Unhygienic conditions, bad management and a virtual absence of professional staff prevailed at the Noupoort Christian Care Centre, according to a report released on Friday.
The treasurer of the centre had no control over finances, says the document, compiled by a task team of experts commissioned by the Social Development Department.
The reported prompted Social Development Minister Zola Skweyiya this week to refuse the controversial drug rehabilitation facility permanent registration.
Social Development director general Vusi Madonsela said in a statement a copy of the report was given to the centre - "to allow it to explain why it should not be closed as such".
The 74-page document says the centre was scattered in many different buildings and patients stayed in extremely unhygienic conditions.
Residents were exposed to extreme weather conditions without appropriate heating or cooling systems.
The buildings, particularly where young patients reside, were not suitable for them, and they required renovations.
"The most worrying factor is the kitchen was unhygienic, storage facilities that were not appropriate and food that, on the day of the inspection, had expired two months ago."
The dreaded disciplinary facility where both young and adults patients were punished for transgressions of the rules was not property managed.
The disciplinary programme was militaristic and excessive, and was often not matched to the type and severity of offences committed.
The report says medication was not allowed at the facility even for chronic ailments such as epilepsy.
The failure to store medication appropriately, like the insulin that was used for diabetics, made the administration of the medicine risky to patient.
"This medication is also not administered in the prescribed times leading to unnecessary medical complications."
The report says the centre had no emergency tray, first aid kit, dressings and oxygen supplies which were critical in a facility where 160 people were cared for.
There were no mechanisms for the disposal of needles and expired medicines.
Medical records were not kept and there was no monitoring of the administration of medicines.
The centre had no HIV and Aids policy, even though residents were a high-risk group. There was also no detoxification protocol and a project leader who was not qualified in this regard managed was employed.
The report says the centre used unqualified and unregistered professionals to provide services that should be rendered by recognised professionals.
The centre was operating without a multi-disciplinary team. Only one professional staff member, who was a social worker, was employed.
There was a one-size-fits all approach to therapy, which did not take into consideration the individual needs of patients.
The report says the entire treatment programme was based on religious doctrine, which was forced on all patients.
In general most patients complained about the strict rules of the centre and the sometimes-inhumane discipline, which led to them to live in fear.
On finances, the centre failed, in spite of numerous opportunities provided through temporary registration, to improve the management of the facility.
There were six signatories of the accounts and some them were board members. However, they did not have a say in the management of the finances.
"It seems one of the directors and his wife, who is a financial manager, take financial decisions."
There was no proper budgeting system in place and the expenditure was managed on an ad hoc basis. Financial statements were not audited and none had been submitted to the department in line with legislation.
The government task team has proposed to Skweyiya that the facility be closed.
Other recommendation the team made included:
- the centre be given a six-month period to phase out its programme;
- a moratorium be placed on admission of new patients.
- patients who have completed the eight months treatment programme should be released to their families;
- the Northern Cape social development department should monitor the functioning of the centre regularly;
- there should be an urgent meeting with parents, sponsors and other stakeholders to brief them about the findings and developments; and
- the SA Revenue Service and other law enforcement agencies should be requested to do further investigations within six months. - Sapa