Saxony: Lack of skilled workers in nursing

Werdau/Leipzig. Klaus Irmscher walks through the glass door of the nursing home on Zwickauer Strasse as if it were the most natural thing in the world. Just as he always did when he visited his mother, who has since passed away, and then his brother and sister-in-law. There is a small bar right in the entrance area. On the tables are vases of fresh carnations, color-coordinated with the purple upholstery of the chairs. Irmscher celebrated his brother’s 90th birthday here: “We all sat at a long table,” says the 86-year-old. That is over now.

The nursing home is located just outside Werdau, a log building with a park and fountain. There is room for 83 residents, but the occupancy rate has recently been far below that. Until recently, 29 people lived in the house. At the end of April, the operator, the German Red Cross (DRK), gave them notice to vacate.

They ask that the transfer to another facility be carried out “as quickly as possible.” All rooms must be empty by June 30 at the latest. Klaus Irmscher calls this “irresponsible.” People cannot be treated like this.

Despite personal and written inquiries, the DRK does not want to comment. However, the LVZ has the letter of termination to the residents. It states: The company feels compelled to take this step out of responsibility towards its residents. “Due to a massive shortage of nursing staff and nursing assistants (…) it will no longer be possible to guarantee the provision of nursing and care services in the future.”

It does happen that nursing homes reduce capacity due to a lack of staff, close beds and private providers file for bankruptcy. It is unusual that residents have to be laid off at such short notice. And so the question arises: is the capitulation in Werdau an alarm signal? Is the already tense situation in Saxony’s nursing care landscape getting worse?

In Werdau, several homes compete for skilled workers

The number of people in need of care in Saxony has been rising for years – and now more than previously thought. In 2019, experts predicted that there would be 282,504 people in need of care by 2035. This number has already been exceeded. More than 311,000 people in Saxony are currently dependent on support.

Most are cared for at home by relatives. In many cases, an outpatient care service helps. 48,000 people are accommodated in inpatient care. The need in this area will increase massively, especially in places where there is hardly any immigration and the population is getting older.

In Werdau, a town with 21,000 inhabitants, they actually seemed well prepared for this: In addition to the German Red Cross home, there are three other homes in the town. Two are privately run, one is run by a non-profit organization. And so Klaus Irmscher’s brother and sister-in-law were able to move into the “Haus am Brühl” after being laid off a week and a half ago. Geraniums are blooming on the small balconies. Irmscher hasn’t been inside yet. He’s heard it’s quite nice.

The good infrastructure in Werdau is a blessing for relatives who needed a replacement as soon as possible after the termination. However, the homes are now competing for fewer and fewer nursing staff. One home manager sums it up: “Many homes, few staff.” Actually, she could take in even more people, there are enough rooms. But they remain empty.

When the first rumors about the situation in the Red Cross home began to circulate, the other facilities hoped that not only residents but also staff would move to them. And some actually decided to come. But there could have been even more.

Demand planning and reality are drifting further and further apart. And this is the case throughout Saxony. A large proportion of the inpatient nursing homes in the state are run by private providers. Anyone who tries to fill vacancies with temporary workers is now paying so much that it is hardly worth it anymore, as an industry expert reports.

If the beds are empty, the operator is left with the investment costs. “In a situation like this, a private investor will look for new opportunities.” This happened at the end of March, when the Muldentalstift in Naunhof (Leipzig district) had to close for good.

Is there a risk of inpatient facilities being closed?

In Leipzig, the situation still seems stable. But if you ask the providers, things could soon change here too. “Relatives are already calling us in desperation because their father or mother is due to be discharged from hospital and there is no nursing place available at such short notice,” says Sebastian Steeck. He is the commercial director of the Diakonie in Leipzig, which operates eight homes with 570 places and employs 600 nursing staff.

The municipal company Städtische Altenpflegeheime Leipzig (SAH) is the largest provider in the trade fair city with 1300 full-time care places in ten homes. There are now waiting lists. Around 1200 employees work at SAH. “Overall, there will be a shortage of staff and places in the foreseeable future,” says Managing Director Stefan Eckner, looking at the development of the industry.

Sibylle Dölling is deputy managing director of the Leipzig regional association of the Workers’ Samaritan Federation (ASB), which has almost 300 full-time places in four homes. 450 employees work in nursing at the ASB. It is particularly difficult to find people for rural areas, says Dölling. She is currently particularly critical of the Kitzscher location in the Leipzig district: “Either someone moves there, or it looks bad.”

For Sebastian Steeck of the Diakonie Leipzig, there is no doubt that there could be a dramatic reduction in the number of residential care homes in the future: “And faster than we think.” The transformation process is in full swing. “Actually, almost everyone in the industry is thinking about restructuring,” he says. This means offerings that require fewer staff – such as assisted living facilities. Steeck knows providers who are converting empty areas into accommodation for trainees.

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To counteract this, more staff are needed. By 2035, 5,000 additional nursing staff will be needed. But where will they come from? The number of those who have received training and retraining in recent years has recently fallen to 8,804. This is shown by figures from the Saxon Ministry of Social Affairs.

The pay cannot be the problem, providers, nursing experts and politicians agree on this. Newcomers to the profession now earn around 4,000 euros gross plus allowances. According to the Ministry of Social Affairs, other factors are crucial for the satisfaction and motivation of nursing staff: compatibility of family and career, work-life balance.

However, the Saxony Nursing Council is calling for the nursing profession to be upgraded and for more say. The associations are campaigning for a state-wide nursing chamber, like the one that exists for doctors. In addition, nurses with expanded skills and university degrees should be given more responsibility, for example in medical tasks. They hope for corresponding changes in the federal government’s planned Nursing Competence Act, they said in response to an inquiry by LVZ.

The reform of nursing home law passed in March is intended to provide a certain degree of flexibility in Saxony. The previously rigid 50 percent quota for skilled workers will no longer apply. A nursing home in which residents primarily need everyday care will then no longer be so dependent on highly specialized professionals.

Help from abroad

The organizations are now recruiting new members and reinforcements in a variety of ways. Some are even on Instagram and Tiktok. And they are relying on support from abroad. Leipzig Diakonie manager Steeck has just returned from Recife in the Brazilian state of Pernambuco.

He conducted 40 interviews there. Around 450 young people applied for the 18 training positions that the Diakonie had advertised there. Eleven will begin their German course next month and their nursing apprenticeship next year in Leipzig, seven in Zwickau.

According to Steeck, it is important to the Diakonie not to poach skilled workers, but to train them in Germany itself. The apprenticeships are in addition to those previously filled by German trainees.

The municipal nursing homes in Leipzig would also like to work with migrant specialists. However, despite all political announcements, there are still extremely high bureaucratic hurdles, says managing director Eckner. There is a risk that newly trained employees will be lost again due to a lack of a residence permit.

Back to Werdau, back to the DRK home: It is unclear what will happen there once the last residents have moved out. Klaus Irmscher would think it a shame if the house had no future: “It’s a modern building,” he says, looking around the entrance area again, with the upholstered chairs and carnations in vases.

Does he sometimes worry about himself? Irmscher is 86 years old, but is constantly on the move. Because his wife is seriously ill, he takes care of the shopping, the household, and the 1000 square meter garden plot. What if he can no longer manage it all – if he needs care at some point? “I’d rather not think about that,” he says.

LVZ