A damning 15-page report from Canadian Forces personnel assisting in long term care homes in Ontario paints a picture of the disgusting, and degrading conditions that some senior citizens live in at five Ontario properties. The report released to the public on Tuesday has increased the verocity and volume in demands for a full public inquiry, and the rolling of some political heads on the part of Premier Doug Ford.
“The health and safety of the residents and staff in our long-term care homes is our number one priority. It is clear the long-term care system in Ontario must be fixed,” said Ford in his prepared remarks. “The report from the Canadian Armed Forces on these five long-term care homes is extremely troubling. Our government will take immediate action to investigate the concerns raised by the Canadian Armed Forces to ensure the safety of our residents in these five long-term care homes and in homes across the province.”
Combed from two weeks of observations at Orchard Villa in Pickering, Altamount Care Community in Scarborough, Eatonville Care Centre in Etobicoke, Hawthorne Place in North York and Holland Christian Homes’ Grace Manor in Brampton, Canadian Forces reported instances of neglect, sightings of insects and other vermin, loose standards, and stingy managers keeping personal protective equipment under lock and key.
At Altamount Care Community it’s reported that some residents were not receiving three meals a day, let alone three square meals. Inadequate nutrition is an issue here, and so is inadequate patient care. Some bed-bound patients went for days or weeks without being moved, re-positioned, or even washed properly. If resident did need their wounds and sores dressed, the staff didn’t always have proper supplies. It was also not an unusual occurrence that no personal support worker would be on hand after 2:30 pm, which isn’t all bad considering that one resident passed a note alleging abuse at the hands of a PSW.
A “general culture of fear” is not exactly the four words you want to hear used for a long term care home, but they were used by the Forces to describe Eatonville Care Centre, and the administration’s attitude about supplies. Some pretty import supplies, like wipes, were kept locked up and much of the medication on hand was out of date. The sterility of other supplies, like catheters, was also an issue, while residents diagnosed with COVID-19 were allowed to wander the halls while staff wore the same PPE between rooms with infected persons and non-infected persons.
“Significant deterioration of cleanliness standards” is another thing you never want to read about a healthcare facility, but that was life at Hawthorne Place before the Canadian Forces. There was “little to no” disinfection inside the facility, which is okay because it’s not like there were numerous fans in the hallways blowing potentially infected air around. Actually, it was a lot like that. There were also insect infestations; ants, ‘roaches, and other unidentified bugs. Residents, meanwhile, were often left in soiled garments for prolonged periods resulting in skin irritations, and all that captures point one out of seven on this facility alone.
Patient care didn’t seem to be a high priority at HCH Grace Manor either where staff would “rather write the resident refused to eat rather than helping them [eat],” and there was also a reported incident of a resident falling asleep with food in their mouth. Staff would also wear the same pair of gloves to do several tasks over several different patients, and their idea of sterility was to clean their used gloves with hand sanitizer. The administration of medication was not always documented, and neither was the wishes of the patients when it came to DNRs, or “do not resuscitate” orders, which is kind of an important detail in end of life care.
And at Orchard Villa there were more bugs in the hall, but they were probably drawn to the smell of rotten food outside of a patient’s room. Of course, it’s hard to eat when your nurse or PSW doesn’t sit you up to eat, drink or take your medication, and that carelessness might have resulted in the death of at least one patient from suffocation as observed by Canadian Forces. Resident lying in filth? Yup. Unsafe medication administration? You know it! Also, staff at all levels were careless with PPE and they were careless with patients who fell. It’s alleged that no examination was done for breaks and fractures after a fall, and apparently one patient had a fractured hip that went unaddressed until they were transferred to the hospital.
You can read the full report here:
Between these five homes, at least 221 residents have died of COVID-19 with the lowest being eleven at HCH Grace Manor and the highest being 77 at Orchard Villa. Eatonville and Hawthorne Place have already been cited as problematic when media reports identified three homes (along with Anson Place) owned by Rykka Care Centres that collectively lost 79 residents on April 22. Altamount is owned by Sienna Senior Living, which is a publicly traded company, while Holland Christian Homes is administered by a volunteer board of directors, and Orchard Villa is run by the medical authority of Durham Region.
Sometimes emotional in his daily media conference, the Premier admitted that the 15-pages were hard to read. “The reports they provided us were heartbreaking, they were horrific, it’s shocking that this can happen here in Canada. It’s gut-wrenching and reading those reports was the hardest thing I’ve done as premier,” Ford said.
The Ontario government has been warned several times recently about issues in long term care throughout the pandemic. Earlier this month, the Province announced that they will be pursuing an independent commission for long term care homes after repeated reports about the destructive effect on the virus in seniors’ facilities. A report from the Ontario Health Coalition released at the beginning of May noted that 1,057 of the fatalities from COVID-19 were in long-term care homes, and that 700 of those were in for-profit homes specifically.
Before that, a CBC News investigation in April revealed that only nine of the Ontario’s 626 homes received regular resident quality inspections (RQIs) in 2019 while completing nearly 2,800 inspections instigated by complaints to the Ministry of Long Term Care, and the follow-ups to those “critical incident inspections.” As CBC noted, this followed a 2018 Long Term Care Homes Public Inquiry report that was conducted after the arrest and conviction of Elizabeth Wettlaufer, a nurse who was convicted of killing eight people in long term care, which recommended more “proactive inspections” or RQIs.
Only 18 of the inquiry’s 91 recommendations were implemented before the start of the pandemic.
So what about responsibility? The media statement from the Government of Ontario said that an active investigation has begun into the allegations made by the Canadian Forces, and at least one death has been referred to the Office of the Chief Coroner. The Ministry of Long-Term Care’s Inspections Branch will also start an immediate investigation into the critical incidents mentioned in the report.
At the press conference, Ford said that the buck stops with him, but he did not join the chorus for a public inquiry in lieu of a independent commission, at least not explicitly. “Everything’s on the table. I’m not ruling out anything after reading this,” he said.
“We cannot allow Doug Ford to waste another second. We need inspections, takeovers of all homes that are not safe, and we need to launch a full, transparent public inquiry,” said Official Opposition leader Andrea Horwath in a statement. “For him to waste another second before having public health or a hospital take over these homes — and many others — would be unconscionable. For him to say the government will hold an internal investigation is disturbingly inadequate.”
“We need now, more than ever before, a full independent public inquiry into long term care deaths,” added Liberal leader Steven Del Duca. “I welcome the Premier’s attention on these homes and the sector as a whole. I’m glad he will take this report seriously – but it is more than just about five homes – we must ensure that every resident of long term care is treated with dignity and respect.
Guelph MPP and Green Party of Ontario leader Mike Schreiner agreed with Horwath and Del Duca, and said that Ford should be thinking about more than short-term politics, and assigning blame. “While I support a police investigation to get to the bottom of any criminal action, Mr. Ford is wrong if he thinks these conditions are limited to just 5 facilities,” Schreiner explained.
“The problems in long-term care are chronic and systemic, and a government controlled commission will not bring justice to victims,” Schreiner added. “It is shameful that political calculations are getting in the way of making the right decision to call an independent public inquiry.”