Manitoba’s home care system plagued by inefficiencies and inconsistent service: auditor general


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Manitoba’s auditor general says the province’s home care system is plagued by inefficiencies and inconsistent service.

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This article was published 05/08/2015 (2677 days ago), so information in it may no longer be current.

Manitoba’s auditor general says the province’s home care system is plagued by inefficiencies and inconsistent service.

Norm Ricard examined home care services in the Winnipeg Regional Health Authority and Southern Health, which provides services in rural areas south of the city.

In a 42-page report released today, Ricard said his audit found problems with timeliness and reliability of services, incomplete client assessments and inefficient work schedules.

WAYNE GLOWACKI / WINNIPEG FREE PRESS FILES Norm Ricard, Manitoba's Auditor General, releases a report on the state of home care in the province, calling for a number of changes to the current system.

The audit found, based on a sample of files, that clients waited an average of 37 days in the WRHA for personal care and household services to start after requesting service. Nursing services began promptly, it noted.

“While related standards or targets are not in place to guide regions, an average time frame to start services of greater than three weeks is worthy of follow-up,” Ricard said.

Home care services include health care, personal care and household services to people living at home and needing support. The services allow people to remain in their homes rather than staying in hospital or moving prematurely to a personal care home.

The audit found that over a three-month period almost 40 per cent of clients reviewed had to use their back-up plans — for example, relying on family and friends — at least once because service visits were cancelled. Use of backup plans by individuals during this period ranged from once to 13 times.

Ricard said neither region tracks the frequency with which clients must call upon family and friends to make up for cancelled visits.

He also found that both regions encountered difficulties implementing a province-wide initiative that provides some home care workers with guaranteed hours and set schedules.

The initiative has resulted in significant wage payments for guaranteed hours that could not be matched with client assignments, he said.

“We estimated that over a one-year period, the two regions could have paid over $4 million for these unmatched hours, while at the same time cancelling an estimated 16,000 client visits because staff were unavailable when needed,” Ricard said.

The audit also found that there was a lack of guidance to help staff members to determine whether family and community supports were available to prospective clients.

“Because negotiation plays a large role in determining available family resources, we are concerned that this may lead to the unequal treatment of clients in similar circumstances,” Ricard said.

Health Minister Sharon Blady immediately responded to the auditor general’s report, announcing that she has created a new home care ‘leadership team,’ led by Reg Toews, to delve into the issues raised by the AG.

The group will develop a comprehensive plan to guide home-care services into the future, Blady said in a news release.

“I want to thank the auditor general for the recommendations on how we can strengthen home-care services in Manitoba,” Blady said. “Home care was created here. Our program is widely regarded as one of the best in North America and in order to ensure it remains accessible to all Manitobans who need it, we will continue to reject calls to base home care on one’s ability to pay.”

The minister indicated that in the 40 years that these services have been offered, the number of clients and complexity of health needs being met have changed substantially. She said all provinces face similar challenges, and some have responded by introducing user fees and privatizing services.

She said Toews is a recognized leader in the province’s health system. He most recently led a review of emergency medical services in Manitoba.

One of the auditor general’s recommendations is that the Health Department examine how much the demand for home care will grow, given the province’s aging population.

He also recommended that the department make its home care standards and policies public, as is done in other provinces.

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