Military teams raise concerns about conditions at Ontario care homes
Posted: May 27, 2020
(May 26, 2020)
By: Mercedes Stephenson, Stewart Bell and Andrew Russell, Global News
Military personnel sent to nursing homes in Ontario have observed shocking conditions, including “blatant disregard” for infection control measures, mistreatment of residents and a level of care described as “horrible,” according to documents obtained by Global News.
Canadian Armed Forces teams deployed to five of the province’s worst-hit long-term care homes to help control COVID-19 have raised concerns about each of the facilities, describing the care as ranging from below best practices to “borderline abusive, if not abusive” and worse, the documents show.
Infection prevention and control measures were found to be a particular problem, with Personal Protective Equipment protocols going unheeded by staff, many of whom were not properly trained, according to the documents obtained from a source familiar with the mission.
The soldiers reported witnessing cockroaches, flies, rotten food, as well as residents left in soiled diapers or crying out for help for lengthy periods, the documents allege. At one facility, residents had not been bathed in weeks, they said.
Staff at a Brampton nursing home allegedly recorded a Taylor Swift Dance Video showing them dancing through the facility, passing between areas deemed infected with COVID-19 and area that were uninfected without wearing any protective equipment, the documents claimed.
At a facility in Etobicoke, residents who tested positive for COVID-19 shared rooms with uninfected residents, separated only by a curtain, the documents said.
Global News was not able to independently verify the allegations made by the military concerning the homes. The military documents did not always specify at which of the five long-term facilities the problematic care practices were alleged to been been observed.
After Global News first reported on the concerns Tuesday, the Ontario government released a report summarizing the military’s findings, which the province said it had received from the federal government over the weekend.
Ontario Premier Doug Ford said his government had launched a full investigation into the allegations contained in the report, and the results would be shared with police to “look into any possible criminal charges.”
“I think it is appalling, I think it is disgusting what has happened,” the premier told reporters. “It is so disturbing that when I read this it was hard to get through. It is the most heart-wrenching report that I have ever read in my entire life.”
“There will be accountability, there will be justice for these residents and their families as soon as we receive these reports,” he said.
The province has referred one death depicted in the report to the coroner for investigation.
Prime Minister Justin Trudeau said the military’s observations were “extremely troubling” and he had spoken to Ford about the matter.
The Ontario Long Term Care Association said in a statement the pandemic had “exacerbated systemic issues, like the longstanding staffing challenges.”
The industry association called on the Ontario government to immediately provide “more personal protective equipment and rapid testing,” invest in older homes and urgently expedite “capital redevelopment funding.”
The CEO of Holland Christian Homes said he was “shocked and dismayed” at the issues identified in the report but said the problems at his facility, Grace Manor, had been addressed and the military deployment ended Tuesday evening.
“Over the past two weeks, the situation at Grace Manor has stabilized to the point where the military recommended they withdraw from Grace Manor in order to be redeployed to situations considered more critical,” Ken Rawlins said.
Meanwhile, the company that operates the Altamont care home said it was committed to ensuring the problems identified by the military were “all dealt with immediately and permanently.”
“As the report notes, we have already increased staffing levels and flattened the infection curve,” said Natalie Gokchenian of Sienna Senior Living.
“To deliver the level of care that our seniors deserve, the staffing challenges we face in the long-term care sector must be addressed. We are committed to working with the government, and our health system partners, to solve this urgent issue.”
Allegations of abuse and neglect
The report released by the Ontario government gave failing grades to the Hawthorne and Eatonville care homes for improper Infection Prevention and Control measures as recently as May 24.
It found “major concerns” at Eatonville about care, infection control and narcotics abuse.
The home was “severely understaffed” and residents were subjected to aggressive and abusive behaviour, the military said.
Charts were inaccurate and families were given inaccurate information, the military added.
Residents who tested positive for COVID-19 were allowed to wander the facility, putting everyone “at risk of being exposed” and passing the virus “throughout the home.”
There was a “general culture of fear” at the home among personal support workers who were worried about using costly supplies like wipes, gloves and dressing gowns, the report said.
There were also allegations about the reuse of hypodermoclysis supplies, including catheters, even after their sterility had been compromised, Brigadier-General C.J.J. Mialkowski wrote.
Meanwhile, at Hawthorne Place Care Centre, Mialkowski detailed numerous instances of apparent patient neglect and wrote that t“little to no disinfection” had been conducted amid the COVID-19 pandemic,
He said troops noted “significant fecal contamination in numerous patient rooms” and that some staff “delayed changing soiled residents leading to skin breakdown.”
CAF members also noted an infestation of ants and cockroaches, and nurses and support workers were also observed not changing their personal protective equipment for several hours as they moved between patient rooms, potentially hastening the spread of the virus.
Residents were left soiled, crying for help and were forcefully fed, causing choking, he alleged.
At Grace Manor, staff moved between units without changing their protective gear, and did not wash their hands between patient interactions, the report said.
Some staff wore the same gloves while dealing with different patients, or attempted to clean the gloves with hand sanitizer.
Food was left in residents’ mouths while they slept, the report alleged.
