Aging facilities, staff shortages affecting standard of long-term care at some Sask. facilities: SHA report

A report on long-term care in Saskatchewan describes aging facilities that do not meet current standards of care, facilities where four residents share one room, widespread problems hiring and retaining nurses, and overall problems with facilities struggling under current funding levels.

Since 2013 the Saskatchewan Health Authority (SHA) has prepared annual reports on the standard of long-term care in the province based on visits to the facilities by SHA leadership. The 250-page 2019 report was released late Friday afternoon. 

Along with praise for some facilities, the 2019 report includes problems with resident care at homes across the province. Many of those problems are related to staff shortages, funding shortfalls and aging infrastructure.

"This report again pointed to the environment of underfunding, understaffing and crumbling infrastructure," Danielle Chartier, the Saskatchewan NDP's critic for seniors, said on Sunday.  

"Dignity starts with legislated minimum care standards that really have teeth, but to support that we need adequate funding."

Health Minister Jim Reiter said in a conference call Monday that the minimum standards of care are in the program guidelines for special care homes.

"You can call them whatever you want but obviously there [are] guidelines or standards that need to be met and we need to be doing the best we possibly can to ensure that's happening," Reiter said.  

He said part of the role of government is to make sure facilities are adequately resourced, adding that the province has increased funding for long-term care homes by 45 per cent since it was elected in 2007.

Staff shortages a widespread issue  

High staff turnover, low staff-to-client ratios and difficulties retaining workers — including nurses — were among the most prominent issues raised by residents, family members, workers and administration at long-term care facilities. 

Some locations reported turnover had led to a lapse in training for nurses.

SHA CEO Scott Livingstone said recruiting staff with the right expertise is challenging when communities are geographically dispersed.

Livingstone said co-horting of staff at long-term care homes, which started in April to stop workers moving between multiple facilities and avoid the spread of COVID-19, would be an "experiment" brought on by COVID-19. 

"Lots of staff were working part-time at many different facilities and that also is a challenge for us with respect to consistency, staffing and hiring and keeping people employed in a single facility," said Livingstone.  "Now that we are cohorting ... it's going to be interesting to see if we have the ability to continue that long-term with

respect to the staffing mix and the ability to ... staff in a consistent way across the province."

Four-bed rooms

Maintenance of old facilities was another prevalent issue highlighted by the report. 

The report includes a blunt description of conditions at Extendicare Parkside, a 228-bed facility in Regina that has 34 four-bed rooms.  

"The facility is old and in need of replacement due to pending infrastructure and large system (HVAC) failures," reads a comment in the report.  

"The current design with a large number of four-bed rooms does not meet current standards of care or resident and family expectations for a home environment." 

It said Extendicare has submitted a proposal to replace the facility and, at the time of the visit in August 2019, was waiting for a response from the SHA and the Ministry of Health. 

The report said another facility, Pioneer Village in Regina, had only a curtain to provide privacy for the tub rooms where residents bathe.

Clients and their families at other facilities complained that "bowel and bathroom routines are not consistently implemented." 

Some residents complained of long wait times to receive assistance from a nurse. 

Chartier said the report confirms what was already known about long-term care.

"People have been telling us for years that the staff work so hard to meet their residents' needs and they want to be there and they love their job and leave at the end of every day feeling frustrated that they can't do what they want or what they need to do for residents in their care," she said. 

'You see the pros and cons' 

Health Minister Reiter said the report is fulfilling its purpose. 

"You see everything. You see the pros and the cons, the pluses and minuses. This is used by the SHA management team to decide what improvements should be made. It helps inform those decisions," he said. 

"I think it's important that we always strive to do better."

Issues with food service were also high on the list of complaints about the facilities, with one resident complaining that soft-cooked eggs were not on the approved list of menu items. Others complained of small portion sizes and too much processed food. 

A survey of residents and their families was also released by the SHA on Friday. About 2,700 residents and 2,100 family members responded.

According to the survey, the overall level of satisfaction among residents decreased from 88 per cent to 85 per cent from 2016-17 to 2018-19. Family satisfaction remained the same at 83 per cent.