A necessary condition for the existence of social service facilities is correctly configured management, sufficient resources, and the efficiency of the operation's own economy. Social services in Slovakia are far from covering the needs of the population and have long faced uneven distribution and a lack of financial resources. Moreover, the legal conditions for the existence and functioning of these important services are constantly changing with changes in political parties at the head of government and with the promotion of various lobbying interests of stakeholder groups (government, state and regional institutions, founders, management, employees, supporters, suppliers, sponsors, volunteers, as well as clients and their loved ones) (1). Meanwhile, each stakeholder declares their primary interest in the client, but in reality the client is often the last priority and, in the worst case, may not even live to receive adequate and appropriate social care.

Introduction

This paper deals with the management and economics of year-round residential social services (2) in social service facilities, such as social care homes (DSS) and facilities for the elderly (ZpS). In other types of social care facilities, management and economics are similar, applied proportionally to the type of activity provided. For the client, it is ideal if they receive social services in facilities of the so-called family type; however, the economics of such a facility may be more financially demanding. Many organizations provide several types of social care for multiple clients, or in combination with healthcare. In general, when an organization provides a mix of social-health or purely social services to a broader clientele, the economics are more efficient, but management is more demanding in ensuring client-oriented care. From the client's perspective, the ideal arrangement is home care or nursing care, where the client remains within their family and in their own environment. It is not always possible to provide such care in the home environment, whether due to an absent or failing family (the social aspect) or the client's dependence on continuous assistance from another person (the health aspect).

Management of Social Services

For the management of any organization, the most important elements are people, their professional qualifications and skills, as well as their commitment to the cause and ability to cooperate with all stakeholders. Selecting the right people and defining their responsibilities and competencies within an appropriate organizational structure is key to successful management. An organization wishing to provide social care services must fulfill the conditions for obtaining a license, which is issued by the relevant self-governing region under Act No. 448/2008 Coll. on Social Services (2), and the launch of a social facility's operation requires meeting hygiene conditions, minimum staffing requirements, and material-technical equipment standards in accordance with the relevant laws.

Minimum staffing constitutes, from a management perspective, the so-called line personnel, who are in direct contact with the client and who provide the main activity of the organization or one of its units — in this case DSS or ZpS. Based on Henry Mintzberg's theory and his concept of organizational structure, which he published in the 1980s (3), in addition to line personnel, the organization has additional support staff and a so-called technostructure. These support units include, besides administration and management: the kitchen, laundry, cleaning, rehabilitation, etc. (figure 1 – Organizational provision of a social service facility).

These support activities can be provided by the organization with its own staff or through subcontracted services, with the decision depending on the size of the organization, the number of clients, and the conditions of operation. For example, a generally valid principle is that the operation of a dining facility is not financially efficient if it serves fewer than 100 diners. However, a specific facility with a larger capacity of diners may not have the space or financial means to establish its own kitchen. Support staff should be encouraged to maximally support line personnel, who are their internal clients, and their satisfaction will be reflected in quality service to the final, i.e., external client, which in the case of social care includes not only the client but also their family and loved ones.

The functioning of the main and support activities of a social service facility should maximize the efficiency and quality of achieving the organization's main goals and objectives in accordance with its mission and Act No. 448/2008 on Social Services (2):

  • Performing professional activities (social counseling, institutional nursing care, social rehabilitation, and others) § 16.
  • Performing service activities (accommodation, meals, cleaning, laundry, ironing, and maintenance of linen and clothing) § 17.
  • Performing additional activities (such as food preparation and distribution, performing essential basic personal hygiene, education, recreational activities, and others) § 18.

The above goals are resource-intensive, primarily in terms of the quality and quantity of professional and auxiliary staff. The set goals are difficult to measure and evaluate at first glance, and therefore the cooperation of a well-functioning team as well as the education and training of staff are extremely important. The service of people working in social facilities is more of a vocation and a mission than mere employment. At the same time, the work of people in the social field is not financially rewarded as it truly deserves.

