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ltc manager allowed to go in to work while infected: report

in the midst of a covid-19 outbreak that left 47 reside...

in the midst of a covid-19 outbreak that left 47 residents and two psws dead, the executive director of ottawa’s madonna care community allowed a manager to go in to work while infected, a provincial inspection report has found.
“a management staff was found to be covid-19 positive, with no symptoms, in april 2020,” said the report that was posted publicly on oct. 13. “the management staff was considered to be an essential staff member and was allowed by the home’s executive director to come in to work for one day to gather items necessary (for) their work.”
that is just one of the infection prevention and control violations at the long-term care home cited by ministry of long-term care inspectors in a report that resulted in seven written notifications, six voluntary plans of compliance and one compliance order.
a separate report found serious infection control violations at laurier manor, where 26 residents died of covid-19 during two separate outbreaks, beginning in april and in september, according to ottawa public health.
on may 21, 2020, an inspector saw a psw feeding a resident at laurier manor while not wearing a mask. when asked about it, the psw said they had just come back from lunch and had forgotten. the psw then went to get one, but failed to wash their hands, didn’t put on a required face shield and put the mask on inside out, according to the report. in june, a staff member was observed not wearing a mask.

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the report also found a manager came to work but didn’t report atypical symptoms of covid-19 during screening. that manager was not swabbed until later in the day when another manager requested it.
for those and a number of other issues reported by inspectors — including failing to record the medication and health history of a resident who later died in hospital of covid-19 — the home run by extendicare was issued a director’s referral order, generally issued in cases where there has been a history of compliance issues. the ottawa hospital later worked with it and other homes to improve infection control and other issues.
advocates say it is frustrating that there is a such a delay between the finding of serious problems at long-term care homes and making changes, especially during a pandemic in which close to 4,000 long-term care residents died. family caregiver advocate vivian stamatopoulos of ontario tech university is calling for rapid response and immediate action for homes that violate the rules, putting residents at risk.
“they only get in there after the damage has been done,” she said, “it is always too late.”
stamatopoulos said the kinds of “preventable errors” documented by inspectors would likely be found at most homes with large outbreaks and could have been stopped or slowed with better whistleblower protection and a rapid response system of inspections.

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she also said it is discouraging to see managers at some of the homes ignoring the rules.
“how can you trust managers to uphold when they are violating the rules themselves?”
inspectors also found that managers at madonna care community were not screened as they entered the long-term care home one day in may, while the deadly outbreak was ongoing. a staff member later told investigators that they did not screen managers when they entered the home, something that violates pandemic regulations.
staff did not always wear personal protective equipment, inspectors reported. that finding was based, in part, on a video from a family showing a staff member removing their mask and face shield to eat a snack while in a resident’s room, with a resident nearby.
one nurse who volunteered to help out at the home during the outbreak earlier told this newspaper that she was encouraged to re-use ppe and it was difficult to get it. she also described severe staffing shortages.
and inspectors found that the home failed to have a backup staffing plan, leaving it severely short staffed and relying on workers doing double shifts. one night in april during the home’s major outbreak, six night staff provided care for the home’s 160 residents, including 32 who were confirmed covid-19 positive.

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inspectors visited the home on 23 separate days between late july and early september. the home had three covid-19 outbreaks prior to the report being filed, staring on april 6, july 14 and aug. 25.
inspections were paused during outbreaks, so investigators relied on interviews, videos and documents for some of the report.
operated by sienna senior living, the 160-bed long-term, care home was one of the worst-hit in ottawa during the pandemic and staff from cheo eventually assisted the home.
not only did 47 residents die from covid-19, but about 30 residents died of other causes during a period that covered less than a year, meaning about half of the homes 160 residents were dead in that period, said betty yakimenko, whose mother is a resident and who chairs the home’s family council.
madonna remains the only home in the province where more than one staff member died as a result of covid-19. in addition, the spouse of a staff member died after contracting covid-19 from his spouse, said yakimenko.
a spokesperson for sienna said steps were taken to “respond swiftly to the evolving information and directives given by madonna care community” from public health and ministry officials. the home strengthened policies and protocols and is now in full compliance with provincial standards and regulations.

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the company installed a new leader at the home who is working with sienna’s chief medical officer dr. andrea moser and infection prevention and control consultant dr. allison mcgeer “to improve our infection prevention and control protocols, education and training, resident care, and communication with residents’ families. we continue to work closely with our community health partners and are taking every action necessary to ensure the residence is in full compliance and following all directives,” said a company spokesperson.
in a statement, extendicare, which operates laurier manor and other long-term care homes in the city, said the ministry of long-term care’s inspection process plays an important role in ensuring quality care.
“we take the process seriously and cooperate fully with each stage, regularly applying inspection findings to improve our processes. laurier manor has delivered a full plan of action to the ministry in response to the report, including updating policies and procedures, and re-training staff members, and the items identified have been resolved.”
an extendicare spokesperson said employees are “strongly encouraged” to stay home if they are feeling unwell or have even mild symptoms and all staff are screened for symptoms before each shift. extendicare provides sick pay for staff experiencing symptoms from covid-19 or post-vaccination.

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