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Care homes fail standards: audit

Patient-care plans among deficiencies highlighted

By: Bruce Owen

Posted: 11/26/2009 1:00 AM | Comments: 0 (including replies)

MANITOBA'S auditor general says the province has to provide better information about nursing home wait times and get its inspectors to conduct more unannounced visits.

"It's one thing for the department to say it's fine," Carol Bellringer said Wednesday. "It's another for you to say, 'Show me.' "

Bellringer's audit, done between April 1, 2006 and Dec. 31, 2008, found more than half the care homes did not meet four of the five core standards. While most met safety and security standards, many did not meet standards for patient-care plans, the use of restraints, pharmacy services and staff training. An example where a standard was not met includes the use of a pencil or whiteout on a patient-care plan.

The province brought in personal care home standards in 2005 to be consistent with other provinces. According to that audit, there were 1,137 seniors waiting for a personal care home.

Bellringer said the audit was not launched because of any particular concern about personal care homes.

She also said Manitoba Health should bring in a system of monitoring personal care homes on a provincewide basis rather than relying on the 11 regional health authorities to monitor care homes in their jurisdictions. Such a move would make it easier to compare Manitoba's care homes to those in other provinces. The audit also recommends RHAs and the province track wait times to allow for better planning of personal care home capacity.

Bellringer also said inspections of care homes should be more risk-based with inspectors targeting specific areas to look at and then do a followup inspection to ensure compliance.

Bellringer said for the most part, the province keeps track of what's happening in the 126 care homes in Manitoba -- it's just that it could be doing it better.

"They are doing them," she said. "It's not as if the whole thing is being ignored."

Health Minister Theresa Oswald said the province knew the standards brought in four years ago would take a period of time to be adopted.

"We knew it would take a shift in culture," she said.

She added the province is changing how it inspects nursing homes, including inspection of interim nursing home beds in hospital settings and more unannounced inspections.

Progressive Conservative health critic Myrna Driedger said she was shocked to see things have moved so slowly since the new standards were introduced.

She said she expected the province to move more quickly on inspections and getting nursing homes to follow the rules.

"That's a disservice to seniors and the families," she said.

Driedger added the province is also dealing with a shortage of health-care aides to staff care homes and is doing little to keep an earlier commitment to train more people.

The audit found that as Dec. 31, 2008, only $5.2 million of $40 million earmarked by the province a year earlier, to be spent over four years on hiring staff, had been spent.

bruce.owen@freepress.mb.ca

The greying of Manitoba:

The number of seniors 75 and older is projected to increase to more than 157,000 in 2036 from 82,000 in 2006, a jump of 91 per cent. Most of this growth will happen after 2017.

The average age of a person going into a personal care home is 83. The average length of stay is 2.7 years.

There were 1,137 seniors waiting for a placement in a personal care home in Manitoba as of Dec. 31, 2008.

There were 126 personal care homes with 9,832 beds in Manitoba as of March 31, 2008.

Manitoba has roughly 116 personal care home beds per 1,000 persons 75 and older. The Canadian average is 90.

The estimated cost for a personal care home bed in 2007 ranged from $176,000 to $210,000.

The province spent about $290 million to operate personal care homes in 2007/2008. In the same period, care- home residents in for-profit centres paid about $142 million in fees.

Republished from the Winnipeg Free Press print edition November 26, 2009 A3

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