Serious problems in long-term care home inspections
TORONTO - There are "serious, systemic problems" with the Ontario government's oversight of long-term care facilities, which house 75,000 people in the province, ombudsman Andre Marin reported Tuesday.
However, the provincial watchdog said he was "guardedly optimistic" new legislation and changes at the Ministry of Health would address the concerns.
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.
That issue and other concerns raised by the ombudsman have been addressed to focus more on the needs of long-term care residents, said Health Minister Deb Matthews.
"It used to be an inspector would go to inspect a home and not even speak to a resident," Mathews said in an interview.
"Now, speaking to residents about the care they're receiving, speaking to family members, that's where they start, so it's way more about how a resident is doing."
Marin might be willing to give the government the benefit of the doubt for now, but the Opposition isn't convinced the Liberals have really changed things at long-term care facilities.
"Six years ago, (then) health minister George Smitherman promised a revolution in nursing home care in Ontario, and yet the same complaints in this report crop up time and time again," complained Progressive Conservative critic Jim Wilson.
"We see our seniors are continuing to be neglected."
The New Democrats said the Liberals have had years to fix the problems in long-term care homes but haven't done a good job of addressing the issues.
"The ombudsman paints a disturbing picture of a government that isn't enforcing standards," said NDP health critic France Gelinas.
"Seniors and families have nowhere to turn for answers when something goes wrong."
Among the serious concerns raised by the ombudsman were "the inconsistent interpretation and application of standards, inspection delays and slow and insufficient response to complaints."
Different regional offices of the ministry had divergent approaches, said Marin, with some wanting an "advisory" relationship with homes 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.
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.
However, Matthews said things have changed dramatically in the long-term care sector and people should have confidence when moving a loved one into one of the homes.
"People are getting very, very good care," insisted Matthews.
"They're getting better food, more activities. We know exactly where we're going and ... we really can improve the quality of life for people in long-term care."
The government is now taking the problems seriously, agreed Marin, and implemented a new Long-Term Care Act last summer, so 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.
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.