Health and social care institutions

Melilla has the Centro Polivalente under Imserso management, offering services specifically for dependent and other elderly people. The Centro Polivalente has a total of 160 places, broken down as follows: 138 in residential care (15 for non-dependent and 123 for dependent people); 7 for temporary residence and 15 at the day centre.

In addition to its services for older people at the Centro Polivalente in Melilla, the Imserso offers permanent residential and day care places under contract with other organisations in Ceuta and Melilla, within its territorial competence. These places are intended for people who are older and/or have physical and mental disabilities, and for older people who are dependent.

The territorial directorates of Ceuta and Melilla manage two social welfare centres for older people, which basically promote community living and involvement of older people. They offer social and geriatric care, occupational therapy and other cultural and leisure services. Both centres also have day care units for older people who are dependent.

Centro Asistencial de Melilla care home Places: 100 (95 permanent and 5 temporary).

• Fundación Gerón care home and day centre, Ceuta· Places: 65 (55 residential and 10 at the day centre)
• ‘Nuestra Señora de Los Ángeles’ care home and day centre, Ceuta (Hermanos Franciscanos de Cruz Blanca) Places: 21 places for people with an intellectual disability, who are in a situation of dependency (on a residential basis).
• COCEMFE day centre, Ceuta Places: 15.

These are governed by the Imserso Directorate-General decision of 26 August 1987 (Spanish Official Gazette of 1 October 1987), establishing the criteria for admission, transfers, exchanges and payment for stays.

Conditions of admission:

• Have the recognised degree of disability.

• Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes.
• Not have serious mental disorders which might disrupt usual shared living at the centre.
• Achieve the minimum score required at any given time for admission to the chosen centre, in accordance with the current admission scale.
• Be a beneficiary of the Social Security System or entitled to social services under the Social Security System by law or international convention for centres owned by the Social Security System.
• Applicants must be over sixteen years of age for residential places. Children under 16 are eligible for places with half-board.
• Have a physical disability as a result of which, in the opinion of the relevant assessment and guidance team, another person’s help is required for essential daily activities, such as dressing, walking, eating and the like.
• There are no reasonable prospects of rehabilitation or returning to work. So that, admission to or continuing treatment at a centre dedicated to this end is not appropriate.
• Encounter serious difficulties in being cared for in a family setting or at home.

The cost of boarding places is 75% of their pension.

CRMF centres are governed by the Imserso Directorate-General decision of 18 January 1993 (Spanish Official Gazette of 23 April 1993).

Conditions of admission:

• Have the legal status of a person with disabilities.
• Have no infectious disease or need for continuous medical care in healthcare institutions.
• Not have serious mental disorders which might disrupt usual shared living at the centre.
• Achieve the minimum score required at any given time for admission to the chosen institution.
• Be a beneficiary of the social security system or entitled to social services by law or international convention.
• Be at least 16 years old. In exceptional cases, individuals aged 14 and over may be admitted if their educational progress and personal needs so require.
• In the opinion of the relevant Assessment team, show reasonable potential to return to work.
• Possess the level of knowledge necessary to complete the education that they wish to undertake.

The CREDINE is governed by Order SSI/411/2018 (Spanish Official Gazette of 23 April 2018).

Admission requirements:

• Be a beneficiary of the social security system or entitled to social services by law or international agreement.
• Have a recognised situation of dependency at any level, or a degree of disability of 33% or more. In both cases, they must be due to neurological causes and primarily spinal cord injuries, acquired brain damage or amyotrophic lateral sclerosis. Alternatively, a person may be in the process of having such conditions recognised, or be at risk of developing them.

• Be over 18 and under 60 years of age. In exceptional cases and at the suggestion of the CREDEF interdisciplinary team, younger or older persons may be admitted, provided that the services prove beneficial to the user.

• Have no transmissible disease at an acute stage, and not need continuous medical care in a hospital setting.

• Have no behavioural changes that would impede usual shared living in care homes.

• Succeed in the adaptation and observation period to become a user of the centre. This period may not exceed three months, though it may be extended, in exceptional cases, for a further three months.

The CREER exists for research, education, study and knowledge management in the field of rare diseases. It creates and disseminates good practices and offers technical advice on improving the quality of life of patients and their families.

The CREER is governed by Order SAS/2007/2009 of 20 July 2009.

Conditions of admission:

• Be a beneficiary of the social security system or entitled to social services by law or international agreement.
• Be under 65 years old.
• Have a rare disease as defined by the European Union.
• Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes.
• Have medical stability.
• Have no behavioural changes that would impede usual shared living in the centre.

The CRE was created and is governed by Order TAS/3460/2007.

Conditions of admission:

• Be a beneficiary of the social security system or entitled to social services by law or international convention;
• Be older than 16 and have a serious disability needing care from another person for BADL and to improve personal independence;
• Severe or significant limitations to their personal independence;
• Be medically stable;
• And have minimum capability for communal living within the centre.

This CRE is designed as a specialist centre for advanced health and social welfare. It engages in research, analysis, assessment and training to develop the knowledge of Alzheimer’s and other forms of dementia, and the care and treatment of patients and their families.

It is governed by Order TAS/3775/2007, of 19 December 2007.

