
2.6.4 National Minimum Standards (NMS) 50
2.7 Long Term and Short Term Care for the Elderly 52
2.8 Provision of Care Home for the Elderly in Malaysia 54
2.8.1 Residential Care Home for the Elderly (RCHfE) 55
2.8.2 Nursing Care Home for the Elderly (nCHfE) 56
2.8.3 Day Care Centre (DCC) 57
2.9 Care Home Fees and Procedures 57
2.10 Responsibility of the Care Home Providers at Residential
Care Home for the Elderly (RCHfE) 59
2.11 Facilities Management (FM) 61
xi
2.12 Audit 64
2.12.1 What is Audit? 64
2.12.2 Types of Audit 65
2.12.3 Advantages and Disadvantages of Conducting
Audit 66
2.12.4 Facilities Management Audit (FMA) 66
2.12.5 Process of Audit 67
2.13 Summary of the Chapter 69
CHAPTER 3 RESEARCH METHODOLOGY
3.1 Introduction to the Chapter 71
3.2 Research Methodology 71
3.3 Types of Research Approach 72
3.3.1 Quantitative Approach 73
3.3.2 Qualitative Approach 73
3.4 Problem Statement 73
3.5 Determination of Research Objective and Scope 74
3.6 Research Design and Adopted Methodology 76
3.7 Research Area 76
3.8 Research Framework 78
3.9 Literature Review 79
3.10 Data Collection 79
xii
3.11 Research Instrument: Interview 80
3.11.1 Types of Interview 80
3.11.2 Semi-Structured Interview 81
3.11.3 Justifications to Conduct Interview Sessions 81
3.11.4 Research Design: Interview 83
3.11.5 Interview Process 84
3.12 Data Analysis 85
3.13 Summary of the Chapter 86
CHAPTER 4 DATA ANALYSIS AND RESULTS
4.1 Introduction to the Chapter 87
4.2 Data Collection 87
4.2.1 Interview Sessions 88
4.3 Interview Sessions Results and Analysis 89
4.3.1 Research Analysis Phase One (1) 121
4.3.2 Research Analysis Phase Two (2) 131
4.3.2.1 Discussion on Research Question (1) 131
4.3.2.2 Discussion on Research Question (2) 137
4.3.2.3 Discussion on Research Question (3) 141
4.3.2.4 Discussion on Research Question (4) 147
4.3.2.5 Discussion on Research Question (5) 152
4.3.3 Discussion on Research Objective (5) 155
4.4 Summary of the Chapter 167
xiii
CHAPTER 5 CONCLUSION AND RECOMMENDATIONS
5.1 Introduction to the Chapter 168
5.2 Research Summary 169
5.3 Research Limitations 179
5.4 Recommendations for Future Research 180
5.4.1 Conducting Similar Studies with Other Provision
of Residential Care Home for the Elderly
(RCHfE) in Malaysia 180
5.4.2 Conducting Social Care Facilities Management
Audit (SCFMA) at the Residential Care Home
for the Elderly (RCHfE) in Malaysia Based on
the Proposed Checklist 180
5.5 Conclusion 181
REFERENCE 182
APPENDICES
VITA
xiv
LIST OF TABLES
TABLE TITLE PAGE
2.1 Elderly Demographic Pattern in Malaysia 23
2.2 Population by Age Group (Elderly) in Year 2006 – 2010 24
2.3 Factors Affecting Future Living Arrangement of Elderly
People in Malaysia towards Residential Care Home for the
Elderly (RCHfE) 26
2.4 Number of Elderly Care Homes in Malaysia from Year
2002 – 2013 26
2.5 Number of Inmates at the Rumah Seri Kenangan (RSK) and
Rumah Ehsan in Malaysia from Year 2002 – 2013 27
2.6 Housing Related Support Needs for Elderly 32
2.7 Background of the Ministry of Women, Family and Community
Development (MWFCD) in Malaysia 33
2.8 Background of the Department of Social Welfare (DSW)
in Malaysia 35
2.9 Chronologies of Social Care Policies for Older People in
Malaysia 36
2.10 Sources of Social Care Practices 45
2.11 Ranking of the End-of-Life Care across the World 48
2.12 National Minimum Standards (NMS) for Care Homes for
Older People in United Kingdom 50
2.13 Location of Senior Citizen Activity Centre (PAWE) in Malaysia 57
xv
2.14 Elderly Eligibility to Reside in Rumah Seri Kenangan (RSK) in
Malaysia 58
2.15 Operation, Management and Supervision at the Care Centres