Residents at the Altamont home were not being fed three meals a day. One resident wrote a letter alleging abuse and neglect, and staff made “degrading or inappropriate comments” about the residents.
The Orchard Villa home had cockroaches and flies, and residents were “left in beds soiled in diapers.” New staff were not trained adequately, nor was protective gear used properly.
It said staff were not always sitting residents up before feeding them, and that this may have contributed to the death of a resident who choked after being fed “while suppine.”
COVID-19 outbreaks have devastated Ontario long-term care facilities with at least 1,500 residents and six staff dying of the virus.
The observations of the Canadian medics, who were deployed last month to a handful of the province’s long-term homes, have raised doubts about the ability of the facilities to adequately respond to the COVID-19 crisis without outside help.
Caller to Drex on The Shift talks about long-term home conditions
While conditions were said to have improved since the deployment, the soldiers questioned whether the homes were capable of operating effectively once the military had left, and have suggested the province conduct assessments of the facilities.
Long-term care homes have been hit the hardest by the pandemic by far, accounting for more than eight out of ten COVID-19 deaths in Canada. On April 23, the federal government approved Ontario’s request for help from the Canadian Forces.
The teams were dispatched from April 24 to 27 to assess the homes, and began deploying on April 28 to Orchard Villa in Pickering, Altamont Care Community in Toronto, Eatonville Care Centre in Toronto, Hawthorne Place in Toronto and Holland Christian Homes’ Grace Manor in Brampton.
The teams are made up of senior medical personnel and medical workers from 4 Health Services Group, along with support personnel.
The initiative was part of Operation Laser, the Canadian Armed Forces response to the global pandemic.
A total of 285 military members are working in Ontario care homes. In Quebec, more than 1,500 soldiers were sent to 25 long-term care homes, with up to 60 at each facility. More than two dozen Canadian soldiers have now tested positive for COVID-19.
The Canadian Armed Forces said in a statement Tuesday that military members deployed to care homes had an obligation to report “any observation that could be detrimental” to residents, employees and the mission.
“The intent of reporting these observations is to provide constructive situational awareness to the chain of command and report on any possible issue that might hinder mission success or, more importantly, bring harm to those we serve,” the statement said.Military health personnel also have a legal and professional duty to report concerns about “the professional conduct or practice of an individual health care professional working in a LTCF [Long-Term Care Facility].”
“As such, in the course of their duties in Ontario LTCFs, the CAF’s Augmented Civilian Care (ACC) team have observed and documented a number of issues relating to the provision of care to residents. The CAF have also shared their observations in general with the managing authorities of the designated LTCFs.”
In documents obtained by Global News, the team members expressed frustrations that staff were not properly trained or doing enough to stop the spread of COVID-19 within facilities, noting that high-contact areas and rooms that had experienced infections were not being properly cleaned.
Infection prevention and control was alleged to be an ongoing issue for both recently-hired and long-term staff. In particular, the soldiers said that personal protective equipment (PPE) protocols were either ignored, forgotten or disregarded.
Staff and even doctors were not always properly using PPE, and were not changing their protective gear before moving between rooms and wards, according to the documents. One nurse refused to wear a face shield or gloves on the grounds that she didn’t have to because she couldn’t breathe, they alleged.
It was alleged that some staff were not washing their hands between patient interactions. Staff would wear the same pair of gloves while dealing with multiple patients. Instead of changing their gloves, some staff would use disinfectant on them, the documents claimed.
Natalie Mehra, executive director of the Ontario Health Coalition, said the allegations are “horrific” but don’t come as a surprise to her organization who has been sounding about the abysmal conditions at long-term care homes for months as deaths from COVID-19 shot up.
“It’s incredibly frustrating, it’s unspeakable,” Mehra told Global News. “We have watched the spread of COVID-19 and thousands of staff and residents are infected.
“At every step the provincial response has been slow, it’s been inadequate, and it’s been ad hoc.”
Mehra said there were critical staffing shortages at long-term care homes before the COVID-19 crisis and the homes weren’t prepared.
She said a lack of a full time work has led to severe staffing shortages or a high turn over rates
“The consequences for both the staff and residents are horrific,” she said. “Where is the management? Where is the support for these workers?”
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said she was “devastated” by the allegations of abuse, but not surprised. She called for a complete overall of staffing policies at all long-term care homes to mandate more licensed nurses are staffed full-time.
“Some of these issues are not just in those five homes, but are many other homes and the issues precede COVID-19,” she told Global News. “It’s tragic.”
Grinspun said her organization and others, including several Auditor General reports, have long warned about issues of neglect in for-profit long-term care homes.“Ageism and discrimination is why [governments] don’t act. It’s simple. Except now it cannot be hidden anymore because so many have died,” she said.
A union representing 60,000 frontline healthcare workers welcomed the military’s findings and said it had been “ringing the alarm bells throughout this entire crisis.”
“Unfortunately, we have had to fight the provincial government every step of the way to ensure long-term care companies were keeping workers and residents safe,” said Sharleen Stewart, president of SEIU Healthcare.