Staff shortage and inadequate cleaning at the site of the deadliest nursing home outbreak in British Columbia: report

Staff shortage and inadequate cleaning at the site of the deadliest nursing home outbreak in British Columbia: report

An inspection of a long-term care home that was the site of the deadliest COVID-19 outbreak in British Columbia found staff levels were low and cleaning was inadequate as the virus spread throughout the establishment.

Vancouver Coastal Health’s inspection report obtained by the Canadian Press as part of an access to information request says both of these issues were corrected while the outbreak was underway in Little Mountain Place.

Bernadette Cheung, whose grandmother died of COVID-19 at the facility along with 40 other residents, wants more answers, including details of how understaffing and poor infection control potentially worsened the ‘epidemic.

She filed a complaint that prompted inspection on behalf of several family members who lost loved ones at the Vancouver nursing home. Cheung said she also felt in the dark after receiving the report as before.

“I have a feeling that the investigation was done a lot just to tick a box, rather than to properly find out where the failures were and really dig in to find solutions and make sure families have some kind of peace that it’s taken seriously, ”she told me.

Little Mountain Place referred questions to Vancouver Coastal Health, which did not immediately respond to a request for comment.

In a written statement released in January, the health authority said it was working closely with the nursing home to bring the outbreak under control, including screening and testing staff and residents, quickly isolating cases and using infection prevention and control practices.

The inspection report indicates that a complaint was received on January 6 and that a site visit was carried out on January 11.

The inspector found when the COVID-19 outbreak was declared on November 22, 2020, staff coverage was sufficient. However, as more and more employees contracted COVID-19, staff levels “fell below the establishment’s baseline,” which temporarily affected daily operations and the ability of staff to operate. answer questions from families.

In response, Vancouver Coastal Health has redeployed a significant number of staff to exceed baseline requirements by 20%, the report says, adding that most of the original staff have returned to work and that a third of the staff redeployed from health authorities remained in place. of the inspection date.

72 staff members contracted the virus

The report does not say how many staff were missing from the facility, how long the understaffing persisted, or how it affected the home’s ability to limit the spread of the virus. Figures from the BC Center for Disease Control show 72 staff members contracted the virus during the month-long outbreak. None are dead.

Cheung wondered what was the point of the “vague summary” of understaffing.

“I imagine these processes are in place to learn and understand where the problems can arise and maybe find where the breaking point is in terms of understaffing,” she said.

Bernadette Cheung on January 7 outside Little Mountain Place, where her grandmother died of COVID-19. (Darryl Dyck / The Canadian Press)

The report also says that when the outbreak was declared, Vancouver Coastal Health closely monitored the facility for the rate of transmission and any areas of concern.

“As a result of this audit period, it was found that the facility’s household team did not fully understand or implement the improved infection control / cleaning measures planned as appropriate.” , he says.

On December 13, 2020, three weeks after the outbreak began, Vancouver Coastal Health deployed a specialized infection control cleaning team to the facility. Staff education has been provided and regular audits of improved cleaning measures continue to be carried out regularly, the report said.

‘Kept in the dark’

Cheung said she was frustrated that the focus seemed to be on the cleaning crew not knowing what to do, as opposed to management’s responsibility to train them.

She also took issue with the inspector’s finding about the nursing home’s communication. The inspector said families regularly received letters with updates on the state of the outbreak and weekly Zoom calls were made to answer their questions.

However, Cheung said two weeks passed before Zoom’s first call, when families were shocked to learn that there were already dozens of positive cases. During calls, Cheung felt that managers were evading questions.

“We felt like we were being held in the dark,” she said.

In its previous statement, Vancouver Coastal Health said it takes all concerns raised by residents and families seriously and that any allegations of insufficient care are fully investigated. He also said he regularly shares written communications, in addition to Zoom calls, and that doctors and staff follow up directly with families.

Cheung is still calling for a broader investigation into what went wrong at the care home, where 99 out of 114 residents ultimately tested positive. Cheung also wants to see a nursing home watchdog that exists outside of the health authorities.

“I don’t think anyone really took responsibility for what happened,” she said.

“I understand. It’s a really difficult situation. But at the same time, as family members, we would have appreciated the answers to come.”

Little Mountain Place, pictured December 17, 2020. The November 2020 outbreak ultimately infected 99 out of 114 residents and 72 employees. Forty-one of these residents died. (Ben Nelms / CBC)

Wider review expected

British Columbia Seniors Advocate Isobel Mackenzie is working on a broader review of COVID-19 outbreaks in nursing homes, which she hopes to release in July. She said of about 500 sites in British Columbia, 212 had outbreaks.

Of the sites that experienced outbreaks, most were confined to staff or a few residents. Therefore, his office plans to look at around 25 of the worst outbreaks, including Little Mountain Place, to figure out what went wrong.

The age and size of buildings, whether residents had shared rooms or shared baths, staff levels, sick leave policies, infection control practices, and residents’ ages and conditions could all be letter carriers, Mackenzie said.

Her office will also undertake a survey of nursing home staff in British Columbia which will hopefully provide some insight into the training they have received, she said.

Mackenzie said she expects the provincial government to come under public pressure to implement her next recommendations.

“One of the things that’s been very encouraging is that the public is very supportive of improving long-term care,” she said.

“They now see what can happen, what is happening and they said, ‘We have to do better. We need to make improvements. “So I think people will listen and they will expect their governments to act.”

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