The Ombudsmans report identifies five major areas of concern:
1) Inconsistency in Interpretation and Application of Standards: the regional model of compliance seems to have resulted in serious inconsistency in Service Area Offices in terms of training and orientation. While some regional offices saw their relationship with LTC homes as being advisory others pursued the compliance model. As a result, the same infraction might be treated very differently depending on location and compliance officers might have different or at times insufficient training.
2) Overwhelming Number of Standards: Compliance staff must verify 450 different criteria but the Ombudsman found that often there was inappropriate assessment of these criteria or a serious infraction was not sufficiently weighed against a minor infraction.
3) Timeliness of Inspections: There were some facilities that had not undergone inspection in 18 months. Also, several homes had not seen a specialist advisor in more than 15 years.
4) Treatment of Complaints: Perhaps most egregiously, the Ministry complaints process does not seem to follow a specific protocol resulting in many resident complaints being referred back to the home administers. Understandably, complainants fear reprisal when making a complaint directly to the person responsible for the home. Indeed, after being referred back to the homes, some were threatened with being banned from the home. The Ombudsman also noted that investigation of complaints were often delayed and less than thorough
5) Inadequate Public Reporting: In 2004 the MOHLTC initiated the practice of posting information such as home profiles, inspections conducted, citations to their website. Unfortunately, the Ministry infrequently refreshes this information, leaving the public with dated information.
Despite all of this, the Ombudsman was cautiously optimistic that the Reform Initiatives that the Ministry had and would shortly implement would address some the problems identified. However, he cautioned, it is too early at this time to assess what impact the new approach will have on resident welfare. He also noted that although the Ministry was planning a new system of risk indicators, there was no provincial strategy in place yet for monitoring the data. The Ministry is tasked with the Ombudsman a progress report every six months.
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Keywords: long-term care, homes, complaints