3 London-area care homes rate highest in Ontario for violations

Three long-term care homes in the London area rank among the top 10 in Ontario for the number of violations of provincial rules in place to protect patients and ensure quality of care, a CBC Marketplace investigation has revealed. 

Marketplace reviewed 10,000 inspection reports and found more than 30,000 "written notices," or violations of the Long-Term Care Homes Act and Regulations (LTCHA), between 2015 and 2019 inclusive. The LTCHA sets out minimum safety standards that every care home in Ontario must meet.

Marketplace isolated 21 violation codes for some of the most serious offences that directly affect resident care including failure to provide baths, insufficient hydration, poor oral care, medication mix-ups and nutrition violations. The analysis found that of the 632 homes in the Ontario database, 538 — or 85 per cent — were repeat offenders.

The list of 10 Ontario care homes with the highest number of violations look like this, with London-area care homes in bold:

1. Hogarth Riverview Manor (Thunder Bay) 289.
2. Earls Court Village (London) 224.
3. Midland Gardens Care Community (Scarborough) 212. 
4. Park Lane Terrace (Paris) 190.
5. Bella Senior Care Residences (Niagara Falls) 185.
6. Residence Saint-Louis (Ottawa) 168. 
7. St. Josephs Villa (Dundas) 161. 
8. Village of Glendale Crossing (London) 154. 
9. Caressant Care (Woodstock) 151. 
10. Ceadarwood Village (Simcoe) 151.

All three London-area homes in the top 10 showed multiple repeat violations for crucial aspects of patient care, including basic neglect, failure to address skin care needs, abuse and improper hydration. 

Earls Court was by far the worst in London with 224 reported violations, the second-highest number in all of Ontario over the five-year period Marketplace looked at.

Of those 224 violations, 51 were repeat offences for everything from problems with how abuse was reported, skin care issues with patients and failure to provide proper hydration.

Another London home, Mount Hope Centre for Long-Term Care on Grosvenor Street had 142 violation reports over the five-year period to put it 68th on the list of 632 Ontario care homes. Mount Hope, which is operated by St. Joseph's Health Care London, had 19 repeat offences violations.

After this story was first published, St. Josephs Health Care shared with CBC News information that shows they've made strides in reducing the number of written notification for violations over the past five years. 

Mount Hope received 59 violations in 2016 and the number has dropped each year since. So far in 2020, they've received three written notifications. 

"We are pleased with the progress we have made, in partnership with our Resident and Family Councils," St. Josephs said in a statement to CBC News. "Our team members are dedicated and caring individuals who are committed to the wellbeing of our residents."

'It's an assembly line'

And while Mount Hope has taken steps to reduce the number of written notice violations, a member of the care team told CBC News patients there still aren't always getting an acceptable level of care. 

A personal support worker (PSW) who's worked at Mount Hope for years said he was not surprised the Marketplace investigation found that six in seven care homes are repeat offenders, and there are virtually no consequences for homes that break the rules repeatedly.

CBC News has agreed to the man's request to have his name withheld for fear of retribution by his supervisors.

The PSW said there are often only two PSW on a floor at Mount Hope with up to 34 residents. He said the understaffing, combined with the residents' complicated care needs, make it at times impossible to provide basic levels of care. 

He said on the worst days for staffing shortages, residents are left in bed in the morning far too long, which can lead to serious skin care issues. He said their incontinence needs are also often not met promptly, which can also cause problems with skin care.

Transferring patients, which is done for cleaning or bathing, can tie up two support workers at a time. This leaves one, or none, to care for the other residents.  

The PSW said keeping up with the care creates an environment of rush and triage. 

"There's no time for any holistic care for residents on a unit," he said. "You are being forced to work in what feels like a line shift, where as you go room to room, each resident only receives maybe five to eight minutes of care at a time. It's an assembly line." 

CBC News reached out to the care home operators for comment. A statement from the owner of Glendale Crossing said the home works quickly to address any problems flagged by provincial inspectors. Their statement also said the list of reported violations "does not provide a complete picture of the quality of care that a long-term-care home provides."

St. Josephs Health Care London, which operates Mount Hope, was notified about the story on Friday, Oct. 16. On Thursday CBC News requested an interview and St. Josephs planned to make someone available on Friday. Their comments will be added to this story. 

CBC News has also reached out to Earls Court for comment but they have not provided someone to comment. 

Most Ontario care homes have not faced any punishment for failure to comply with the law. Only two homes have been shut down in the last decade for repeatedly failing to meet safety standards. Other sanctions available to the ministry appear to be ineffective in preventing future repeat offences.

'No tolerance' minister says

CBC News asked Ontario's Minister of Long-Term Care Merrilee Fullerton why so many homes are not addressing well-documented — and many cases repeated — problems with providing basic care.

"There's no tolerance whatsoever for negligence or abuse," said Fullerton, noting that she feels her government is prioritizing serious offences in their inspections. 

"They must be dealt with in a fulsome way."