Vulnerable seniors: Nursing homes could wait five years for a full inspection

It could take more than five years before all of Ontario’s nursing homes receive a full inspection by the Ministry of Health and Long Term Care. Further, the complaints hotline overwhelmed inspection teams with 2,719 complaints last year, leaving many families to wait anywhere from 30 days to a year to get their complaint investigated.

Inspectors say that it is taking so long to investigate that they are sometimes arriving to find the resident who issued the complaint has passed away.

The 2007 Long Term Care Homes Act was meant to address incidents of abuse and neglect in Ontario’s nursing homes, but the government is considering any visit to the home an “annual inspection,” even if it is only for a specific complaint. Prior to 2010, homes were subject to a full inspection of all programs and services.

Each office of the Long Term Care Unit presently has an informal goal of completing two “resident quality inspections” (RQI) per month. RQIs are the new version of what used to be considered an annual inspection. That means the province has a goal of conducting 120 RQIs per year. Ontario has 630 licensed nursing homes.

With such a lag in inspection, it is not surprising that the long-term care inspectors are finding more than they bargained for when they arrive to investigate an individual complaint.

Inspectors say they are being told to focus on the complaint – a not so subtle way of telling them to ignore whatever else they see in the course of their duties. The inspectors say doing so could place their own professional licensing at risk. The problem is many of these complaints are symptoms of much larger problems in the homes.

The inspectors say the homes they have been assigned to conduct an RQI are generally the better performers, considered to be easier for inspection staff to get used to implementing a new, and they say cumbersome, inspection regime introduced two years ago.

That means the homes with more chronic problems are having their RQI delayed.

Surprisingly, the recent task force report on resident care and safety had little to say about the lack of inspection. However, they did want to add to the workload of the beleaguered inspectors by “incorporating an advisory component into the long-term care home inspection process so that inspectors can share their knowledge on how to improve resident care and safety.”

Health Minister Deb Matthews ignored most recommendations from the task force, including a recommendation to increase staffing in the homes.

With too few staff in the homes, and too few staff conducting inspections, Ontario appears to be willing to tackle its deficit woes on the backs of some of the province’s most vulnerable citizens.

Watch for more in this series over the next few weeks.

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2 responses to “Vulnerable seniors: Nursing homes could wait five years for a full inspection

  1. The “RQI” inspection is based on a U.S. inspection program developed by Dr. Andrew Kramer, who operates his for profit American business under the name of “Nursing Home Quality”. Huge amounts of Ontario tax payer dollars have been paid out and continue to be paid in consulting and contractual fees for certain components of this ineffective, time consuming and costly inspection program.
    The RQI is NOT a comprehensive inspection of Long Term Care Homes. As an example, safety and security systems (which includes door security systems, emergency power requirements; emergency plans; required minimum levels of lighting; resident bed systems and bedrails, etc.) are not a mandatory part of the inspection process that has been set out for the inspection team (which consists of Nurses and Dieticians) to follow. In spite of recommendations made by the Ontario Ombudsman to move to a multi disciplinary annual inspection program with Inspectors working within their professional skill sets, the concept of “Generalist Inspector” has been pushed by Inspection program management with no regard to professional expertise. It has been identified that Environmental Health Inspectors have been excluded from formal participation in RQI inspections.

  2. OPSEUdiablogue journalists are among my favourites and I want to say thank you for your amazing work re residents in long term care homes and hospitals and all related healthcare issues. The awareness you create can only help to achieve the accountability from the government that is too often absent. Without independent oversight by the Ontario Ombudsman of the LTC homes and hospital sector our most vulnerable citizens will remain at risk. We obviously cannot trust the MOHLTC to monitor closely or effectively what goes on in our healthcare institutions where the most helpless often have no choice but to reside.

    The MOHLTC kept quiet their new interpretation of what constitutes an annual inspection and they have not been forthcoming about the trouble that’s been brewing due to too few compliance inspectors and not nearly enough inspections to assure the residents and their families that the residents can and will be safe in a long term care home in Ontario.

    Shame on the MOHLTC! Much deserved thanks to you for exposing yet again another serious breach in the system.

    Catherine Richards,
    Cause for Concern: Ontario’s Long Term Care Homes (Facebook)

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