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The people living in Ottawa’s city-run nursing homes are content, they’re cared for by diligent professionals, and if there are any problems they’re mostly the miserly provincial government’s fault, city council’s community-services committee agreed Thursday.
Those problems include a personal-support worker’s being recorded punching a debilitated resident in the face, patients’ families being barred after complaining about their loved ones’ care, and the Ministry of Health and Long-Term Care issuing an extraordinary set of orders to the city to stop neglect and abuse and live up to residents’ care plans.
Managers responsible for the city’s four nursing homes — also called long-term care homes — and their 712 residents have been busy since the Citizen’s Elizabeth Payne broke the news in July that a worker at their Garry J. Armstrong nursing home had been caught by a suspicious family’s camera punching 89-year-old Georges Karam 11 times when Karam resisted having his diaper changed.
Jie Xiao pleaded guilty to assault. But that was just the start of it. The health ministry looked at the city nursing homes’ histories and found them severely deficient.
Georges Karam, in his room at the Garry J. Armstrong home in Ottawa. The Citizen published a video showing a personal support worker repeatedly punching the 89-year-old, leading to an investigation of the city’s four municipal nursing homes.
Steve Kanellakos (the city manager), Janice Burelle (his deputy in charge of social services), Dean Lett (her deputy in charge of nursing homes) and Lise Girard (his deputy in charge of Carleton Lodge in particular) faced their political overseers for the first time Thursday morning to account for themselves.
“As a group, I have to say that I’m extremely proud and stand behind our staff. It is extremely difficult, it is emotional, they deal with loss every year,” Burelle said, taking the lead. The assault on Karam was an isolated incident in a system that overwhelmingly works well.
“The criminal actions of a single worker were truly upsetting to every one of us,” Lett said. “It has given us a timely reminder of the need to take a look at our daily operations … with new eyes.”
The city filed “compliance plans” last week for fixing the problems the provincial inspectors identified.
If the province approves them, the plans will have the city:
“I know this has been a difficult few months for you,” Coun. Diane Deans told the senior staffers before her. “I think what you have done today is give this committee great confidence that you have taken this with the seriousness we expect (and) that you are making monumental efforts to improve care for our most vulnerable residents.”
Clearly a great deal of work has gone into all this. Nobody imagines the people in charge of nursing homes are OK with seeing patients mistreated. Standards in this field can be very fussy: the lovely non-profit nursing home where my grandfather lived for 10 years was once written up for leaving soup in front of a frail resident for six minutes before someone was free to feed the person.
Still, when part of the response to findings that care isn’t meeting standards is to revise the standards so they’re “more realistic,” it’s hard not to worry a little. Also, they’ve surveyed residents and boast a 95-per-cent satisfaction rate. But it turns out that that survey was completed by 286 people. Nearly two-thirds of residents, by definition the most vulnerable, were judged incapable of answering the questions.
In spite of everything that needs fixing, politicians and staff alike laid a lot of responsibility on the provincial government. Nobody is happier than a politician with somebody else to blame.
The city spent $64 million to run its nursing homes last year. The provincial government, which pays for the medical component of care in any nursing home, paid the city $34 million and residents’ fees covered $17 million. Municipal taxes covered the rest.
Over the past 10 years, the city’s share of the bill has crept up from 27 per cent to 29 per cent, Girard explained. “We’ve had cost-of-living increases (from the province). That’s about all,” she said.
But inflation isn’t the only pressure on the budget. Nursing home residents are generally living longer and dealing with more complex health problems, which means caring for them is more expensive.
“There’s a huge ghost and shadow in the room,” Rideau-Vanier Coun. Mathieu Fleury said sympathetically. “There’s an increased need and an increased demand for our services.”
“Look at it as a bigger picture, the staff is doing the best they can given the resources they have, from the city but more importantly from the provincial side,” Stittsville Coun. Shad Qadri agreed.
Councillor Diane Deans listens to presentations as councillors take part in the City of Ottawa’s draft 2017 Budget being tabled at City Hall.
It’s only going to get worse, Deans said, as the elderly population grows. Ontario should be on a spree of nursing-home construction but it isn’t.
Nevertheless, Lett told the councillors that Ottawa’s municipal nursing-home residents get less direct personal care than the provincial average. The average is 3.1 hours of care per resident per day; in Ottawa’s city-run nursing homes, residents get half an hour less.
Deans repeatedly said it’s not right to compare the hours of care a city-run nursing home gives with the hours given in a private nursing home that charges $5,000 or more a month. Private facilities pull up the average hours, so maybe the city’s not doing too badly, she suggested.
The problem: All nursing homes charge the same fees, regulated by provincial law. A shared room costs a patient $1,819 a month; a nicer private one is $2,599. No matter where you go.
Deans had confused nursing homes with retirement homes, which can charge whatever residents are willing to pay. Many of them offer add-on services like those in nursing homes, from medication assistance to personal hygiene to secure floors for dementia patients, but they aren’t nursing homes. Whatever care they provide isn’t included in the reckoning of nursing-home care hours.
This is admittedly complicated but Deans is the chief overseer of the city nursing homes and she’s had more than two months to get to grips with the material. Lett eventually had no choice but to correct her.
Rideau-Rockcliffe Coun. Tobi Nussbaum observed that the health ministry cracked down after three years of bad inspection reports, totalling hundreds of incidents. Can you tell us that the next three years will have fewer violations of provincial standards? he asked.
We expect what we’re doing will lead to more realistic expectations and better care, Lett told him.
dreevely@postmedia.com
twitter.com/davidreevely
查看原文...
