Nursing home inspections branch understaffed, Wettlaufer inquiry hears

An Ontario Health Ministry inspector who makes sure nursing homes are safe for residents testified Thursday at the inquiry into long-term care that her office is understaffed and cannot meet the obligations laid out in legislation. 

Rhonda Kukoly is testifying at the Elgin County Courthouse in St. Thomas, Ont. 

She said the 36 inspectors tasked with making sure the London, Ont.-region's 150 long-term care homes are unable to do their jobs properly because they're short-staffed. 

"You don't feel that the London office has been properly resourced to meet its inspection obligations?" Kukoly was asked by lawyer Alex Van Kralingen. 

"To be honest, at this current time, no." 

Inspectors are expected to perform annual intensive resident-focused inspections, where they interview residents, staff and family members, and go over nursing home records, as well as carry out inspections prompted by complaints and critical incident reports. 

The most urgent inspections which pose an immediate threat to patient safety are being done within legislated timeframes but those deemed less serious are not, Kukoly has said. 

Wettlaufer's 'evil' not preventable

On Wednesday, Kukoly said she didn't think the provincial inspection process could have prevented the "evil" that serial killer Elizabeth Wettlaufer brought into long-term care homes. 

"I can't think of anything that's going to be able to detect if someone is so evil and devious to intentionally harm residents — and conceal their actions to that degree."

Kukoly spent five months at Caressant Care in Woodstock after Wettlaufer confessed to killing seven residents by injecting them with insulin while working at the home from 2007 to 2014. 

Wettlaufer was not caught and went on to kill another resident at her next job, at Meadow Park nursing home in London. She also harmed others at both homes and while working as a temp agency nurse in southwestern Ontario. In June 2017, Wettlaufer was sentenced to eight concurrent life terms in prison with no parole possibility for 25 years.

But Kukoly said Wettlaufer's crimes have shaken the long-term care industry to its core. 

"That trust in long-term care and nursing has been absolutely battered. I am a nurse and I always wanted to be, whether I'm in a home as an inspector or a nurse, I bring the same level of care and reasonability. The impact on this sector will be vast." 

Rigidity of regulations under fire

Caressant Care lawyer David Golden on Thursday suggested to Kukoly that the regulations governing long-term care homes force front-line workers such as nurses to substitute their own clinical judgment because they fear being "non-compliant" with legislation. 

He also criticized her handling of interviews with staff and residents in the days following Wettlaufer's confession and murder charges. 

"You went into the home on the same day the police held their news conference to announce the charges against Ms. Wettlaufer. Did you consider the impact to staff when the ministry shows up on the same day as this is becoming a huge media story?" Golden asked her. 

"I didn't choose the day we went in," she replied. 

While she didn't get specific training on how to deal with people impacted by the shock and trauma of being told they'd worked with a serial killer, Kukoly said she was able to rely on her professionalism to do so. 

"I am a registered nurse. I have experience talking to people who are in distress. I can figure things out based on my experience and education and generally being a kind person," Kukoly told Golden. 

Impact 'unimaginable'

Kukoly said she lies awake at night thinking of the pain the family members of Wettlaufer's victims must be going through. 

"I close my eyes and I think about it. It's unimaginable."

Earlier Wednesday, Kukoly detailed going into Caressant Care just 24 hours after staff learned former co-worker Wettlaufer had confessed to serial murder. 

She also went through the five months of intense scrutiny placed on Caressant Care by provincial Ministry of Health and Long-Term Care inspectors, leading to a stop-admission order and the home being ordered to hire an outside company to manage it. That mandatory management order remains in place. 

The inquiry into the safety and security of residents in long-term care is expected to last until September