Conditions of admission:

• Be a beneficiary of the social security system or entitled, by law or international convention, to social services.
• People with dementia is understood as multiple cognitive impairments that cause significant difficulties in their daily activities, regardless of the underlying cause: Alzheimer's, vascular and other forms, whether early-onset or late-onset. People with cognitive impairment that first appeared before the age of eighteen, regardless of the cause, and those with focal brain lesions caused by trauma, degenerative disease or any other cause are excluded;
• No infectious disease or need for continuous medical care in healthcare institutions.

Founded and governed by Order SSI/2416/2014 of 17 December 2014.

Admission conditions or requirements:

• Be a patient with a serious and prolonged mental disorder, confirmed by a report issued by their mental health team of origin;
• Be a beneficiary of the social security system or entitled to social services by law or international convention;
• Have a recognised situation of dependency at any level, or a recognised disability of 33% or more, or be in the process of having either case recognised, or be at risk of developing either;
• Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes;
• Have no transmissible disease in an acute stage and no need for continuous medical treatment in hospital;
• Not in a stage of active crisis with serious injuries that could disrupt usual life at the centre or prevent them from benefiting from these services, and they must not exhibit serious aggressive behaviour;
• Be over 18 and less than 65; older or younger ages may exceptionally be admitted, at the relevant team’s discretion.

The CREDEI was formed and is governed by Order SSI/1189/2015, of 18 June 2015.

Its purpose is to drive improvement of the quality of life of people in a state of dependency deriving from mental incapacity.

Conditions of admission:

• Be beneficiaries of the social security system or entitled to social services by law or international convention;
• Have a chronic situation of dependency caused by intellectual disability, or at risk of such a situation developing, in the opinion of the interdisciplinary team at the centre;
• Be aged 45 or over. In exceptional cases, and upon the recommendation of the centre’s multidisciplinary team, persons aged 40 or over may be admitted, provided that the services are likely to be beneficial to the user;
• Have family or community support. Have sufficient social, family or community support to enable them to stay in their environment;
• Have no transmissible disease at an acute stage and not need continuous medical treatment in hospital;
• Have no behavioural changes which would be detrimental to normal communal living in the CRE.

CREDEF was formed and is governed by Order SSI/1190/2015 of 18 June 2015.

It was founded as an advanced centre for the promotion, development and dissemination of knowledge, innovative experiments and working methods in social and healthcare and family support. It is also a highly specialised centre providing integral multidisciplinary care to people in a chronic or reversible state of dependency deriving from physical disability. It promotes their independence so that they are able to stay in their usual surroundings.

Admission requirements:

• Be a beneficiary of the social security system or entitled to social services by law or international convention;
• Show a chronic or reversible state of dependency deriving from physical disability, or a risk of such a state, in the opinion of the interdisciplinary team at the CREDEF;
• Be at least 50 years old (at the suggestion of the CREDEF interdisciplinary team, younger ages may exceptionally be admitted, from age 40, provided that their services may prove beneficial to the user);
• Have sufficient social, family or community support to ensure the ability to stay in their surroundings;
• Have no transmissible disease at an acute stage, and not need continuous medical care in hospital;
• And show no behavioural changes which would be detrimental to normal communal living in care homes.

The CEAPAT was founded and is governed by ministerial order of 7 April 1989.

As a reference centre, the CEAPAT offers the following forms of support:

• Analysis, systematic organisation and distribution of information and knowledge;
• Promotion of research, development and innovation in working methods and techniques;
• Professional training and cooperation in the development and application of technical standards;
• Support, advice and technical help to institutions and other resources in the sector;

The CEAPAT's aims are as follows:

• To achieve universal accessibility, both in the house and in its surroundings and spaces, to products, equipment and services;
• To instil a culture of design for all individuals;
• To facilitate digital interaction;
• To ensure the active participation and interaction of users and all staff;
• To encourage the development, knowledge and application of legal and technical standards;
• To drive R&D and innovation in the fields of accessibility, design, products and services;
• To offer information, advice, evaluation and training, and manage the knowledge in worthwhile ways;
• To participate in national and international platforms and forums and facilitate coordination between agencies.

The mission of the CEAPAT is effectively to implement the rights of disabled and older people, by full accessibility of supporting products and technologies and design to suit everyone.

CEADAC is a public social and healthcare facility dedicated to the comprehensive and intensive rehabilitation of people with non-progressive acquired brain injury in the subacute phase, promoting their personal independence, and providing support for their families, as well as research, teaching, information provision, documentation, advisory services and consultancy within this field.

It was founded and is governed by Order TAS/55/2002 (Spanish Official Gazette of 17 January 2002).

The CEADAC user profile is as follows:

• Be a social security beneficiary or entitled to benefits.
• Be over 16 and under 45 years old.
• Be affected by consequential and non-progressive damage of any origin.
• Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes.
• Have medical stability.
• Be recently discharged from hospital.
• Have a reasonable prospect of rehabilitation.
• Have the ability for a minimum level of shared living within the centre.

Objectives:

• To offer social and health rehabilitation programmes to people who have suffered brain injury and drive the improvement of quality of life of patients and their families;
• To provide information and technical advice on rehabilitation of an existing brain injury;
• To offer information and teach professional people about acquired brain injury;
• To promote and cooperate in research projects in the field of brain injury.