City making 'monumental effort' to deal with issues in long-term care: councillor
Hard working staff say they deal with huge diversity of ages, needs, medical issues

Ottawacommunitynews.com
Sept. 22, 2017
By Jennifer McIntosh

It's a tough job dealing with some of our most vulnerable residents, but the city says it is doing what it can to improve care at the four municipally-run long-term care homes.

The oldest resident in the city's homes is 109 years old, the youngest 43. Staff highlighted the differences, as well as the complex medical needs, in a report to the community and protective services committee on Sept. 21.

The committee heard the report as part of the response to a "direction" from the province following a string of events, which included covered up injuries and abuse at the Garry J. Armstrong home on Island Lodge Road.

The incidents resulted in a director referral order from the Ministry of Health and Long-Term Care. The order made a series of suggestions - including the supervision of non-regulated staff, such as support workers.

Among the complaints was a staff member punching a resident in the face.

There are 712 residents at the city's four long-term care homes. Garry J. Armstrong is the subject of four complaints under the Long-Term Health Care Act subsection that deals with abuse and neglect.

There are 1,023 staff members for those homes. Residents could come in contact with as many as 15 staff daily and 468 of those staff members are personal support workers.

City manager Steve Kanellakos said that staff, along with council, had a visceral response to the incident.

"Many of us have parents in long-term care facilities," he said. "That said, staff is accountable for the service and care in our homes."

Among the fixes proposed by staff are an advisory group, made up of families of residents, staff, stakeholders and management. There was a feedback session held at the Carleton Lodge in Nepean on Sept. 20, with more than 100 attendees and 40 pages of comments. Janice Burelle, general manager of community and social services, said staff is going over the comments and stakeholder engagement will continue into October.

Dean Lett, head of long-term care for the city, said all mandatory training on abuse will be done by Dec. 1 for current employees.

The group has met weekly since mid-August when the order was issued, said Burelle.

There are also plans for mandatory training to be done annually on things like infection control and abuse. All staff must follow residents' care plans 100 per cent of the time. Not following can constitute abuse - especially if it's things like a late meal or a missed dose of medication.

Jamie Dunn, executive director for the Civic Institute Professional Personnel, the union that represents nurses who work in the homes, said members are overworked and underpaid, but attention to the issue over the summer has led to them being scapegoated.

"The finger pointing should stop and we should look for solutions," he said.

Dunn said nurses are being assaulted at work and working without taking lunches or breaks.

"They're often working later without being paid as well," Dunn said.

Lett said he wanted to recognize that the city homes are lively, loving places, with activities that recognize different levels of cognition.

The issue of long-term care is complicated by the needs of the patients. Seniors are going into care later in life, often with several diagnoses and many suffer from dementia.

Included in the report was information about satisfaction surveys completed by residents and their families. Last year, 95 per cent of respondents said they were satisfied with their home.

Shad Qadri, who chairs the board of health, asked about the ability of residents with cognitive impairment to properly complete a satisfaction survey.

River Ward Coun. Riley Brockington was concerned about the disconnect between the hours of care Ottawa provides and the province — as well as high scores on satisfaction surveys, paired with complaints of abuse by nursing staff.

"The comments from Mr. Dunn about overworked staff and the amount of resident care doesn't mesh," he said. "What am I missing here? How can satisfaction be so high? Are you just not asking questions that get to the heart of it?"

Lett reiterated that the set of incidents shouldn't tarnish the city's care as a whole.

"I appreciate the reactions to this order and the disbelief that one of our staff would abuse a resident," he said, adding the city was surprised to see three homes included in the order.

"The response was that inspectors felt there was a risk at the other facilities," he said, adding any  changes will be implemented across the board.

Adele Furrie, a member of the advisory board, commended the dedication of the members through a difficult period. Furrie said management should take responsibility for what happened in their home, but so should the ministry.

"The ministry should revisit the standard. Does it really reflect today's reality?" she asked, adding residents have more complex needs.

Furrie said the ministry should also look at the funding for personal support workers and whether they get paid adequately for their services.

The city provided $14.3 million toward long-term care last year, Burelle said.

Beverlee McIntosh, from the Ottawa Council on Women, said hours of care provided to seniors in Ontario is among the nation's lowest.

The provincial average is 3.15 hours a day per resident. In Ottawa, that number is 2.56.

Committee chair Diane Deans asked if the hours of care provided by the city is enough; Burelle said staff is looking at the service delivery model to see if staffing levels could be brought up during peak times.

While Deans said staff have shown a "monumental effort" to deal with the problems, she thinks there needs to be a national strategy on long-term care.

"What keeps me awake at night is the future, as baby boomers get older."