摘要

2019年11月民政部在《对“打造精准化社区养老服务模式”的答复》（民函〔2019〕702号）中提到发展社区养老服务，顺应了大多数老年人居家和社区养老的意愿，是养老服务体系建设中十分重要的基础性工作，要加强养老服务领域的社区、社会组织、社会工作“三社联动”。社会组织参与嵌入式社区养老服务是近年来新兴的典型“三社联动”养老服务模式。天津益美嵌入式养老院是由天津市和众社会组织负责运营的天津市首家区级嵌入式社区养老院，其与基层政府、基层社区以及其他社会组织产生了良好的互动，为所在社区的老人提供机构服务、社区服务和居家服务三种类型共计26种服务，能够满足所在社区中自理老人、半失能老人、失能老人的基本生活需求和文化生活需求。

本文运用文献分析法及案例研究法，对天津市益美嵌入式养老院的院长、工作人员、享受服务的老人进行调研访谈，把握天津益美嵌入式养老院整体运营情况，了解其运营过程中社会组织、区政府、基层社区对于该嵌入式养老院的支持情况，对养老服务型社会组织运营益美嵌入式养老院的过程中出现的运转资金紧张这一问题，提出建议：市政府应鼓励社区筹建社区基金会、积极推动长护险落地实施，社会组织自身调整经营策略分包养老服务项目、扩大便民项目营收，多策并举缓解资金压力；对养老服务型社会组织综合评估机制欠佳这一问题，提出建议：市政府建立完备的评估机制，细化相关评估制度并引入第三方评估机制；针对养老服务型社会组织养老护理专业人才紧缺这一问题提出建议：市政府应科学定制养老护理员培训计划，并采取有效激励政策适合从事养老护理的劳动者去参加养老护理员资格考试并且愿意从事此项工作；针对养老服务型社会组织监督体系不健全这一问题提出建议：市政府应对养老服务型社会组织建立健全的监管体系，具体表现为市民政部建立养老服务型社会组织行业协会加强行业内部监督，并细化监管规章，制定地方性政策法规；针对社会组织参与嵌入式社区养老服务运营经验匮乏这一问题提出建议：探索多元化嵌入模式，促进服务资源高效融合共享，鼓励社会力量合作嵌入。

关键词：社会组织 社区居家养老服务 嵌入式养老院

Abstract

In November 2019, the Ministry of Civil Affairs (MCA) mentioned in its Reply to "Creating a precise community elderly service model" (Minhuan [2019] No. 702) that the development of community elderly services responds to the wishes of most elderly people to age at home and in the community,and is a very important and fundamental task in the construction of the elderly service system, and that it is necessary to strengthen the It is a very important basic work in the construction of the elderly service system, and it is necessary to strengthen the "three social links" of community, social organizations and social work in the field of elderly service. The participation of social organisations in embedded community elderly care services is a typical "three-community linkage" elderly care service model that has emerged in recent years. Tianjin Yimei Embedded Nursing Home is the first district-level embedded community nursing home in Tianjin, operated by Tianjin Hezhong Social Organisation,which interacts well with the grassroots government,grassroots communities and other social organisations to provide a total of 26 types of services, including institutional services, community services and home services, to meet the basic needs and cultural life of self-care elderly, semi-disabled elderly and disabled elderly in their communities. The services can meet the basic needs and cultural needs of the self-care, semi-disabled and disabled elderly in the community.

This paper uses documentary analysis and case study methods to conduct research and interviews with the director,staff and elderly beneficiaries of the Tianjin Yimei Embedded Home,to understand the overall operation of the Tianjin Yimei Embedded Home, the support of social organisations,the district government and the grassroots community for the embedded home in the process of its operation, the problem of financial constraints in the operation of the Yimei Embedded Home by social organisations providing elderly services, and the problem of financial constraints in the operation of the Yimei Embedded Home by social organisations providing elderly services. The government should encourage the community to set up a community foundation,actively promote the implementation of long-term care insurance,and the social organisations themselves should adjust their business strategies to subcontract elderly care services and expand the revenue of the community-friendly projects, so as to alleviate the financial pressure. To address the shortage of professional nursing staff in social organisations for the elderly,it is recommended that the municipal government should formulate a scientific training plan for nursing staff and adopt an effective incentive policy to ensure that nursing staff are qualified to take the nursing staff qualification examination and are willing to work in this field. Suggestions are made to address this issue: the municipal government should establish a sound monitoring system for social organisations providing elderly care services, as evidenced by the establishment of an industry association for social organisations providing elderly care services by the Ministry of Civil Affairs to strengthen the internal supervision of the industry, refine the monitoring regulations and formulate local policies and regulations;suggestions are made to address the lack of experience in the operation of social organisations participating in embedded community elderly care services: explore diversified embedding models, promote the efficient integration and sharing of service and resources, and encourage social forces to participate in the operation of embedded community elderly care services. The Ministry of Civil Affairs of the People's Republic of China should establish an industry association of social organisations for the provision of elderly services to strengthen the internal supervision of the industry and formulate local policies and regulations.

Key words: social organization, community home care service, embedded nursing home