Ontario has bigger conerns then Home Inspectors .
Ontario’s long-term care home inspections suffer ‘serious, systemic problems’: watchdog
Posted on Tue, Dec 21, 2010, 2:22 pm by Keith Leslie
TORONTO – There are some “serious, systemic problems” with the Ontario government’s inspections and monitoring of long-term care facilities, which house 75,000 people, Ombudsman Andre Marin reported Tuesday.
Marin began an investigation of the 616 long-term care homes after The Canadian Press reported three-quarters of them consistently failed to meet the province’s 450 standards of care.
The ombudsman had received 100 complaints before he started his probe in July 2008, but received another 450 during the investigation.
Some homes had repeatedly failed to give residents the minimum two baths a week, while inspectors encountered other seniors wallowing in foul-smelling and bulky diapers.
The investigation found the Ministry of Health and Long-Term Care “routinely” tells people to take complaints to the home operators, something residents and families found intimidating, said Marin.
“Many complainants expressed fear about complaining directly to a home because of the risk of reprisal against them or their loved ones. Some were threatened with being banned from the home, and in one case a lawsuit was threatened,” he said.
Among the serious concerns raised by the ombudsman were “the inconsistent interpretation and applications of standards, the sheer volume of standards, inspection delays, slow and insufficient response to public complaints, and inadequate, and at times inaccurate public reporting on the compliance status of homes.”
Different regional offices of the ministry fostered divergent compliance approaches, said Marin, with some putting more emphasis on an “advisory” relationship with long-term care facilities while others pursued an “enforcement” model.
“At times this resulted in facilities with the same compliance issues receiving different treatment,” he said.
“We also found significant variation amongst compliance advisers in their classification of ‘unmet’ standards, a source of considerable frustration for long-term care home operators.”
Random annual inspections of long-term care homes are rarely the surprise they’re supposed to be, especially when there’s always an end-of-year rush to complete inspections, said Marin.
“Unfortunately, all too often the ministry loses the advantage of surprise when home operators are alerted to the fact that an inspection is likely to occur,” he said.
The Ministry of Health only “very rarely” revokes a home’s licence for consistently failing to meet the provincial standards, but it did issue more frequent cease admission orders in 2008 and 2009.
Inconsistent application of standards can result in dangerous situations going unchecked, warned Marin as he cited the deaths of two residents at Leisureworld O’Connor Gate in Toronto in 2008.
“The ministry’s investigations subsequent to these fatalities brought to light the ministry’s own failure to identify a home with significant problems,” said Marin.
“It was clear that management turnover in the regional office, inadequate staff training and monitoring, gaps and disconnects in the compliance data, inconsistent identification of resident risks and failure to escalate enforcement all contributed to the inability of the ministry to property oversee this home.”
However, Marin said he was hopeful the government was now taking the problems seriously, and after a new Long-Term Care Act took effect last summer, he decided not to release his full report into the investigation.
“I am guardedly optimistic that the proposed organization reforms and new regulatory scheme will lead to more effective oversight by the ministry and ultimately improvement in the living conditions and care experienced by long-term care home residents,” wrote Marin.
“However, this area continues to be a work in progress and I intend to monitor the ministry’s ongoing progress closely.”
The ombudsman released only a summary of his investigation Tuesday, along with responses from the Ministry of Health, but warned he would reopen the investigation and release a report if he feels it’s warranted