Economics of Social Services in Slovakia

The average cost per client per day in social service facilities in Slovakia ranges from €20 to €40, depending on the client's level of need for social services, the financial conditions, and the wage level of the required staff in the region where the facility is located. The financing of social services should consist of multiple sources: the client and their family, the state, self-governing authorities, and health insurance companies (sources in italics are those that do not currently exist). Under the currently valid law in Slovakia, each client of a social service facility should receive a financial contribution for dependency from the relevant self-governing authority (at the maximum level VI, this amounts to approximately €10 per day) and a financial contribution for operations (calculated for the given region based on economically justified costs, which amounts to approximately €2–5 per day). If the client were to pay only at the level of their pension, they could contribute on average €10–15 per day (in Slovakia, as of 1 July 2011, the average pension was €366). In practice, self-governing authorities interpret the valid law in their own way, mainly due to a lack of resources. This means that many non-public providers do not receive a contribution for each client, and the contribution for operations is calculated based on the economically justified costs of facilities in the relevant self-governing region or municipality, rather than as a standard cost determined through empirical research of economically justified costs.

The costs of caring for clients of social service facilities are voluntarily allocated resources to ensure quality care. From the perspective of seeking financial efficiency on the cost side, a non-negligible fact is that personnel costs account for 70% of total costs. As mentioned above, people are the most important component of social care, and their financial compensation is already insufficient, making it almost impossible to cut in this area. Other direct costs include meals, laundry, ironing, and costs for other activities. Savings in these areas are possible at the level of deciding whether to perform these activities with in-house employees or through contracted external services.

Possible avenues for further savings lie in indirect costs and energy. Organizations operating social service facilities are frequent applicants for grant calls and projects because, for the reasons mentioned above, ensuring basic operations is itself problematic, let alone financing the purchase and maintenance of equipment or investing in staff education.

Paradoxes (not only) of Social Services

  1. Legislation and self-governing authorities Staffing levels for social care are set by law, and non-compliance with these conditions can result in the loss of a license or financial contributions from the self-governing authority. If a social service provider does not receive a contribution for each client, they are forced to cut costs on staff wages or to burden the client and their family with higher fees.
  2. Clients Almost every patient has paid contributions to social and health insurance throughout their life and is therefore very surprised that they must pay disproportionately for social care. On the other hand, people in Slovakia are not accustomed to paying for care services because they were used to everything being free. It is also paradoxical that clients often transfer their assets to their family, who are unwilling to pay extra for their relative's care. The paradox is that we are able to spend large sums on expensive vacations, clothing, and furnishings, yet are reluctant to pay the people who will take care of us when we are unable to do so ourselves.
  3. Sponsors Paradoxically, the largest sponsors of social service facilities are their own staff (through undervalued wages) and volunteers. This situation, however, is unsustainable when sponsorship is not voluntary but forced by a poor and unjust economic situation. The paradox is that in many respects, the indirect beneficiary of this sponsorship is not the social service facility or the client, but the state and its institutions themselves, which have not created conditions for fair and adequately resourced financing of this care.

Conclusion

Despite the pessimism of this paper and the difficult situation on the ground in social care, there is hope that there are many supporters of social services, for example also within government and state institutions and especially self-governing authorities, who will seek satisfactory solutions in the interest of the target client, as well as Slovak society itself, which demonstrates its maturity and humanity through its ability to care for its elderly, weak, and helpless people.

Ing. Magdaléna Veselská, Dip Mgmt (Open) financial manager and chair of the board of directors of DOM Božieho milosrdenstva, n. o., Ul. Tibora Andrašovana 44, 974 01 Banská Bystrica References

(1) J. Arnold, T. Hope: "Accounting for Management Decisions", 2nd edition, Prentice Hall International (UK) 1990 (2) Act No. NR SR 448/2008 Coll. on Social Services and amending Act No. 455/1991 Coll. on Trade Licensing (Trade Licensing Act) as amended. (3) Henry Mintzberg, Structure in 5's: Designing Effective Organizations, 1983, Prentice Hall United States ISBN 013855479X (4) Act No. NR SR 311/2001 Coll. § 120 Minimum Wage Requirements, paragraphs 3 and 4

The professional monthly journal Sociální služby is the most widely circulated periodical in the field of social services in the Czech Republic. Its publisher is the Association of Social Service Providers of the Czech Republic (APSS ČR), the largest professional organization uniting providers of all types and kinds of social services in the Czech Republic. Its membership base currently comprises more than 720 organizations, representing over 1,600 registered services.

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The journal Sociální služby was established in 2009 through the transformation of the former APSS ČR Newsletter. It is published ten times a year on 36–48 pages in A4 format with a print run of 3,500–4,000 copies for approximately 16,000 readers from among providers, founders, and users of social services, public administration representatives, students, and university educators both in the Czech Republic and in Slovakia.

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