A Canadian military report says a group of Ontario nursing homes hit hard by the coronavirus have noticeably improved their infection-control and resident-care practices but cautions that concerns about staff training remain at a few of the facilities.
The federal government deployed the Canadian Armed Forces to seven long-term care homes between late April and early July after the virus caused dozens of workers in chronically understaffed homes to miss work, forcing Premier Doug Ford to ask the military for assistance.
In its exit report, released Friday evening, the military says the horrific conditions it chronicled in May at four of the homes have all but vanished. Residents at two of the facilities are now routinely eating three meals a day, the report says, and their soiled diapers are changed more frequently. Only a small number of insects remain at another home that was infested with cockroaches.
With dramatic improvements in infection-prevention-and-control practices, increases in staffing and the virus under control, the homes were no longer in need of military support, said Brigadier-General Conrad Mialkowski in a letter to Ontario Deputy Minister of Long-Term Care Richard Steele.
“The COVID-19 infection rate was zero, or near zero” as the military teams withdrew from the homes, the letter says.
The military’s lingering concerns about the homes revolve around the training and expertise of new staff, many of whom were hired quickly to fill vacancies. The report singles out one facility, Hawthorne Place Care Centre in Toronto, for a high level of tension between staff and residents and for the numerous repairs that were needed.
The provincial government has ordered hospitals to temporarily manage six of the seven homes: Orchard Villa in Pickering; Downsview Long Term Care Centre, Altamont Care Community, Hawthorne Place, Eatonville Care Centre – all in Toronto; and Woodbridge Vista Care Community in Woodbridge.
The coronavirus was particularly lethal in these homes, where 311 residents have died of COVID-19 to date. All six are for-profit facilities.
The government did not appoint a hospital to take over management of the seventh facility, Holland Christian Homes, because the situation at the not-for-profit home had stabilized by the time the military released its first report. A dozen residents died of the virus at the 120-bed home in Brampton.
The military’s initial report “echoed the urgent need for an investigation into the impact of COVID-19 in long-term care,” said Merrilee Fullerton, the Minister of Long-Term Care, in a statement Friday.
The provincial government appointed an independent commission last month, led by Ontario Superior Court Associate Chief Justice Frank Marrocco, to examine how the virus killed more than 1,800 people in the province’s long-term care homes.
At Orchard Villa, the province’s hardest-hit home, 70 residents have died of the virus. The Office of the Chief Coroner is investigating the death of a resident who choked to death while being fed lying down, the military said in its report in May.
In its exit report, the military says the overall mood at the home has improved and that residents are routinely eating three meals a day.
The report raises concerns at some of the other homes about the expertise of novice registered nurses, as well as access to medical supplies. One home kept N95 masks locked in a manager’s office.
But the report reserves its harshest criticisms for Hawthorne Place, where 51 residents have died of the virus.
Members of the military witnessed “verbal altercations” between residents and staff at the home, who were likely suffering from caregiver burnout, the report says.
The military also found a bird’s nest in a boarded-up window, as well as another 26 “non-functional” windows in residents’ bedrooms. On particularly hot days, the report says, several incidents of “heat stress/heat injury” were noted in residents.
A spokesperson for Responsive Management, which manages Hawthorne Place on behalf of its owner, Rykka Care Centres, was not immediately available for comment.
Responsive Management and North York General Hospital, which is temporarily managing the home, are working on plans to address leadership and staff challenges as well as repairs to the building, said Gillian Sloggett, a spokeswoman for Dr. Fullerton, in an e-mail Sunday.
“Our government is committed to ensuring that Hawthorne Place is a safe and secure environment for its residents,” she said. “We take any allegation of improper care very seriously.”
This article first published here www.theglobeandmail.com/canada/article-caf-reports-improved-conditions-in-ontario-care-homes-but-cautions/