Those problems include a personal-support worker’s being recorded punching a debilitated resident in the face, patients’ families being barred after complaining about their loved ones’ care, and the Ministry of Health and Long-Term Care issuing an extraordinary set of orders to the city to stop neglect and abuse and live up to residents’ care plans.
Managers responsible for the city’s four nursing homes — also called long-term care homes — and their 712 residents have been busy since the Citizen’s Elizabeth Payne broke the news in July that a worker at their Garry J. Armstrong nursing home had been caught by a suspicious family’s camera punching 89-year-old Georges Karam 11 times when Karam resisted having his diaper changed.
Jie Xiao pleaded guilty to assault. But that was just the start of it. The health ministry looked at the city nursing homes’ histories and found them severely deficient.
Georges Karam, in his room at the Garry J. Armstrong home in Ottawa. The Citizen published a video showing a personal support worker repeatedly punching the 89-year-old, leading to an investigation of the city’s four municipal nursing homes.
Steve Kanellakos (the city manager), Janice Burelle (his deputy in charge of social services), Dean Lett (her deputy in charge of nursing homes) and Lise Girard (his deputy in charge of Carleton Lodge in particular) faced their political overseers for the first time Thursday morning to account for themselves.
“As a group, I have to say that I’m extremely proud and stand behind our staff. It is extremely difficult, it is emotional, they deal with loss every year,” Burelle said, taking the lead. The assault on Karam was an isolated incident in a system that overwhelmingly works well.
“The criminal actions of a single worker were truly upsetting to every one of us,” Lett said. “It has given us a timely reminder of the need to take a look at our daily operations … with new eyes.”
The city filed “compliance plans” last week for fixing the problems the provincial inspectors identified.
If the province approves them, the plans will have the city:
- improve nurses’ supervision of “non-regulated staff” like personal-support workers,
- update the system for tracking the care plans for residents and revising them so they’re clear and “more realistic,”
- invest more energy in dementia patients who have language and cultural barriers compounding their mental declines, and
- retrain staff to remind them not to abuse or neglect patients or stand by while someone else does.
“I know this has been a difficult few months for you,” Coun. Diane Deans told the senior staffers before her. “I think what you have done today is give this committee great confidence that you have taken this with the seriousness we expect (and) that you are making monumental efforts to improve care for our most vulnerable residents.”
Clearly a great deal of work has gone into all this. Nobody imagines the people in charge of nursing homes are OK with seeing patients mistreated. Standards in this field can be very fussy: the lovely non-profit nursing home where my grandfather lived for 10 years was once written up for leaving soup in front of a frail resident for six minutes before someone was free to feed the person.
Still, when part of the response to findings that care isn’t meeting standards is to revise the standards so they’re “more realistic,” it’s hard not to worry a little. Also, they’ve surveyed residents and boast a 95-per-cent satisfaction rate. But it turns out that that survey was completed by 286 people. Nearly two-thirds of residents, by definition the most vulnerable, were judged incapable of answering the questions.
In spite of everything that needs fixing, politicians and staff alike laid a lot of responsibility on the provincial government. Nobody is happier than a politician with somebody else to blame.
The city spent $64 million to run its nursing homes last year. The provincial government, which pays for the medical component of care in any nursing home, paid the city $34 million and residents’ fees covered $17 million. Municipal taxes covered the rest.
Over the past 10 years, the city’s share of the bill has crept up from 27 per cent to 29 per cent, Girard explained. “We’ve had cost-of-living increases (from the province). That’s about all,” she said.
But inflation isn’t the only pressure on the budget. Nursing home residents are generally living longer and dealing with more complex health problems, which means caring for them is more expensive.
“There’s a huge ghost and shadow in the room,” Rideau-Vanier Coun. Mathieu Fleury said sympathetically. “There’s an increased need and an increased demand for our services.”
“Look at it as a bigger picture, the staff is doing the best they can given the resources they have, from the city but more importantly from the provincial side,” Stittsville Coun. Shad Qadri agreed.
Councillor Diane Deans listens to presentations as councillors take part in the City of Ottawa’s draft 2017 Budget being tabled at City Hall.
It’s only going to get worse, Deans said, as the elderly population grows. Ontario should be on a spree of nursing-home construction but it isn’t.
Nevertheless, Lett told the councillors that Ottawa’s municipal nursing-home residents get less direct personal care than the provincial average. The average is 3.1 hours of care per resident per day; in Ottawa’s city-run nursing homes, residents get half an hour less.
Deans repeatedly said it’s not right to compare the hours of care a city-run nursing home gives with the hours given in a private nursing home that charges $5,000 or more a month. Private facilities pull up the average hours, so maybe the city’s not doing too badly, she suggested.
The problem: All nursing homes charge the same fees, regulated by provincial law. A shared room costs a patient $1,819 a month; a nicer private one is $2,599. No matter where you go.
Deans had confused nursing homes with retirement homes, which can charge whatever residents are willing to pay. Many of them offer add-on services like those in nursing homes, from medication assistance to personal hygiene to secure floors for dementia patients, but they aren’t nursing homes. Whatever care they provide isn’t included in the reckoning of nursing-home care hours.
This is admittedly complicated but Deans is the chief overseer of the city nursing homes and she’s had more than two months to get to grips with the material. Lett eventually had no choice but to correct her.
Rideau-Rockcliffe Coun. Tobi Nussbaum observed that the health ministry cracked down after three years of bad inspection reports, totalling hundreds of incidents. Can you tell us that the next three years will have fewer violations of provincial standards? he asked.
We expect what we’re doing will lead to more realistic expectations and better care, Lett told him.
dreevely@postmedia.com
twitter.com/davidreevely
查看原文...
