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Seniors Suffer from Contracting Out

Inspection reports reveal grim conditions at seniors' homes. One operator blames new contract employees.

By Russ Francis 25 Feb 2005 | TheTyee.ca
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The operator of a Victoria seniors home cited repeatedly by the Vancouver Island Health Authority for the poor conditions suffered by its residents has blamed the problems on disruptions caused by contracting out the work of support staff and other employees.

In one case, last August a VIHA inspector found a bedspread at Beacon Hill Villa --which is practically across the street from the legislature--covered in stool. In another case at the Villa, a resident awoke one day last October to find her bed soaked in urine, after staff failed to wake her for a bathroom visit.The Villa is owned by Retirement Concepts, a privately-held Vancouver-based company. Its chief operating officer and president is Mary McDougall, who says the contracting-out was disruptive.

'As a result of the change in how we deliver services, there were incidences,' McDougall says. 'It was tough.'

Before 2004, the Villa had an 'outstanding' reputation for service, she adds. 'We're confident that we are very close to getting that reputation back.'

Asked if the company planned to reverse its contracting out policy, McDougall replied: 'No. The wages weren't at market.'

She explained that the staff pay rates had been too high.

The jobs of dietary and laundry staff and housekeepers at the Villa were contracted out to the British-based Compass Group in 2002. Last year care aides' jobs were also contracted out.

According to VIHA records, obtained under a Tyeefreedom-of-information request, inspectors handed Beacon Hill Villa a 'high' health and safety hazard rating on 14 separate occasions in the first 10 months of 2004. Names of the facility residents and some other details were withheld from the reports, on the grounds that releasing them would constitute an unreasonable invasion of privacy.

The problems appear to have since been dealt with.

A block from legislature

The Villa, on Superior Street in James Bay, is less than one block away from the legislature; the education ministry sits on the same block, on the opposite side of the street.

Health authority inspectors found many problems at the Villa during a series of inspections last year. Its residents appear to fall more often than expected in similar facilities, according to a June 30 inspection report. Villa residents suffered about 70 falls per month, says the report.

During a routine inspection last July 13, health authority licensing officer Myles Lenner, reported, among other problems, urine smells in various parts of the building, including the main lobby.

'[S]mell of urine extremely strong upon exiting stairwell,' Lenner wrote about the third floor. 'Please advise licensing IN WRITING of a plan to address the smell of urine on or before 1500 hrs July 16, 2004.'

Another problem concerned records keeping.

'Numerous inconsistencies, inaccuracies and omissions from the residents' care plans are noted,' wrote Lenner in his report, which awarded the facility another 'high' health and safety hazard rating.

During that inspection, Lenner found three 'Texas hats' on the floor of a residents' bathroom. Texas hats are containers that attach to toilet seats to collect samples.

'[W]as the floor the most suitable storage area?' Lenner asks rhetorically in his report. In her report of a July 27 inspection, Amanda Arwen found an 'extremely strong' smell of feces in a second-floor lounge area, hallway and room 204. The smell seemed to be coming from 204's bathroom.

Follow up visit to Villa reveals more problems

On an unannounced follow-up inspection on August 5, Lenner and Arwen discovered numerous other problems.

For instance, they found a linen cart carrying multiple prescription drugs and antiseptic soaps left unattended in a second-floor corridor.And the urine smell remained on the main and second floors, despite increased cleaning by staff.

On August 20, in room 211 Lenner found a bedspread 'covered [with] stool, ensuite floor and toilet had large amounts of stool on them.' In room 227, 'sheets and bedding soiled/stained [with] body fluids. [The room] had a foul odour.'

During an October 14 inspection, Lenner again handed the Villa a 'high' health and safety hazard rating when he visited it for an announced inspection. Lenner was following up on complaints received over the previous two days concerning the way residents were cared for during the Thanksgiving weekend. Complaints centred on inadequate staffing, apparently due in part to 'casual' sick calls by staff.

One resident complained to a nurse on October 14 that she'd awoken to find her 'bed clothes and bedding soaked in urine, having not been awoken during the night for toileting.'

Villa manager Connie Haseldon told Lenner that employee sick calls will now be monitored, and a doctor's note will be required.

Lenner also discussed with Haseldon an 'allegation of neglect' concerning a since-deceased resident. The report provided no other details.

'Contracted out, wall-to-wall'

Hospital Employees Union spokesman Mike Old says that what long-term senior residents really need is stability, something that has been absent from the Villa in recent years.

'They've contracted out wall-to-wall and that causes a lot of disruption in a long-term care facility,' says Old.

The contracted-out support staff jobs were formerly held by HEU members. However, last year the HEU managed to organize the Compass workers, though the two sides are yet to reach agreement on a contract. 'We're now engaged in a very long struggle for a first contract,' says Old.

