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Abusive behaviour, cockroaches, force feedings documented by military in Ontario long-term care homes

Posted: May 27, 2020

(May 26, 2020)

By: Victoria Gibson, iPolitics

A person who appears to be a staff member looks out of a resident’s window at Eatonville in Etobicoke. April 14 2020. Richard Lautens/Toronto Star

Military members deployed to Ontario long-term care homes have blown a whistle on harrowing conditions inside five particularly hard-hit facilities — going beyond the Forces’ mandate of providing aid to pen a report that documents incidents from “abusive” behaviour by staff, to cockroaches skittering and residents sleeping on bare mattresses.

The document — which was released by the Ontario government today, and brought to their attention by federal public safety minister Bill Blair this weekend — offers damning observations around infection prevention, safety, staffing and the quality of care in the five homes. Residents in more than one were allegedly being left in soiled diapers; to the point of skin breakdowns in one facility in North York.

Catheters in one home were reportedly being “pulled out” of patients, then reused after being left on the floor for an “undetermined” amount of time. Allegations of force-feeding, causing audible choking, were detailed. Nurses appeared to document assessments of residents that hadn’t actually been done, the report alleges. And a death that took place at Orchard Villa, a long-term care facility in Pickering, has now been flagged to the province’s chief coroner to probe.

Ontario’s long-term care sector, like other provinces’, has been devastated by COVID-19 since the virus reached Canada. Both Ontario and Quebec requested aid several weeks ago from the Armed Forces, with Ontario’s ask made on April 22. Documenting the conditions inside care homes was not part of that request.

iPolitics has not independently verified the allegations contained in the newly-released report. Along with Orchard Villa, the military document details issues inside Altamont Care Community in Scarborough, Hawthorne Place in North York, Eatonville in Etobicoke, and Holland Christian Homes’ Grace Manor in Brampton.

Four of the five homes are privately owned, and one is a non-profit.

In a briefing prior to the public release of the report, Ontario officials told reporters that the owners of the affected homes — as well as other facilities in the province deemed to be high-risk — had been asked to prepare plans for management and staffing. They noted, too, that the situation had improved since Forces members were deployed to provide aid. Some of the facilities in question had not been inspected in person by the ministry since the start of the COVID-19 pandemic.

Ontario Premier Doug Ford, in a press conference on Tuesday afternoon, said reading the military report had been his most difficult task since assuming the role in 2018, and pledged to investigate the concerns that were detailed. “Until yesterday morning, we didn’t know the full extent of what these homes, what these residents were dealing with. The reports they provided us were heartbreaking,” Ford said.

An excerpt from the Canadian military report, dated May 20, 2020, detailing standard-of-practice and quality-of-care concerns about a long-term care home in North York. The allegations in the report about five homes have not been independently verified by iPolitics.

Ford’s government, in recent weeks, has been facing calls from opposition parties to launch a public inquiry into long-term care. So far, the PCs have committed instead to a commission of inquiry, which is to begin its work this fall. The call for an inquiry was reiterated by several other party leaders on Tuesday afternoon.

“The report spells out negligence on a level we could not have imagined. We need a full public inquiry into long-term care deaths — we cannot look away,” Liberal leader Steven Del Duca wrote on Twitter. Green leader Mike Schreiner alleged that the Ford government was making “political calculations” with their decision.

Asked again about the calls for an inquiry on Tuesday, Ford replied that no option was being ruled out. The premier also declined to reject bringing nursing homes into the public healthcare system, though he noted that the province couldn’t afford to do so on their own and would need federal assistance to make it “sustainable.”

The opposition NDP, meanwhile, called for severe action within Ford’s cabinet on the heels of the report. Party leader Andrea Horwath urged Ford to “immediately” require the resignation of his long-term care minister, Merrilee Fullerton.

“It’s shocking that the Canadian Armed Forces needed to lift the veil,” Horwath said — arguing that the PCs “ought to have known” about conditions inside the homes, and subsequently taken them over. “The premier cannot pass the buck, finger-point and express outrage about what his own government is doing on his watch.”

The province, on Monday this week, had announced that a pair of hospitals would temporarily be managing two long-term care homes — but neither of the affected homes was among the five facilities where military members were stationed.

While the Forces’ presence in long-term care was in direct response to COVID-19, some of the problems they documented appear to pre-date the crisis. At Eatonville, much of their medication stock was observed to be months out of date. “Inference: residents have likely been getting expired medication for quite some time,” the report says.

Concern about the use of agency staff — including some who, in this case, allegedly “would rather write the resident refused to eat, rather than helping them” and left food in sleeping residents’ mouths — was also documented in the public inquiry that followed the Elizabeth Wettlauffer murders, which released its final report last summer. The use of agency nurses was connected to struggles maintaining staffing.

The report flagged issues, as well, around infection control in several homes. At Hawthorne, protocols in place were alleged to have a “near 100% contamination rate for equipment, patients and overall facility,” and equipment was “seldom” seen to be disinfected between use on residents who were positive for COVID-19 and negative. As reported by iPolitics last week, long-term care homes in Ontario had already been documented to have nearly three times as many outbreaks of respiratory infections than retirement homes in the five years before COVID-19.

As of May 25, government data shows 150 of 626 long-term care homes in Ontario dealing with COVID-19 outbreaks, down from a high of 190. At least 1,335 residents have died so far from the virus or its complications, as have four staff members.

The Ontario Health Coalition urged the province on Tuesday to bring retired nurses and family caregivers into care homes — asking them to do so “as soon as possible” — and to introduce a government-led plan to increase staff in homes facing worker shortages due to sickness, departures or having to chose other part-time jobs.

“This cannot be voluntary and there is no path to stability without the provincial government undertaking these measures,” coalition spokesperson Natalie Mehra said in a statement — while urging Fullerton to utilize powers under the Long-Term Care Homes Act to revoke licences and appoint new management for homes with “uncontrolled outbreaks and evidence of negligence and poor practices.”

Prime Minister Justin Trudeau, who spoke to journalists on Tuesday in Ottawa prior to the report’s public release, said he’d first learned of the document’s existence on Friday afternoon — and called its contents “deeply disturbing.”

“This is a situation that has gone on for a long time,” Trudeau said. “We need to take action as a country. The federal government would be there to support provinces in their jurisdictions on dealing with this.” 

— With files from Jolson Lim

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