Sexual abuse at city nursing home initially unreported, AG finds
Laura Osman | CBC News | Posted: April 30, 2018 5:35 PM | Last Updated: May 9, 2018
Male resident found naked, attempting to position himself atop female resident in wheelchair
UPDATE | City council unanimously passed the auditor general's recommendations May 9.
A possible case of sexual abuse at a city-run long-term care home could have been prevented, but instead went unreported until the next day, an investigation by Ottawa's auditor general has concluded.
Auditor General Ken Hughes also had no assurance that a similar incident would be handled properly in the future to protect residents, he said Monday.
It's quite possible that there were other incidents that went unreported. - Auditor General Ken Hughes
The report doesn't reveal precisely when the incident occurred, or in which of the city's four long-term care homes.
According to the report, a female resident who can't speak or leave her wheelchair disappeared at one of the homes last year. When a personal support worker discovered her absence, he had a feeling he knew where she was and dashed to the room of a male resident who had been showing signs of "sexually inappropriate behaviour" earlier that day.
The worker found the man naked, trying to position himself on the fully clothed woman in her wheelchair.
Nurse intervened
The manager on call at the time decided the incident wasn't a case of sexual abuse and chose not to report it to police or the Ministry of Health and Long-Term Care.
It wasn't until the next morning when a nurse arrived on shift and reviewed what had happened that she and the manager decided to report the incident after all.
If it hadn't been for the nurse's intervention the incident may have gone unreported, said deputy auditor general Sonia Brennan.
The auditor launched the investigation after receiving two anonymous letters accusing management at the home of mishandling a case of abuse.
Inconsistent policies
In some cases, the city's policies that tell staff when to report an incident contradict each other, the auditor found. While one policy dictates any suspected case of abuse must be reported, another says to report only cases where an injury has occurred.
The auditor also found the incident could have been prevented. Staff knew the man had been behaving inappropriately, yet he was allowed to remain in a unit where most of the other residents were women.
It wasn't until after the incident that he was placed under one-on-one monitoring, then eventually transferred to an all-male unit.
Because of the gaps that existed at the time of the incident, "it's quite possible that there were other incidents that went unreported," Hughes said.
The ministry eventually found staff at the home had done their due diligence to protect the resident and report the incident, and police did not lay charges.
Since the incident there have been major changes at city-run homes, said Janice Burelle, the city's general manager of community and social services.
Those added measures include enhanced staff training to clarify their responsibilities when it comes to reporting abuse.
$3M problem
The 2018 city budget provides $1 million less for long-term care than what was spent in 2017.
The auditor's report found staff-to-resident ratios are insufficient at the city-run homes, and staff are burning out.
A third-party expert hired by the city to review its four long-term care homes in an attempt to curb abuse also found the homes to be short-staffed. Greg Fougère, the former head of Ottawa's Perley and Rideau Veterans' Health Centre, uncovered examples of emotional abuse and neglect of residents, and pointed to overworked staff as a possible cause.
Ottawa's city-run homes provide 18 fewer minutes of one-on-one care to residents per day than the 2016 provincial average for non-profit homes, Fougère said.
The report, which has not been made public, recommends the city will need to spend $2.6 million per year to hire 35 new full-time personal support workers, and $600,000 to hire nurses and other staff members to bring care levels up to the provincial average.
'Aggressive plan'
The community and protective services committee voted to accelerate that hiring using $800,000 in 2018.
"The one consistent message is that we need more staff," Burelle said.
On Tuesday the city's finance committee will consider a $1-million cash injection to replace equipment and upgrade technology at the homes.
It's all part of an "aggressive plan" to curb abuse that includes recommendations from the auditor general, the ministry and Fougère's investigation. It will be implemented by the end of next year, according to city manager Steve Kanellakos.
Both the plan and the spending needed to fund it must be approved by city council on May 9.