Externe Pflegequalitätsprüfung in den Einrichtungen der stationären Altenhilfe: Ethische Herausforderungen und Klärungsbedarfe im Fokus der Ethikberatung

Care quality audits in accordance with section 114 ff SGB (Sozialgesetzbuch) XI and inspections by the FQA (Fachstelle für Pflege- und Behinderteneinrichtungen—Qualitätsentwicklung und Aufsicht; formerly the home supervisory authority) were resumed once the pandemic subsided. Despite the introduction of a new inspection tool, this continues to lead to confusion and ethical problems in practice. Starting in summer 2021, this was the subject of a consultation process in the “Hilfe im Alter” ethics advisory board and led to a discussion in the spring 2022 meeting with representatives of the StMGP (Staatsministerium für Gesundheit und Pflege) and MD (medizinischer Dienst) Bayern as well as to a consensus paper that addressed the objectives of the audit, the processes involved in the facilities, and their effects on people in need of care and care staff from an ethical point of view.

Even if the fundamental necessity of a quality audit is not called into question, the effort involved in collecting indicators, the challenge of the expert discussion and the way in which the results are formulated must continue to be critically discussed and further developed. The organizational ethical relevance of the care quality assessment is evident both in terms of its structural anchoring in the facility’s own quality management system and in terms of the need for a culture of participation by those affected.

This once again demonstrates how important the ethics advisory board’s concern to “turn those affected into participants” is for the employees and the culture of the facilities, but also for all other levels of care and political decision-making that are responsible for making decisions in this regard.