Ontario’s LTC inspection system fell apart in the early days of COVID

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The inspection system for Ontario’s long-term care system collapsed in the early days of the COVID-19 pandemic and took months to recover. The findings of the Ontario Ombudsman’s report are hardly shocking to anyone who has been following the story, but they do highlight some of the reasons why the collapse occurred.

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A lack of personal protective equipment, a lack of infection prevention techniques for staff and an effective refusal to work by the union representing inspectors are among the issues raised by Ombudsman Paul Dube.

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“In one case we investigated, Peter complained to the ministry four times between April 6 and May 5, 2020, about troubling conditions at his mother’s nursing home. None of his concerns were investigated until October 2020, many months after his mother had already died of COVID,” Dube reported.

This was an example of the stories families shared as they sought to ensure quality care for their loved ones.

In another case, the report describes how a woman complained to the Ministry of Health and Long-Term Care that the home where her parents lived had a lack of personal care workers and that residents were not being fed, cleaned or given medication . The report shows that the file was closed without any action being taken, despite the ministry official assuring the woman that the matter would be investigated.

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The inspections that should have detected these types of problems were not carried out. On-site inspections stopped around March 13 and did not resume until early May.

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Complicating the report, the Ministry of Health and Long-Term Care’s inspection department stopped inspections but did not notify the rest of the government.

“The Inspection Department has not clearly communicated its decision to cease on-site inspections to other areas of government, nursing homes, complainants or the public. Few knew that this oversight mechanism had broken down. In one area of ​​the province, there were no on-site inspections for three months,” Dube wrote in the report.

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In April, the government spent two weeks trying to persuade the inspectors’ union to resume on-site inspections. Smokey Thomas, then president of the Ontario Public Service Employees Union, wrote to the government stating that on-site inspections had “zero value” and should not be resumed.

“Due to low staffing levels and the multi-party risks associated with such inspections, this plan is not only unwise but also unnecessary. “In-person inspections will not give us any more information than we already have,” Thomas wrote at the time.

However, these inspections could have uncovered the deteriorating conditions that eventually led to the Canadian military being called in to help in certain homes.

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After inspections resumed, only those who volunteered went to houses where there was a COVID outbreak. This still resulted in many homes not receiving proper and timely inspections and many of the inspections carried out did not comply with existing guidelines.

“Even in situations where the branch took enforcement action and required homes to comply with the law, homes generally had many months to correct serious issues related to the care and safety of residents,” it said Report.

In one case, an inspector found that a home did not meet legal requirements for infection control and prevention. The same home was recently found to be out of code on the same issue.

Instead of taking strong action, including revoking the home’s license, the inspector gave the home three months to comply.

The report makes frustrating reading, a horrific reminder of the early days of the pandemic. Dube’s report contains 76 recommendations to the government, each of which was adopted.

Developing plans for personal protective equipment, infection protection or developing a human resources strategy in the event of a new pandemic sounds good. History teaches us that many of the lessons learned from this pandemic will be forgotten or will no longer apply in the next one.

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