Continuing Problems in Ontario LTC homes December 2011-- In 2003 The Toronto Star published a hard-hitting series about the problems in nursing homes in Ontario . It was headlined “Natalie's Story” and it galvanized the Minister of Health and Long Term Care at the time into action. Eight years later, we have seen fundamental changes in the long-term care homes system. To name a few: • Unannounced annual inspections • A new Long-term Care Homes Act with corresponding regulations, intended to be more outcome-focused. • A transformed inspection system, which includes complaint, critical incident, and follow up investigations, as well as annual inspections of every home. The inspection protocols include interviews with residents and family members. As previously, all reports are public. As well, there are several new initiatives underway aimed at improving the quality of care of residents in long-term care homes in various ways. For example:
The recent Toronto Star articles (published in November 2011) reported on the results of the many complaint and critical incident investigations that the MOHLTC inspectors have undertaken in the past year under the new inspection system. They show incidents of poor care, neglect and even abuse. Minister Deb Mathews called an emergency meeting (which included Concerned Friends) to discuss the issues raised by the articles. As a result a task force has been formed to address these issues and produce an Action Plan. At the time of writing, the task force is being formed and its Terms of Reference formalized. We do know that its work will be very focused on receiving input from residents, family, staff and administrators in Ontario 's long-term care homes to order to address these issues in an Action Plan. We have seen eight years of hard work on the part of all stakeholders, as well as innovative programs, and increased monitoring of the LTC homes focused on patient safety, care, and quality of life. In fact, it is the increased monitoring by Ministry inspectors that has resulted in these public reports which are detailed in the Star. This demonstrates that long-term care homes are being carefully monitored and held to account for their deficiencies. This is a good thing. On the other hand, it is discouraging that, in spite of all the initiatives and innovate programs such as those listed above, we are still hearing sad stories about poor care in long-term care homes. Concerned Friends is actively participating in the Task Force and will work hard to ensure the Action Plan is practical and effective. Concerned Friends recognizes that residents with aggressive behaviours are a growing problem in long term care homes. As stated in the Star, more staff, and in particular, staff with extra training, are needed to deal with this problem. Pat Morden, the excellent speaker at our AGM in November, spoke eloquently about the importance of relationships in long term care homes. But how can a front-line worker develop a relationship with the residents she cares for when she has to get 13 (or more) frail and possibly confused individuals up, groomed, dressed, and to breakfast on time? It takes time, patience, skill, expert knowledge and training. All of which cost money. Everyone sitting around the table at the emergency meeting called by Minister Mathews, in response to the Star series, was already well aware of the situations outlined in the reports. The Task Force is an important undertaking, and we hope it will result in the creation of a safer environment for our residents, families and staff. We also believe that more money is needed in the long-term care system to deal with the increasing acuity of residents overall as well as the increasing number of residents with severe behavioural issues. Hiring practices need to be improved and we need to find ways to attract and sustain good staff to long-term care. Here are three fundamental changes Concerned Friends believes must occur in order to achieve real improvement in the long-term care system in Ontario . • Improve the funding system so that homes are funded based on the needs of their residents (get rid of the case-mix system, which everyone, including the Ministry, knows does not work well) • Attract and hire more and better trained front-line workers ( standardize and improve the education and training of PSWs ) • Spend wisely ( e.g. on improved home care rather than on more LTC beds) Let us hope that this is the last “expose” of long-term care homes in Ontario that we read about in The Toronto Star! |