FRESH CASE OF PATIENT ABUSE PROMPTS THIRD-PARTY INVESTIGATION
‘Independent, third party’ to address what needs to be done to prevent further incidents
An outside investigator will look for systemic failures in Ottawa’s city-run nursing homes after another three workers were fired Thursday morning over the “disturbing and offensive” verbal abuse of a resident.
It’s the third time in a year that the city has fired nursinghome workers for mistreating patients, and just a week after the top managers responsible for the four municipal centres promised city councillors that they were on top of things.
“My confidence is shaken. I’m not going to lie about that. I still believe that we have a lot of caring and nurturing and hard-working staff in our homes (but) I wonder if there’s a process problem or some sort of culture in there that is adding to this problem,” said Coun. Diane Deans, the chair of city council’s community-services committee.
“I thought they were changing the channel and things were going to improve. I don’t think anybody was more disappointed than I was when I heard this news yesterday.”
In the latest case, two workers were fired for not reporting the abuse by the third at the Peter D. Clark Centre, said Janice Burelle, the city’s general manager of social services, and a fourth is still being investigated for possibly not giving medicine to a resident.
Burelle and her managers found out about the latest case from the resident’s family on Tuesday, after relatives complained to the provincial Ministry of Health and LongTerm Care. The incidents were recorded in late August and early September, on a camera the resident’s relatives had put in her room to keep an eye on her.
That means one personal-support worker abused a vulnerable resident, and two others knew about it and said nothing, after a summer of extremely public discussion about how patients are treated in the city’s four publicly run nursing homes. News stories led to internal investigations, to a provincial order for the city to clean up its act, and to extensive meetings at the homes themselves.
“I have to admit it’s very disheartening and very confusing. We have been very vocal. We have sent emails out to staff reminding them of their responsibility,” Burelle said in an interview.
“There’s been so much work that’s been done and is underway … To have this happen is absolutely unacceptable and unexplainable.”
The ministry contacted the Peter D. Clark Centre on Tuesday afternoon, word shot up the chain of command, and Burelle was watching the disturbing video the next morning.
The Citizen watched portions of the videos, which also include a PSW repeatedly saying “byebye” to an elderly woman and asking her, “Why is it taking you so long to die?”
Firing three people two days after getting the complaint is meant to send a message to workers in the city’s nursing homes about their responsibilities and a message to residents and families about how seriously these cases are taken, she said.
In July, a personal-support worker was charged with assault after being caught on camera punching a resident in the face repeatedly when the resident resisted having his diaper changed. Jie Xiao pleaded guilty to assaulting 89-year-old Georges Karam, who has both Parkinson’s and Alzheimer’s and lives at the Garry J. Armstrong nursing home.
Just last week, Burelle was in front of Deans’s communityservices committee explaining what she and nursing-home managers had done so far.
That was “an isolated incident” that horrified everyone working in the city’s nursing homes, Burelle said then.
“The criminal actions of a single worker were truly upsetting to every one of us,” agreed Dean Lett, the manager under Burelle who’s specifically in charge of the four nursing homes.
The system has zero tolerance for abuse, Burelle said, and staff had been reminded of their own obligations to report abusive behaviour by other workers. They get refresher training every year on the rules covering abuse, she told the committee.
Another story emerged in the summer from late last year, about another resident falling out of his improperly secured wheelchair at the Garry J. Armstrong home and being left in a pool of his own blood; the worker responsible for him cleaned the man up and put him to bed without telling anyone. They fired that worker, too; in the course of the investigation, another worker reported that a nurse said not to record the incident on the man’s file
Family members have complained of being barred from nursing homes after complaining about their loved ones’ care. In just a few years, the city nursing homes, which have 712 beds among them, have racked up hundreds of documented violations of the province’s detailed rules about how they’re to operate and how their residents are to be cared for. Some are petty. Some not.
The provincial government issued the city a rare set of orders to fix its mess, a major effort that involves detailed plans Burelle’s department is still finishing. One of them involves training workers further on their obligations not to abuse residents in their care.
Until now, Burelle didn’t think she had a systemic problem with abuse on her hands. Now she admits it’s possible.
“As a result of these latest incidents, management will take an additional step and recruit an independent, third party to review the City of Ottawa’s four Long Term Care Homes,” Burelle told city councillors in a memo.
“I am confident that this additional initiative will provide vital information on what actions can be taken to prevent incidents and to further ensure the safety of our residents. This review will be over and above actions currently being planned and undertaken to improve resident care.”
Deans wants a full audit of the nursing homes, and one is coming, but that’s a time-consuming, painstaking process. This review is meant to reach conclusions more quickly. Nobody is sure yet who will conduct it. Deans prefers a well-known person with an unimpeachable reputation in the community, if such a person can be found to do it, but it could also be a firm with specific expertise in long-term care.
The examination will extend to the management overseeing the homes, Burelle said.