Allegations of resident-on-resident abuse at Simcoe County’s four long-term care homes have been revealed as part of the annual inspection reports presented to county council on Tuesday.
However despite the reports, the county is still below the provincial average in 2018 for number of inspections. The four long-term care homes overseen by the County of Simcoe are Trillium Manor in Orillia, Georgian Manor in Penetanguishene, Simcoe Manor in Beeton and Sunset Manor in Collingwood.
“When we look at all the homes, they have either zero or one finding of that type of infraction. We’re pleased with that because when you look at averages, our average is about 0.5 of compliance orders [per year],” said Jane Sinclair, general manager of health and emergency services with the County of Simcoe in an interview this week with Village Media. She added the average number of written notices received by the ministry at county homes is 2.6 per year in 2018, whereas the provincial average is 3.6 per year for 2018.
In the 2018 calendar year, three of the four long-term care homes run by the county received a resident quality inspection (RQI). In addition, the Ministry of Health and Long-Term Care conducted three complaint inspections, two critical incident inspections and two follow-up inspections.
The inspections revealed some residents sustaining injuries due to resident-on-resident violence and alleged abuse by staff members. There were also reported instances of medication incidents, issues with infection control, concerns about incident reporting and training issues across the board.
At Sunset Manor in Collingwood, five inspections took place in 2018. In addition to the regular resident quality inspections, there were also two complaint inspections and one critical incident inspection. While there were no findings of non-compliance in regards to the two complaint inspections, the critical incident inspection outlined an incident of resident-on-resident violence.
The action plan’s areas of focus included bed rails, plan of care, zero tolerance of abuse by anyone, duty to report to the director, safe transferring, training, administration of drugs and drug incidents.
However, on Jan. 8, 2019, another inspection took place at Sunset Manor, due to allegations by four residents of abuse by a staff member, according to another report.
“It is common,” said Sinclair of resident-on-resident abuse. “It’s common in all long-term care homes. Unfortunately you sometimes see those worst-case scenarios on TV or in the media.”
“What we’re seeing is, the clients we care for – not just in our homes, but in all homes – they’re older, they’re more frail. They have more complex needs, and we’re seeing a much higher level of folks with dementia,” said Sinclair. “Those are typically the folks we see in these situations. Because of the disease they’re struggling with, they can’t communicate well. They get aggressive sometimes. Sometimes, that means they’ll get angry with a co-resident.”
Trillium Manor in Orillia saw two inspections in 2018: one complaint-driven and one critical incident inspection. The inspection was triggered by allegations of resident-on-resident abuse. The findings of the report concluded the licensee failed to ensure steps were taken to minimize the risk of altercations and potentially harmful interactions between residents by identifying and implementing interventions.
Georgian Manor in Penetanguishene saw two inspections in 2018. As a result, the action plan for the home included staff re-training on head injury routines, labelling of personal items and medication administration.
Simcoe Manor in Beeton had one full resident quality inspection in 2018, resulting in an action plan with a focus on a resident plan of care, medication incidents, infection control, critical incident reporting, doors and furnishings.
Despite the outcome of the inspections, all county-run homes were rated low risk due to their plan of action to rectify ongoing issues.
“Anytime the ministry comes in and does any review, if there are any findings from the ministry at all, we automatically pull a team together and put together a plan of action,” said Sinclair. “We’re fortunate that we have a quality assurance team that supports all the long-term care homes.”
Depending on the issue, the plan of action could include further education or training for staff, or looking at scheduling or staffing levels.
“For example, one of the homes was looking at moving some staffing numbers from an afternoon shift into a night shift to better manage dementia-related behaviours during the night shift,” said Sinclair. “In the evenings, dementia patients get a little more confused and mixed up... so we actually targeted enhanced staffing in the evenings to provide more support.”
While, ideally, the number of incidents at any long-term care home would be zero, Sinclair says the nature of dementia as a disease makes that an unlikely outcome. However, there is hope on the horizon.
“The good side of it is, there’s been a lot more funding of the last couple of years to help with training and education,” said Sinclair, noting when the county received an influx of cash last year from the provincial government, that money was invested in new mandatory training around responsive behaviours, which teaches staff how to de-escalate volatile situations in homes.
“Some of it looks daunting, but some of (the issues) are more about reporting. We’re required to report any incident of potential abuse immediately with written documentation within 24 hours. Sometimes there might be a delay,” said Sinclair. “They might not get the notification for, say, two days, and that might be what the citation is about.”
“For some of them, we didn’t dot the i or cross the t, but they’re not very serious in nature,” she added.
Results of inspections for long-term care homes are publicly posted. To view the detailed reports on each inspection, or to search for a specific home, click here.
