Eight care homes need improvement
Out-of-date information raises alarm about oversight in virus spread
Seven long-term care facilities in Hamilton and one in Burlington are not in good standing with the province.
But the information is years out of date, raising questions about what role oversight has played in the spread of COVID-19 in seniors’ homes.
“I think anybody who sees that, alarm bells should be ringing,” said NDP Leader Andrea Horwath. “If you are not doing the proactive inspections, you are not catching problems before they start and you are basically putting people who live in long-term care at higher risk.”
Four of these eight homes have had coronavirus outbreaks including Heritage Green Nursing Home in Stoney Creek, the Village of Tansley Woods in
Burlington, St. Joseph’s Villa in Dundas and Grace Villa on the east Mountain.
The others are Blackadar Continuing Care in Dundas, Hamilton Continuing Care on Wentworth Street South, St. Peter’s Residence at Chedoke on the west Mountain and Orchard Terrace Care Centre in Stoney Creek.
St. Joseph’s Villa and Grace Villa are listed as needing “significant improvement,” which is described as “continual high-risk concerns identified,” “continued increases in complaints and incidents where residents are harmed or at risk,” “home has not demonstrated their ability to improve” and “further actions taken by the province.”
The rest are under “improvement required,” which is “several areas of concern identified,” “increasing number of
complaints and incidents where residents are harmed or at risk,” “home needs to take action to improve” and “the province continues to monitor.”
But the performance levels date back to Dec. 31, 2017, so it’s not clear if these homes had made the improvements long before COVID-19 or if other homes have fallen out of good standing in that time.
“A part of those quality inspections is ensuring the home has a plan in place, they have the necessary resources and they know what to do,” said Dave Hauch, long-term care sector co-ordinator for the Canadian Union of Public Employees (CUPE). “The movement away from that has blinded them in the run-up to this and blinded all of us to the actual state on the ground in terms of preparedness when this actually hit.”
Long-term care has been the epicentre of COVID-19 with outbreaks in 163 Ontario homes — including six in Hamilton — and 835 death as of Friday. Two of three health-care workers who have died of COVID-19 in Ontario worked in long-term care.
Six of Hamilton’s 20 deaths have been in care homes while another nine have been in other congregate living settings.
Of Hamilton’s current 439 confirmed and probable cases of COVID-19, 15 per cent are residents in congregate living and hospitals with active outbreaks. However, this doesn’t include those infected in outbreaks that have already ended.
“We know there are hundreds of families who have had their loved ones exposed to COVID-19 in long-term care outbreaks and also people who have lost their lives,” said Horwath, Hamilton Centre MPP. “There should have been a lot more done to protect those folks including those regular inspections.” While the virus has peaked in the community, it’s still accelerating in long-term care. Both the prime minster and Ontario’s premier have said the pandemic has revealed gaps in the system that need to be fixed. “We know long-term care homes are particularly vulnerable,” said Health Minister Christine Elliott on Friday. “We know we need to pay particular attention to long-term care.”
But no government has been doing thorough annual inspections of every home, including infection control procedures, since 2016, says the Advocacy Centre for the Elderly (ACE).
“If you’re not looking, you’re not going to find anything, and we’ve absolutely seen that during the pandemic,” said Jane Meadus, staff lawyer for ACE. “People don’t generally complain about infection control because they don’t know what the rules are.”
Meadus says the result has been homes woefully unprepared for the pandemic.
“Homes are having to have public health and hospitals come in to teach them infection control protocols and that is absolutely ridiculous,” she said. “These homes should be masters of infection control because the population in those homes are one of the most susceptible. They should every day be doing proper infection control protocols ... The regulations require it.”
CUPE says there are clear infection prevention and control rules in the provincial oversight of long-term care.
“If there were the regular quality inspections and compliance audits being done, it would hold the industry’s feet to the fire to make sure those thing were in place,” said Hauch. “Homes should always be prepared for an outbreak. COVID may have been something that developed relatively quickly but the whole notion of outbreaks in long-term care facilities is par for the course and happens all the time.”
While all homes have at least one inspection a year, the scope of those vary considerably. ACE says the Liberal government was doing comprehensive Resident Quality Inspections each year, but loosened the requirements for what would be included in them in 2016. It meant some homes still got the thorough review, but others got a watered-down version and there’s no way to tell which is which from the inspections posted by the government online.
The Progressive Conservatives scaled it back even further to focus primarily on inspections based on complaints and outbreaks, says Meadus. She believes it contributed to cracks in the system that have turned tragic during a pandemic.
“The transmission within the homes has been in many cases horrendous,” she said. “This should have all been stuff they were taught and trained in and it would appear that didn’t happen.”
ACE acknowledges the homes had some concerns about the inspections, particularly around excessive paperwork.
“If there was a problem with certain elements, they should have changed it,” said Meadus. “You don’t just stop doing it.”
She points out the population in long-term care is particularly vulnerable now that visitors aren’t allowed.
“Families aren’t able to go there, they aren’t able to advocate for the person and they don’t know what is going on.”