Overnight staffing a concern
The minimum number of staff required overnight in private nursing homes could be revised in the wake of the fire that ravaged a L’IsleVerte seniors’ home and killed 32 residents who could not flee the flames.
“I am very concerned by that,” Quebec Health Minister Réjean Hébert told The Gazette in an interview Friday.
“But I was already very concerned by the safety (of senior residents) and by an eventual tragedy like in L’Isle-Verte, which is why I pushed very hard to adopt the regulation for private (nursing) facilities and to set up the committee on the sprinkler issue.”
New regulations for private nursing homes call for centrally managed smoke detectors, mandatory evacuation exercises and staffing ratios at night.
In the months before the fatal fire, Résidence du Havre had been successful in completing evacuation exercises with its night staff, Hébert said, but the exercises were held during the day.
“With one person, people in such facilities could be evacuated usually in less than 10 minutes,” Hébert said. “The L’Isle-Verte facility succeeded in the fire exercise.”
Critics, however, note that daylight evacuations when everyone is awake is hardly the same as trying to clear a burning facility full of sleeping people, many sedated on anti-anxiety and sleep medication, and often with disabilities that would prevent them from hearing alarms or smelling smoke.
New regulations adopted by cabinet late last year say that a private nursing home with a semi-autonomous clientele with 100 rooms should have minimum of one employee on staff to ensure surveillance, a home with 199 spaces should have two employees, and a residence with 200 or more beds should have a minimum of three employees.
Asked whether such a ratio is enough to ensure resident safety, Hébert said: “Last year, when we were discussing the new regulations, the advice we got was that it was enough. Should this regulation be revised after the tragedy in L’Isle-Verte? I’m very open to look at it again.
“I am told that there was a violent wind and that could explain the rapidity of the fire,” Hébert said. “But we will wait for the investigation (by the Sûreté du Québec and the office of Quebec’s Coroner) to see what happened and how we can prevent another disaster like this.”
Hébert also reiterated that an error had slipped into the wording of the new regulations, which was intended only for small private residences with autonomous clientele. The changes would allow for a resident trained in CPR and evacuation plans to be in charge of emergencies at night rather than a professional employee.
Owners of small nursing homes had asked for looser regulation on night staff. The changes were proposed to allow smaller homes to comply with the accreditation requirements without adding to management costs that would trickle down to the residents as higher fees.
That’s already the practice in some small, rural nursing homes, Hébert said.
Hébert said he only realized changes would apply to all private seniors homes after media reports this week.
“But as soon as I became aware of this I stated that I acknowledged that there was a mistake and it will be removed from the bill. But the intention is to accommodate small facilities lodging autonomous people. It was to allow those facilities to continue to be certified, otherwise they would have dropped from the certification program and that is not the intention.”