in Malaysia 60
2.16 Summarised Definitions on Facilities Management (FM) 61
3.1 Summary of the Research Objectives and Adopted
Methodology 75
3.2 Rumah Seri Kenangan (RSK) in Malaysia 76
3.3 Typologies of Interview Methods 80
3.4 Summarised Advantages of Interview 81
3.5 Research Design for Interview 83
3.6 Schedule of Interview 85
4.1 Category of Interview Set (1) 88
4.2 Category of Interview Set (2) 88
4.3 Particulars of the Respondents 89
4.4 Interview Outcomes with Care Home Managers of
Rumah Seri Kenangan (RSK) in Malaysia 90
4.5 Interview Outcomes with Officers from State and Headquarter
of Department of Social Welfare (DSW) Malaysia 102
4.6 Formal Standards Used to Govern the Provision of
Residential Care Home for the Elderly (RCHfE) in Malaysia 132
4.7 Informal Standards Used to Govern the Provision of
Residential Care Home for the Elderly (RCHfE) in Malaysia 133
4.8 Elements of Rules for the Management of Elderly Persons
Home 1983 135
4.9 Instruments Used to Conduct Social Care Facilities
Management Audit (SCFMA) at the Residential Care Home
for the Elderly (RCHfE) in Malaysia 141
xvi
4.10 Example of Informal Checklist for Cleanliness Evaluation
at Rumah Seri Kenangan (RSK) in Malaysia 144
4.11 Set of Forms Used to Asset Management at Seri Kenangan
Home (RSK) in Malaysia 145
4.12 Social Care Facilities Management Audit (SCFMA) at the
Residential Care Home for the Elderly (RCHfE) in Malaysia 148
4.13 Elements for the Acts and Regulations in United Kingdom
and Malaysia 156
4.14 Comparison of Elements for the Acts and Regulations in
Malaysia with National Minimum Standards in United Kingdom 158
4.15 Proposed Checklist for Operational Facilities Management
(OFM) at the Residential Care Home for the Elderly (RCHfE)
in Malaysia 163
xvii
LIST OF FIGURES
FIGURE TITLE PAGE
1.1 Total Population of Malaysia 4
1.2 Research Framework 15
2.1 Human Life Cycle 18
2.2 Physical Appearance of an Elderly 19
2.3 Average Annual Population Growth Rate in Malaysia 21
2.4 Malaysia Population Pyramid – Year 2000 and 2010 21
2.5 Malaysia Population Pyramid – Year 2010 and 2040 22
2.6 Number of Inmates at the Rumah Seri Kenangan (RSK) in
Malaysia from Year 2002 – 2013 27
2.7 Number of Inmates at the Rumah Ehsan (RE) in Malaysia
from Year 2002 – 2013 27
2.8 Classifications of Social Care Service Users in Malaysia 29
2.9 Maslow’s Theory for Elderly Needs 31
2.10 Key Agencies in the Ministry of Women, Family and
Community Development (MWFCD) in Malaysia 34
2.11 Types of Social Care Services by Department of Social
Welfare (DSW) Malaysia 35
2.12 Strategies for Plan of Action for Older Persons 43
2.13 Guiding Principles and Strategies of National Health Policy
for Older Persons 44
xviii
2.14 Hierarchy for Sources of Social Care Practices 46
2.15 Category of Standards 46
2.16 Types of Care Services Available in United Kingdom 53
2.17 Range of Care Services for Long Term Care Home (LTCH) 53
2.18 Institutional Care Provision in Malaysia 55
2.19 Location of Rumah Seri Kenangan (RSK) in Malaysia 56
2.20 Location of Rumah Ehsan (RE) in Malaysia 56
2.21 Process of Application for Admission to the Rumah Seri
Kenangan (RSK) in Malaysia 59
2.22 Concepts of Facilities Management (FM) 63
2.23 Process of Audit 68
3.1 Location of Rumah Seri Kenangan (RSK) at Peninsular of
Malaysia 76
3.2 Research Framework 78
3.3 Online Application for MYRESEARCH 84
4.1 Respondents of the Interview Session 89
4.2 Main Departments at Rumah Seri Kenangan (RSK) in Malaysia 122
4.3 Schedule of Duty for the Staffs at Rumah Seri Kenangan (RSK)
in Malaysia 123
