The Oise Health and Social Coordination Association is celebrating its twenty years in this form and its thirty years of existence. On this occasion, a conference brought together the main partners with one ambition: to project the structure into the future.
An opportunity to take stock with Kahina Atiris, director of Acsso.
OH: Acsso is already twenty years old. Why celebrate it with a conference?
Kahina Atiris : The activity of the association was built 20 years ago. It was a question of ensuring needs which were not then covered. The association is the initiative of Doctor Bocquet, who it is true, was a little ahead of his time since he believed that to support people at home, we all had to work together. His idea was to create an association which brought together several health establishments, town halls and health insurance. The objective was simple: to determine what the needs were and, above all, how to meet them.
A precursor?
Today, the subject is more and more topical. Even more so in the face of increasingly impacted financial resources and a health system in difficulty. We must therefore find other working methods. Working together means reducing costs and therefore finding certain solutions. It’s constant work.
What are the needs that need to be highlighted? An observation after 20 years of practice?
The priorities are quite simple. The first observation is that more and more people want to live at home. This was already the case 20 years ago, but today it is felt even more. 20 years ago, there were fewer needs in terms of health, in terms of dependency and even in terms of family resources and caregivers. Today, we have more and more people at home so we must meet these needs, on demand. In this context, we realize that the accommodation is not necessarily suitable. We must therefore think and see how to make them evolve, and therefore support families. Finding solutions to make the house or apartment as comfortable as possible is one of the challenges for the future. There is another, which is to adapt to a world in which artificial intelligence is increasingly present, connected objects, home automation devices. These are technological advances that can serve us on a daily basis.
A need for human resources as well?
The other point actually concerns staff. We have fewer and fewer caregivers, whether doctors, liberals, the situation is general and this is a real difficulty, particularly in terms of recruitment. This conference is a sort of reminder that we must work together to find lasting solutions. Recruitment and training are at the heart of the debates.
But to work together, we also need to make people aware of the different services that each person is able to offer. Department, town hall, association, public service, this allows everyone to be brought around the table.
Is presenting feedback on experience also one of the objectives of the day?
Yes, it is about establishing an observation, but not only that. It is up to us to work on the paths of tomorrow. It is in this sense that this conference is important. We are celebrating the 20th anniversary of the site, but Acsso has existed for 30 years now. There is hindsight, a certain experience, but we must imperatively project ourselves into the future. A work that we must do on a local scale, for our population in the city of Creil, Nogent-sur-Oise, Montataire and the entire south of Oise.
So human resources are ultimately the big issue?
Human needs are simply enormous. Structures, whether health or medico-social, are in difficulty today. We are struggling to recruit staff. The Covid phase was a form of catalyst. Many caregivers have left for radical changes in profession, sometimes the desire to try something else. It is up to structures like ours to overcome this. Acsso has made the bet of working on recruitment and loyalty while naturally working on the quality of life at work. For me, the essential element is the question of meaning at work. As a trained caregiver myself, I attach a lot of importance to it. We must determine what drives us today. What makes us want to accompany people in need of care in the morning? The human aspect must remain essential. It’s the desire to help a vulnerable person.
Beyond the technical and relational constraints, it is also knowing how the social project of the association can respond to our personal desire.
Does internal training exist?
There has been an evolution in recent years. Five years ago, for example, we mainly recruited trained staff. Once again, with the Covid crisis, we had great difficulty recruiting and replacing vacant positions. We worked a lot on learning. Today, we test professionals who are more focused on home help, with qualifications which are not necessarily those we expect today, so we support them in training. We support six to seven staff every year. This is done through apprenticeship with establishments in Clermont or Greta de Beauvais. After one year of training, these staff obtain their nursing assistant diploma. They divide their time between face-to-face courses and carry out the practice within the framework of the association. It works very well. We are banking on the future and on professionals who have the talent for this profession.
The headquarters is in Nogent-sur-Oise and a branch exists in Crépy-en-Valois. Do you have the ambition to expand across the entire department?
Previously, we had local branches which were grouped together at the Nogent headquarters, but we rather want to redeploy ourselves. The idea is to be closer to the people we support. A few months ago, we developed a new system called the team specializing in precarious nursing care. This summer, we opened a territorial resource center based in Creil, we developed the cancer resources space in Chantilly as well as an antenna in Creil then very soon, we will have three territorial resource centers, one on Senlisien, on the Compiegnois and the third on the Noyonnais. The idea is to promote proximity.
Is this a response to the challenges of tomorrow?
The issues are the question of adapting housing, but not only that. The question of autonomy is not only about dependency, it is also autonomy in civic life. The needs for the home, whether for the patient or the caregivers, have not yet all been identified. We still have many actions to take to respond to them.
Is Acsso a model used in other departments?
There are associations across France which have the same working base, but perhaps our specificity is to develop a basket of services which is very concentrated in a single entity. We are able to respond to a request concerning the delivery of meals for example, and when needs evolve, they can benefit from a social worker, care, and others. We are able to support and graduate according to needs. The idea is to be available and then, we build around the needs. It’s a project that was set up like this 30 years ago, it is even more relevant today.
What do you remember from this first part of the conference?
The first of these is that we are able to respond to a request. We have important work to do in terms of communication. The department, present, remains a privileged partner. Mr. Sanchez, from the CCAS of Nogent-sur-Oise came to present the APF, a system which seems very interesting to me. Our goal is to communicate and make all these services easy to access. We understand that this seems complicated to someone outside of the healthcare industry. He must be allowed to access the right person, directly.
After 30 years of existence and around twenty years in home care, we must continue to make ourselves known. This conference participates in it.
