Review concluded serious security breaches 'inevitable' at Hillsborough Hospital

A security review of Hillsborough Hospital delivered to Health PEI in 2016 concluded that "without significant changes to the security operations of the site, the potential for serious security breaches [is] inevitable."

The report was prepared by private security consultant Richard Allen to review "security concerns put forth by management," and its findings were never released to the public.

CBC News obtained a redacted copy through a freedom of information request.

• Read the redacted copy of the report

The report found the hospital buildings, the oldest of which it says dates back to 1920, lacked important security and safety features including panic alarms for staff and sufficient isolation rooms for patients.

"When we did the security review of Hillsborough Hospital, it was very obvious there'd been a lot of need for safety of our patients and safety of our staff," said Dr. Heather Keizer, P.E.I.'s chief of mental health and addictions.

New security staff added within past month

Health PEI said it prioritized the 88 recommendations in the report based on safety, security and feasibility, and has implemented or is in the process of implementing half of them, while continuing to evaluate others.

Keizer said just within the past month, Hillsborough has been made a secure building, and now has its own security staff, fulfilling one of the report's key recommendations.

The hospital now has three commissionaires on duty around the clock, according to Health PEI, along with 62 security cameras, a new security control centre, and a new door control system with secure zones within the buildings.

"Our security guards are actually trained specifically for our population of patients, so they're specially trained in mental health … to provide service to this population of patients and to our staff here," Keizer said.

Sufficient staff to deal with violent outbursts: Health PEI

The report also said staff required further training on how to deal with violent outbursts from patients — referred to as a "code white" incident — and concluded there were not always sufficient staff to deal with violent patients according to the hospital's own policies, particularly at night.

The report found there were 32 documented cases where staff had been assaulted over a period of less than a year, from November 2014 to October 2015. Overall, the report said "staff are very concerned about their safety in their work environment." In a survey included as part of the report, 70 per cent of staff said they had been attacked or assaulted on the job.

Anonymous comments from staff included in the report point to challenges in caring for an increasing number of higher-risk, forensic patients coming through the court system.

"We are … required by the courts to keep patients secure but we do not have the resources to manage this population or program to provide appropriate care, no trained staff in forensic care," reads one comment.

"We have been expected to try and keep patients and staff safe without proper facilities [safe/secure rooms] sometimes without adequate staff," reads another.

Health PEI said that it now has sufficient staff on duty to respond to code white incidents at all times, though it didn't specify whether any nursing or care positions have been added. It also said staff are being provided with advanced training to respond to code whites.

Union says government response lacking

But the union representing many staff at Hillsborough said government's response so far to the security report has been lacking.

Karen Jackson is president of the Prince Edward Island Union of Public Service Employees, which represents licensed practical nurses, resident care workers and personal care workers at the hospital.

She said the hospital needs more than $2,000,000 in upgrades to meet all the recommendations in the report, but so far government has only spent $600,000.

"Who [does that] leave at risk?" she said. "And why are they at risk, and what's being eliminated from the report the government itself commissioned?"

For the upcoming fiscal year, government has committed to spend a further $1.5 million on upgrades to the existing Hillsborough Hospital, even as it prepares to replace the facility with a new mental health campus, with construction on part of the new facility scheduled to begin in this fiscal year.

Government says $55 million has been set aside for the new campus over the next five years.

Concerns around items in patient rooms, communications system

Some other concerns raised by the security review:

• The report said staff who found they needed assistance while doing rounds had to "yell for help" because they had no other means of communication. Health PEI said it has since upgraded its communications system, and installed 29 panic buttons.
• The report said electric, adjustable beds with plug-in cords posed a risk to be used by patients for self-harm, and recommended they be replaced with battery-powered or hand-crank models. Health PEI said some beds "have been replaced in high risk areas, with several more beds being replaced this fiscal year in lower risk areas."
• Health PEI said bars in closets in patient rooms for hanging clothes have been replaced with shelving, as recommended in the report.
• The report said the existing smoking policy for patients at Hillsborough was responsible for creating "many security breaches." Just last month Health PEI said patients are no longer permitted to leave on a cigarette break without supervision.

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