Personal support workers should have governing body, employee group says

High demand for health-care staff means little attention is paid to qualifications

Ontario’s personal support workers need their own governing body to offer more accountability to residents in long-term care and their families, says the head of a group that represents 25,000 of these workers.

On Monday, the Citizen released video of a personal support worker (PSW) in a city-run retirement residence delivering 11 punches to Georges Karam, an 89-year-old man with Alzheimer’s and Parkinson’s who is a patient at the Garry J. Armstrong long-term-care facility on Island Lodge Road. The video was taken by a camera installed in the room by Karam’s family.

The worker, Jie Xiao, 44, pleaded guilty to assault last week. A sentencing hearing is expected to be held later this year.

Miranda Ferrier, the president of Ontario Personal Support Workers Association, says judges often tell PSWs convicted of assault or theft that they can’t work in the field again.

“But there’s no followup. There’s nothing to say that they can’t go to work privately,” Ferrier said.

“In a situation like this, if this PSW were a member of a governing body, we could implement an investigation and make sure he could never work as a PSW again. It’s the only way to protect the public.”

There are about 135,000 PSWs in the province who support sick and elderly people at home and in longterm-care facilities and hospitals with daily living activities such as feeding, lifting and transferring, bathing, oral hygiene, toileting and light housekeeping. Accredited PSWs take a course that lasts between six and eight months at a community college, career college or from a school board.

Lawyer Graham Webb, the executive director of the Advocacy Centre for the Elderly, a community legal aid clinic that specializes in elder law, says a governing body or “college” for PSWs would be a good idea.

“In general, PSWs are looked down upon as the people who change diapers and do other menial tasks,” Webb said. “But they perform a very important function. They have to work with people who are not aware of their own conduct. You need skill and training. A college would emphasize the professional nature of their work.”

The Karam case is not an isolated incident, he said. “In the 22 years I’ve been here, we’ve seen similar types of incidents, but they have never been caught on camera.”

Members of the Ontario Personal Support Workers Association are screened by a third party, and receive a nationwide criminal background check, and must prove that they have been accredited in Ontario, Ferrier said.

PSWs must also be able to prove that they are entitled to work legally in Ontario, and be who they say they are. There have been cases of impostor PSWs, and others with faked police checks and accreditation, she said. The members of the union also carry $1 million in personal liability, in theory, to protect both the worker and their clients.

But membership in the association is not mandatory. Xiao is not a member of the association, Ferrier said.

She warns that high demand for PSWs means little attention is paid to their qualifications.

“Typically, there are a lot of signs that a PSW just isn’t ‘right,’ ” she said.

The governing body she proposes would be mandatory for all PSWs in the province, with a common code of ethics, scope and standards of practice.

Warren (Smokey) Thomas, president of OPSEU, which has PSW members, also supports the idea. “There would be a code of conduct that would be enforceable by the college. It would provide a measure of assurance that PSWs were properly regulated with oversight.”

Ontario had a registry for PSWs, but it folded in January 2016 after the province engaged a third party to review it and concluded that significant improvements were needed to ensure the public and employers had the information they needed when using services of PSWs, said David Jensen, a spokesman for the Ministry of Health and Long-Term Care.

Reviving the registry was accounted for in the 2017 provincial budget. It’s unclear when the new registry will be in place.

Webb said a registry “falls short of what’s needed.” Ferrier agrees. In January 2015, as an experiment to test the old registry, Ferrier’s husband, who is a contractor, applied online using a falsified letter saying he had worked with a private client as a PSW. He did not provide a police check. His deception was not discovered until November of that year, only a few months before the registry was scrapped.

Meanwhile, provincial NDP Leader Andrea Horwath says situations such as the Karam case point to the need to expand the scope of an independent inquiry that will be looking into the case of serial killer Elizabeth Wettlaufer, a nurse who took the lives of eight residents in care facilities.

Horwath wants the inquiry to consider a broader range of issues in long-term-care facilities, such as staffing levels, funding, waiting lists and resident-on-resident violence.

“I think it’s really evident that the long-term-care system is in crisis mode and has been for a long time. We need to expand that public inquiry to ensure that these incidents are dealt with, but also to shine a brighter light on the whole system,” Horwath said. “I haven’t talked to a single person who thinks the system works well.”

The Ministry of Attorney General is the lead on the inquiry, the

parameters for which have yet to be announced.

“It’s not simply a matter of pointing a finger and saying, ‘It’s the staff,’ ” Howath said.

“Everywhere I go, I hear that staff are just run off their feet.”

More technology is not necessarily the answer, she said. The camera in Karam’s room had been placed with the knowledge of the staff in his long-term-care home.

“You can add all the cameras in the world, and you’ll still have rogue situations. The camera didn’t stop it from happening,” Horwath said.

Ferrier said many long-termcare facilities already have cameras in common areas such as halls and lounges. She is in favour of cameras in every room. “If you have nothing to hide, you should have nothing to fear. But it should be up to the family,” she said.

Webb pointed out that there are privacy issues around cameras in private areas, and any plan to put a camera in every room without the consent of the resident or their decision-maker would likely lead to a Charter of Rights and Freedoms challenge.

“This is the home of the resident. It would be like putting a camera in every bedroom in every home.”