4.4 In-House Activities and Out-Source Activities at the Case
Study Rumah Seri Kenangan (RSK) in Malaysia 123
4.5 Respondents from State and Headquarter of Department of
Social Welfare (DSW) Malaysia 126
4.6 Organisation Chart for State Department of Social Welfare
(DSW) Malaysia 126
4.7 Organisation Chart for Headquarter Department of Social
Welfare (DSW) Malaysia 127
4.8 Ways of Communicating Within the Management Level 128
xix
4.9 Division In-Charged for the Residential Care Home for the
Elderly (RCHfE) in Malaysia 130
4.10 Government’s Supervision for the Residential Care Home for
the Elderly (RCHfE) in Malaysia 131
4.11 Types of Standards 132
4.12 Example of Sticker Tag Attached on Government’s Asset 145
4.13 Process of Conducting Social Care Facilities Management Audit
(SCFMA) at the Residential Care Home for the Elderly (RCHfE)
in Malaysia 151
5.1 Research Question 1 (RQ 1) and Required Research Objective 169
5.2 Research Question 2 (RQ 2) and Required Research Objective 169
5.3 Professionals Involved in Documenting Acts to Regulate
Residential Care Home for the Elderly (RCHfE) in Malaysia 171
5.4 Research Question 3 (RQ 3) and Required Research Objective 172
5.5 Instruments Used to Conduct Social Care Facilities Management
Audit (SCFMA) at the Residential Care Home for the Elderly
(RCHfE) in Malaysia 173
5.6 Research Question 4 (RQ 4) and Required Research Objective 173
5.7 Process of Social Care Facilities Management Audit (SCFMA)
at the Residential Care Home for the Elderly (RCHfE) in Malaysia 175
5.8 Research Question 5 (RQ 5) and Required Research Objective 175
5.9 Elements of National Minimum Standards (NMS): Care Homes
for Older People in United Kingdom (UK) 176
5.10 Research Limitations 179
xx
LIST OF ABBREVIATIONS AND SYMBOLS
1M4U - 1Malaysia for Youth
1MFC - 1Malaysia Family Care
BIFM - British Institute of Facility Management
BOS - Blue Ocean Strategy
BSI - British Standard Institution
BWA - Bernard Williams Associates
CCAC - Community Care Access Centre
CHfE - Care Home for the Elderly
CMS - Client Management System
CQC - Care Quality Commissions
CSCI - Commission of Social Care Inspection
CSR - Corporate Social Responsibility
CWC - Central Welfare Council Peninsular Malaysia
DBD - Desa Bina Diri
DCC - Day Care Centre
DCS - Day Care Services
DoH - Department of Health
DSW - Department of Social Welfare
EIU - Economist Intelligence Unit
xxi
ESCAP - Economic and Social Commission for Asia and the Pacific
FM - Facilities Management
FMA - Facilities Management Audit
FMAA - Facility Management Association of Australia
HAWA - Department if Women Affairs (Malay: Hal Ehwal Wanita)
IFMA - International Facility Management Association
ISM - Malaysia Social Institute
ISO - International Organisation for Standardisation
JKR - Public Works Department Malaysia
(Malay: Jabatan Kerja Raya)
JPW - Department of Women Development
(Malay: Jabatan Pembangunan Wanita)
KPKM - Malaysian Population and Family Survey
(Malay: Kajian Penduduk dan Keluarga Malaysia)
KPKT - Ministry of Urban Wellbeing, Housing and Local Government
(Malay: Kementerian Kesejahteraan Bandar, Perumahan dan
Kerajaan Tempatan)
LA - local authority
LPPKN - National Population and Family Development Board
(Malay: Lembaga Penduduk dan Pembangunan Keluarga
Negara Malaysia)
LTCH - Long Term Care Home
MAKPEM - Majlis Kebajikan dan Pembangunan Masyarakat Kebangsaan
Malaysia
MIDEF - Malaysian Institute of Defence and Security
MIER - Malaysian Institute of Economic Research
MNUSD - Ministry of National Unity and Social Development
MoH - Ministry of Health
xxii
MOU - Memoranda of Understanding
