Inspection reports for long-term care homes in Northern Ontario show a variety of different complaints that have been filed in recent years, but none appear to be as serious or disturbing as was revealed in the recent document tabled by members of the Canadian Armed Forces (CAF) who were brought in to lend assistance to several homes in the Greater Toronto Area.
The Canadian Forces report, revealed in the last week of May, outlined "horrific conditions" in several homes located in North York, Pickering, Etobicoke, Scarborough and Mississauga. It was revealed that CAF members were asked to provide personnel, medical aid and logistics support to the homes that were struggling to deal with the COVID-19 crisis.
Among the conditions discovered by CAF members were patients left far too long with soiled diapers, improper installation of catheters, inadequate bathing procedures, outdated medical procedures by staff and even problems with ants and cockroaches.
The CAF report angered Ontario premier Doug Ford and also prompted Ontario Ombudsman Paul Dube to announce his office would investigate conditions at long-term care homes in Ontario in general.
But the provincial inspection reports also reveal that it has not been all roses and sunshine in Northern Ontario long-term care homes.
In recent years several inspections were carried out at long-term homes across Northern Ontario, in most cases responding to specific complaints.
In February 2020 a complaint from a resident of Casselholme in North Bay resulted in a written warning relating to an allegation of abuse that had not been immediately reported to the Director of Care (DOC) at that facility and that the director of care had not notified the Ministry of Health and Long-Term Care (MOHLTC).
It was alleged that a personal support worker (PSW) had "manhandled" a resident and spoke to the resident rudely, and in such a way that the resident was fearful of further contact with the PSW. The incident was alleged to have happened while the PSW was re-positioning the patient and at one point scolded the patient and advised them not to ring the call bell unless it was an emergency. The DOC explained that the incident was not reported to the province because it was regarded as a matter of rudeness and not abuse.
In September 2018, MOHLTC inspectors looked into a situation where the plan of care for a specific patient was not adhered to with respect to treatment to avoid bedsores. It happened at the Bethanni Nursing Home in Thunder Bay. The investigation revealed the patient needed to be assessed at least twice of day to avoid further bedsores, to relieve pain and to avoid infection. The home was given three Written Notifications.
Pioneer Ridge, a home in Thunder Bay was given a Written Notice for staff failing to comply with regulations regarding the safe storage of drugs. This followed a situation in March 2019 where on two separate days, the drug treatment cart was discovered unlocked, unattended and sitting in one of the main hallways of that home. In one of the incidents, a quantity of prescription medication was found sitting in a small basket on top of the drug cart.
A similar incident occurred at St. Joseph's Village in Sudbury, in January 2020. A Written Notification (WN) and plan of action was written up when it was discovered that unused medications were discovered on a resident's bedside table. The WN reminded the nursing staff that they are required to witness the patient take their medication before they leave the patient's room. Self-medication is only allowed by permission of the patient's physician.
In March 2020, the ministry issued a Written Notification to Pioneer Manor in Sudbury after a complaint that a patient did not receive prescribed care from a PSW. The resident reported the incident. The PSW responsible for the care entered false information into the electronic system that documents all procedures. The PSW was confronted and asked about the incident. The PSW admitted the care had not been provided as required and also said they could not remember why false information was entered into the electronic tablet. No other information on the PSW was revealed in the inspection report. The ministry issued a written notification for neglect and failing to follow the prescribed plan of care.
Another situation revealed that a registered nurse gave the wrong medication to a patient. It was reported that the nurse was in the process of preparing medications when another patient exhibited signs of a heart attack. The nurse locked up the drug cart and attended to the patient in distress. When that incident was over, the nurse returned to the drug cart and inadvertently gave medications to the wrong patient.
A physician was notified and the patient was transferred to hospital within 15 minutes for assessment and monitoring.
In several other cases outlined in the inspection reports, infractions were discovered, but they were more along the lines of failing to adhere to regulations such as ensuring inspections of bed rail latches were carried out correctly. In another incident staff were advised of the importance of using the correct assistive devices such as lifts and slings when moving a patient from a bed to a wheelchair.
