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Homes safer than Star report suggests
Compliance reviews seen as helpful outside
look
Tuesday December 9, 2003 John Driscoll
When the Toronto Star reports that 79 per cent of Ontario’s 544
nursing homes had quality-of-care problems in 2002 according to compliance
review data from the Ministry of Health, the situation might sound horrible
to the uninformed.
But that data does not mean that all homes are unsafe with residents at
risk and certainly does not paint a complete picture, says Nelly Hobbs
who has been administrator at Rosebridge Manor for 18 years.
“The vast majority of people in this industry work very hard and
do such a good job that it is unfair to paint us all with the same brush,”
Nelly says.
Every compliance review includes more than 500 specific standards to be
met in every area of operations, Nelly says. “To meet every standard
every day for every resident is impossible in an environment of frail
elderly people that changes every day,” she says.
The Star might have explained what compliance is and what it entails,
to present a fairer picture of long-term care in the province, Nelly says.
“We don’t look at compliance reviews as a negative thing,”
she says. “It’s a good quality assurance tool, giving us another
pair of eyes to look at what is working and where improvements need to
be made.”
Homes tend to “get their knickers in a knot” when they learn
a compliance review is going to happen, says Arlene Lawlor, administrator
and director of care at Maplewood in Brighton. “But the compliance
review is only about what we should always be doing.”
Arlene says she is in favour of “surprise inspections” since
homes do try to comply with the standards and should have nothing to hide.
The compliance review is two or three days of poring over statistics and
case studies but a better view of a home can result from visiting a home
and getting a feel for the place, talking to residents, staff and family,
Arlene says.
Compliance reviews are valuable because they provide an external point
of view but they concentrate only on the negative, she says. “They
are looking for problems while we are taught at OMNI to look also for
the good things you are doing.”
“I’m not saying non-compliance doesn’t happen but all
the good things should not be negated as they were in the Star articles.”
A major problem with the compliance review is that standards are not consistently
enforced throughout the province, says Arlene. Nelly agrees. “There
are huge inconsistencies,” she says.
Nelly gives one small example. At Rosebridge, staff wear aprons when feeding
residents, a regulation important for infection control. “It is
very basic, yet I visited another home (not an OMNI home) in another part
of the province several times where nobody wore aprons. There is no consistency
in how the standards are administered.”
Another weakness in the enforcement of standards is a home’s reputation,
Nelly says. “When I came here 18 years ago, before it was an OMNI
home, Rosebridge had a bad reputation and it took us years to reverse
that. But the reverse is also true. When a home has a good reputation,
the Ministry doesn't look as closely and things are missed.”
Nelly says she and her staff were “really upset” when they
read the tragic tale of 93-year-old Natalie Babineau whose daughter discovered
a bedsore on her back that had begun to decay while she was a resident
in a Hamilton long-term care home.
“This should never have happened to this woman,” Nelly says.
“There is no excuse.” Families must take an aggressive stand
as advocates for a loved one living in long-term care, she says. “You
have to be an advocate.”
Good communications at all times with families are key in long-term care,
she says. “You have to let families know what is going on.”
Families should familiarize themselves with homes before choosing a home
for an aging family member, Nelly says. “Visit a home and see how
the staff are and what the atmosphere is like. If the staff is not friendly
and caring, you should think about another home.”
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To read the series published
in the Toronto Star, click
here.
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