Though the majority of the 113 adult and 9 residential care homes in the South Island area meet provincial standards, Beacon Hill Villa isn't the only one that has sometimes left vulnerable seniors in conditions that worried health authority inspectors.

VIHA inspectors handed 11 homes in the Greater Victoria area 'high' health and safety hazard ratings during 2004. Though in some cases the 'high' ratings were continued after subsequent inspections, all of the facilities had fixed the problems by the end of the year.

Problems at unionized home

However, it would not be fair to blame contracting out as the universal cause of problems at seniors' homes. Staff at Oak Bay Lodge, on Cadboro Bay Road, belong to the B.C. Government and Service Employees' Union; their jobs have not been contracted out. The Lodge earned considerable attention from inspectors last year. A total of seven inspection reports awarded the lodge a 'high' health and safety hazard rating during the first 10 months of last year.

On February 12, 2004, two inspectors arrived at the lodge to observe breakfast service. They found several problems.'Some residents appeared to need assistance with opening jam packages and creamers, and not all of these residents received help,' wrote the inspectors in their report. One resident arrived in the dining room shortly after 8 a.m., but wasn't served food till 8:32 a.m.

Heather Cook, who has been the Lodge administrator since March, 2004, says the home has addressed the problems.

'Changes have occurred so that staffing levels in the dining room now ensure residents are given the support and care they need,' Cook said.

Another hazard rating for Sunset Lodge

Sunset Lodge, run by the Salvation Army, was mentioned in a Tyee report last May for the poor quality of care it provided some residents after support work was contracted out. At the time, lodge manager Blake Mooney called them 'glitches' that had since been sorted out.But on February 18, 2004, Sunset Lodge was handed another 'high' hazard rating'for some of the same problems it had the previous year.

During a two-and-a-half hour inspection, Lenner found that on the third floor, the main corridor, dining room, and resident rooms 'visibly required cleaning.'

Lenner also asked lodge staff about a 'voluntary' $5 monthly fee levied from residents.

The money was used to buy personal and holiday decorations, sympathy cards and flowers for residents and their families, according to a lodge official, quoted in the resulting inspection report.Lodge manager Blake Mooney told Lenner that 'all such expenditures can be accounted for.' Lenner asked the lodge to provide records by March 15.The inspector also found the lodge in contravention of two regulations concerning staffing, the details of which were deleted from the released version of the report. A Salvation Army spokesman could not be reached for comment by The Tyee's deadline.

Food shortage at Dustin House

Dustin House, on Dustin Court in Saanich, is owned by Kardel Consulting Services, which operates 10 residential care homes for adults with developmental disabilities in Victoria, Duncan and Sidney, as well as a day program in Victoria.

Last March 17, health authority inspector Joan Mury found that the facility did not have enough food on hand to provide the meals listed on the menu. For instance, the afternoon snack was supposed to be a fruit shake.

'There is no fruit available for the shake,' wrote Mury in her report.

She found that on March 9, residents were charged $5 each for pizza.

'The pizza was ordered because there was insufficient food to prepare the meal indicated on the cycle menu,' according to the report.As well, 'the $5 does not appear to have been paid back.'

'5,000 long-term beds' haven't materialized

Dustin House manager Jennifer Neely referred The Tyee's questions to Kardel CEO Karl Egner:.

'We are not able to disclose anything,' Neely said.Egner did not return a call by The Tyee's deadline.The Vancouver Island Health Authority's regional licensing manager, Kim Macdonald, says there is no data to compare the quality of care at homes where support staff jobs have been contracted out with that where it hasn't.Says Macdonald: 'I've seen some really good things and I've seen some things that I didn't like.'

Earlier this month, the B.C. Liberal government took flak for failing in its promise to create 5,000 new long-term care beds by 2006. To date, it has created a mere 100.

However, the VIHA reports suggest that some of the residents of existing beds were not being properly cared for.

WHERE 'HIGH' HAZARDS WERE FOUND

Greater Victoria facilities handed 'high' health and safety hazard ratings during 2004:

Beacon Hill Villa: feces on bedclothes, strong urine smell, poor records, improperly stored drugs, staffing
Cedar Hill House: maintenance and housekeeping, administration and records
Victoria Detox: reporting of 'serious incidents,' broken lock on medication cabinet
The Styles: loose electrical wires, missing doorknobs, staffing
Joan Crescent Manor: record-keeping
Sunrise of Victoria: strong urine odour near and in one room, and other problems
Balmoral House:inadequate records of use of restraint, medications, staffing and other problems
Dustin House: insufficient food, extensive black mould, water-damaged drywall and other problems
Oak Bay Lodge: resident given another's morphine, cleaning and other problems
Sunrise of Victoria: strong odour of urine and other problems
Sunset Lodge: staffing and record-keeping


Russ Francis is a veteran legislative reporter in Victoria who contributes regularly to The Tyee, Monday Magazine, and other publications.  [Tyee]

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