'It's crazy what they expect': Newmarket Residence part of a troubled housing system for Ontario's most vulnerable

'Warehousing people is just not healthy'

Yorkregion.com
Aug. 15, 2022
Kim Zarzour

What Lynn Steele witnessed, as caregiver to a woman living in a group home on the outskirts of Newmarket, haunts her still.

“I was beyond shocked,” says Steele, a personal support worker and founder of the Canadian PSW Network, describing what she saw at The Newmarket Residence, a privately-ran, for-profit facility known as Housing with Supports (HWS).

“I was appalled by the amount of wandering, the smell. The place reeked of urine, floors were sticky and I couldn’t find staff anywhere.”

Formerly called Domiciliary Hostels, HWS have faced criticism across the province for lack of regulation and oversight.

They offer housing and meals for people who need supervision for daily living -- with mental health diagnoses, physical or developmental disabilities or frail and elderly -- who can’t find housing anywhere else.

Studies show over one-third of guests have a history of homelessness.

Steele says she was one of only two PSWs employed by a large agency who were willing to work with clients at the home east of Newmarket.

The other agency staff felt unsafe, she says.

“Our ‘do-not-send’ list was massive. People would go once and never go again, or just refuse because of the reputation. It was very scary to work there.”

When asking for help from residence staff, she says was met with arrogance and hostility.

Steele was assigned to Newmarket Residence for three months, caring for a client, a woman in her early 30s, placed there after surgery on her leg.

A rehabilitation facility would have been more appropriate, Steele says, but there were no beds available.

The client had multiple medical issues limiting her ability to be mobile and care for herself, get in and out of bed or to the commode.

“That was the very sad part. If we, as the PSWs from the agency, could not go there that day, she was left in her bed.”

Steele says she visited the client twice a day for three months. The halls and grounds were filled with wandering, sometimes emotionally volatile residents.

“She cried every single visit .... She kept saying ‘I don’t understand why they put me here.’

“I didn’t see how she’d ever get well with no nurses, no exercises, fearing for her life, not sleeping. The only time she felt safe was when police were in the room responding to an assault on her roommate.”

And police were there often, she adds.

After every shift, Lynn filed reports to her agency about her concerns, but she never learned if there was follow up, nor what happened to the woman.

It’s not the first time alarm bells have gone off regarding Newmarket Residence.

In 2017, a YorkRegion.com article reported drivers nearly hitting residents wandering the busy, unlit, sidewalk-free highway. Others reported residents in distress, incontinent, impaired or panhandling at the local plaza.

YorkRegion.com presented 18 questions and concerns to Newmarket Residence, hoping to hear owner Icilda Tate’s side of the story.

We received an email reply:

“The Newmarket Residence is a licensed congregate living facility. It is owned and operated since 2005 by health-care professionals who provide housing with supports for individuals with mental health diagnosis.

“The facility continues to uphold the laws that govern congregate living facilities as outlined by the Regional Municipality of York Homelessness Community Programs Social Services.”

The Region administers 22 congregate living facilities like Newmarket Residence. Privately owned and operated, they receive subsidies from provincial and municipal governments and are geared toward individuals who would not otherwise be able to afford it, including those on Ontario Works, Ontario Disability Support Program (ODSP), or low-income seniors.

Home operators receive a fee subsidy on a per-diem basis, with costs shared between the region (20 per cent) and the province (80 per cent).

The region licenses and inspects the facilities to ensure compliance with the Lodging House Bylaw, operating agreements and standards of care, visiting each home several times a year, York Region spokesperson said.

Residents and families who have complaints can lodge them with the home, their caseworker, or by contacting the region’s licensing and compliance officer, Eman Ali said. Contact info is expected to be posted in each home next to the Residents’ Bill of Rights.

Shmukler Realty, a real estate brokerage specializing in Ontario residential care homes, describes it as a unique, rewarding business, although it’s "not for everyone."

The Realtor advises potential buyers online that they need only a police clearance for Vulnerable Persons and a Basic First Aid certificate. There are no qualifications required for employees other than Vulnerable Persons clearance and Basic First Aid and nurses are not required because residents’ medication is clearly labelled in bubble packs.

As for worries about safety, “violent persons are not candidates for these types of homes. Social service workers who place residents will ensure all residents are compatible” it says.