MWFCD - Ministry of Women, Family and Community Development
MWFD - Ministry of Women and Family Development
MyBN - My Beautiful Neighbourhood
MYR - Ringgit Malaysia
NACSCOM - National Council of Senior Citizens Organisation Malaysia
NBOS - National Blue Ocean Strategy
nCHfE - Nursing Care Home for the Elderly
NCW - National Council of Welfare
NCWSDM - National Council of Welfare and Social Development Malaysia
NFP - National Family Policy
NGO - Non-Governmental Organisation
NHS - National Health Services
NMS - National Minimum Standards
NPFDB - National Population and Family Development Board
NPOC - National Policy for Older Citizens
NSP - National Social Policy
OFM - Operational Facilities Management
PAWE - Senior Citizen Activity Centre
(Malay: Pusat Aktiviti Warga Emas)
PbRCHfE - Public Residential Care Home for the Elderly
PTWEN - Plan of Action for Older Persons
(Malay: Pelan Tindakan Warga Emas Negara)
QMS - Quality Management System Standards
RCHfE - Residential Care Home for the Elderly
RE - Rumah Ehsan
xxiii
RICS - Royal Institution of Chartered Surveyors
RO - Research Objective
RQ - Research Question
RSK - Rumah Seri Kenangan
RTB - Tunas Budi Home (Malay: Rumah Tunas Budi)
RTC - Rural Transformation Centres
SCFM - Social Care Facilities Management
SCFMA - Social Care Facilities Management Audit
SOP - Standard Operating Procedure
SSM - Companies Commission of Malaysia
(Malay: Suruhanjaya Syarikat Malaysia)
STCH - Short Term Care Home
SUHAKAM - Human Rights Commission of Malaysia
UK - United Kingdom
UN - United Nations
UPM - Universiti Putra Malaysia
UTC - Urban Transformation Centres
WHO - World Health Organisation
WPO - World Population Organisation
WOKU - Division of Person with Disabilities
WTK - Unit of Senior Citizen and Family
xxiv
LIST OF APPENDICES
APPENDIX TITLE
A Interview Set (1)
B Interview Set (2)
C Registration Form for Registering Residential Care Home
for the Elderly (RCHfE) in Malaysia
D KEW.PA-10 (Examination Report for Capital Asset)
E KEW.PA-11 (Examination Report for Inventory)
CHAPTER 1
INTRODUCTION TO RESEARCH
1.1 Preamble
“Old age is the most unexpected of all the things that happen to a man.”
Leon Trotsky (1879 – 1940)
The world is facing a situation without precedent: We will soon encounter an
unbalance situation when there will be more older people (elderly) than children and
more people at extreme old age than ever before. As both the proportion of elderly
and the length of life increase throughout the whole world, it leads to an issue called
aging. For the past 25 years, politicians, academics, and the laypeople have been
discussing about the fact that the world’s population is aging (Wacker & Roberto,
2011). The year 2000 marked the first time ever in human history that the number of
elderly has reached 600 million people and the number is expected to climb well into
the middle of this century to a projected 2 billion of elderly people (United Nations,
2007). Virtually across all countries, with the exception of Africa, have experienced
or are on the verge of experiencing a marked growth in their aging population.
Today – in Malaysia and elsewhere, there are more elderly people in the
population than ever before. World Population Organisation (WPO) of the United
Nations (UN) states that when the population at the age of 60 or above in a certain
2
country reached for at least 10 per cent of the total population, or the population at
the age of 65 or above accounts 7 per cent in the whole population, it can be defined
that the whole population is aging and this country or region has become aged