Failure to protect Ontario long-term care home residents, like James Acker who suffered a severe beating at the hands of another resident at St. Joseph Villa in Dundas from all forms of assaults, “lies with the provincial government. To keep residents safer, the Health Ministry must look deeper into the systemic causes of the violence, acknowledge the evidence that links higher care with safer care for residents and act to legislate a daily care standard,” says Ontario Council of Hospital Unions (OCHU) president Michael Hurley.
A ministry of health report into the beating and one other incident of assault made public recently, cites several orders against St. Joseph’s Villa and violations of the province’s Long-Term Care Act.
“We have compassion and deep concern over what’s happened to Mr. Acker,” says Hurley. “We would like to see system changes that would ensure this type of assault becomes a very rare event. This investigation doesn’t do that.”
As Ontario’s long-term care system continues to receive thousands of hospital patients with complex medical and psychological conditions without any additional staffing, training and risk assessments, the acuity of the violence against residents and against staff in long-term care is increasing system-wide.
The beating Mr. Acker received this past January happened at night, when staffing levels are skeleton. St. Joseph’s Villa night staffing is typical of most long-term care homes with one PSW to 24 residents on regular care units and two PSWs for 24 residents on dementia wards. Registered practical nurses (RPNs) are responsible for 100 residents on four units.
“The ministry of health investigation has ignored glaring staffing shortages and found fault with individuals and processes. Having set the impossible goal of trying to safely deliver long-term care without adequate staff resources, the ministry rebukes an institution where there is a public incident, but turns a blind eye to the hundreds of resident assaults by other residents that happen every month system-wide in Ontario. Because the vast majority of residents have some form of cognitive impairment or dementia the staffing levels in long-term care are a critical factor in resident safety,” says Hurley.
In the five years between 2006 and 2011 the number of people 85 and over increased 34 per cent in Ontario. The majority of residents in long-term care in Ontario are over 85 years old and have chronic and complex needs. Despite these key indicators, data confirms that compared with other provinces Ontario underfunds long-term care. Staffing levels are also among the lowest of the provinces.
Expert studies have identified increased direct care and higher staffing as key aspects of decreasing the climbing number of resident-on-resident violence. OCHU/CUPE is calling for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care facilities.