But Connie Evans, past president of the Ontario Homes for Special Needs Association and owner of the Queenview Residential Home for women in Queensville, says it can be a difficult business to operate.

“At Newmarket Residence, they take clients that require a lot more care that many homes won't take ... that are way harder on things, way sicker,” she says, adding all HWS facilities are struggling and underfunded.

York’s per-diem rate is higher than other jurisdictions ($59 compared to an average $53) but it’s still not enough, she says.

Evans says funding has not kept up with increased operating costs such as minimum wage, energy, food, more complex client care programs and standards, regulatory requirements and increased staffing with greater qualifications requirements.

Homes can’t afford to hire trained PSWs or other professional staff, she says.

”We have to do everything in that per diem ... I mean, it's just, it's crazy what they expect .... We could never afford private bedrooms, their own bathrooms, things that we'd love to be able to do.”

Many home operators are selling their facilities, she says, “but it’s very, very hard to sell when you're showing financials that are not showing much income. I don't make as much profit now as when I bought the home 30 years ago.”

The pandemic made it worse, she says, with outbreaks, challenges finding staff and the struggle to keep clients with mental health issues confined to rooms for long stretches of time.

Because HWS are located disproportionally outside of city centres, residents are geographically isolated from community, services and leisure, says Megan Linton, a researcher and one of the top experts in domiciliary hostels in Ontario.

Daryl Urquhart noticed this in Georgina, where he raised concerns about an inordinate number of the homes located in his small rural community.

Living across from Halsey Lodge, Urquhart says he watched residents toss lit cigarettes in bushes, beg for money and peer into his windows. They had little to do besides hang out on the sidewalks, he says, and it led to troubles between hostel residents and the more transient, recreational/vacation-oriented summer populations that swarmed to the surrounding lakeside communities in summer.

That was in 2009 and little has changed since then, he says.

“You get the fire department showing up, ambulance, police every month. Something is happening in these facilities, and we don't really know what it is.”

The homes were created after Ontario deinstitutionalized regional centres, but “when it became a private enterprise, it became a business opportunity,” Urquhart says. It's something he says he’s familiar with as past director of business development and co-owner of privately-owned Shouldice Hospital in Thornhill.

“The quality of health care is challenged by the need to maintain a viable working business plan.”

For decades, critics have called for investigation and an end to these facilities, Linton says.

“We know very little about living conditions ... who owns them, their size and staffing levels, or their record of health code violations. What’s more, there is no centralized database for reporting on these municipally regulated institutions.”

Because there are few qualifications for residing in HWS, there are few specialized supports, she says.

“It also makes it a place where more bad things can happen because of the vulnerabilities of people who end up there.”

Residents can include a mix of people leaving the justice system, moving in and out of shelters or with developmental disabilities.

“Lots of the people who are in these places have been completely abandoned both by our government and often also by their social networks ... and the conditions are further debilitating them, further isolating them.”

Unlike long-term care and retirement homes -- subject to inspections with results publicly posted online -- results of complaints and inspections of HWS are not as readily available, said Jane Meadus, staff lawyer ad institutional advocate with Advocacy Centre for the Elderly.

Dr. Stephen Hwang one of the world's most renowned researchers in homelessness and part of the MAP Centre for Urban Health Solutions at St. Michael’s Hospital, agrees.

“If it were a shelter, or a long-term care home or retirement residence, there'd be someone who tracks it, but because of this kind of odd in-between category and because it's run through the municipalities, there's no standardization.”

Jeff Burch, NDP MPP for Niagara Centre, introduced a private members bill that would do just that.

In response to what he describes as “horrific, unlivable conditions” in some of the homes across the province, Bill 164 called for provincial regulation of supportive living homes.

It passed second reading unanimously but did not become law before government broke up for the 2022 provincial election.

Burch plans to reintroduce it again.

“This idea of warehousing people is just not healthy,” says Rabia Khedr, national director of Disability Without Poverty.

Khedr believes a supplemental income benefit would help, as would a better supply of affordable, accessible housing.

“You hear horror stories everywhere you go. If people don't have natural support, don't have money and don't have allies to advocate for them, we, as a society, are failing.

“We really need to awaken out of this pandemic with a will to change systems and ensure that we don't leave anybody behind, that we give every person basic human dignity.”