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The administrator of a municipally run nursing home in Norfolk County is defending staff after a surprise inspection found numerous infractions.
In March, inspectors from the Ministry of Long-Term Care visited Norview Lodge in Simcoe for a “proactive compliance inspection” to ensure the facility is complying with nearly 400 provincial regulations governing resident care and support services.
After watching regular operations at the home over the course of six days, inspectors issued six written notifications and one compliance order, with an additional issue — “conflicting” information in a resident’s written care plan that could have led to improper care — remedied on the spot.
According to the inspection report, there were 15 occasions when Norview staff allegedly did not check the temperature of food served in the dining room, contravening the home’s policy to make sure the meals served are “safe and palatable to the residents.”
Three orders involved staff improperly handing and storing medication.
Instead of locking up drugs slated for destruction and disposal, staff kept them on the home’s medication carts, where they could have been confused with medicines still eligible for residents’ use.
This situation arose because staff did not have somewhere to lock up the discontinued medication on evenings and weekends when the nursing supervisor — who is responsible for safeguarding the drugs — is away.
An inspector saw a Norview staff member leave a laptop open on an unattended medication cart, with residents’ confidential medical information in full view of residents and a visitor who were in the hallway near the cart.
Staff members also left the medication cart itself unlocked and unattended on at least three occasions, which goes against Norview’s policy.
In one instance, according to the ministry report, an inspector saw “a resident open the drawer of an unattended medication cart, look at medications within the cart, then close the drawer.”
The responsible staff member told the inspector they were surprised, thinking they had locked the cart.
“There was a risk that the resident could have taken a medication that was not intended for them,” the ministry report read.
At Tuesday’s council meeting, Coun. Linda Vandendriessche said she was “terribly disappointed to see these failures.”
“The worst one is not securing the drug supply,” she said. “That is such a severe offence in my mind that it concerns me greatly.”
Norview administrator Bill Nolan did not specify what disciplinary steps were taken, citing confidentiality.
“We handled the conduct of our staff appropriately through (human resources),” Nolan told councillors.
According to a report presented to council, employees were trained on locking the medication cart and safeguarding personal information, with followup audits to ensure compliance.
Within days of the inspection, Nolan said the home installed a one-way safe for staff to securely deposit medications on evenings and weekends.
Regarding the food temperature checks, Nolan noted Norview serves more than 530 meals every day to its 179 residents.
“They add up quite well in a month,” he said. “Not acceptable excuses, but it did happen.”
Any employee who was found to have missed a temperature check received an informal written warning called a “letter of counsel,” with training for all staff to ensure no repeats.
The ministry inspectors also issued notices for missed staff training, along with quality improvement reports and survey results that had not been posted to the facility’s website.
Inspectors returned for a followup visit in June and were satisfied with the steps Norview had taken to address all issues, Nolan said.
All staff are now up to date with training, and the missing documentation has been added to the website and shared directly with residents and families.
“As this is the first compliance inspection we’ve had for several years, Norview has done very well,” Nolan said, noting the ministry checks for “hundreds of things” and no home gets a perfect score despite staff “taking everything seriously.”
“There’s always something that is found,” Nolan said.
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