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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
VDAN-AEW7UN

FACILITY NAME
The Salvation Army Buchanan Lodge
SERVICE TYPES
130 Long Term Care
FACILITY LICENSE #
2501002
FACILITY ADDRESS
409 Blair Ave
FACILITY PHONE
(604) 522-7033
CITY
New Westminster
POSTAL CODE
V3L 4A4
MANAGER
Sara Leibl

INSPECTION DATE
October 19, 2016
ADDITIONAL INSP. DATE (multi-day)
October 20, 2016
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
11.5
ARRIVAL
09:15 AM
DEPARTURE
04:15 PM
ARRIVAL
10:30 AM
DEPARTURE
03:45 PM
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# CHILDREN ENROLLED

Introduction

This is an unannounced annual Routine Inspection of the facility to assess compliance with the Community Care and Assisted Living Act (CCALA) and the Residential Care Regulations (RCR). The following systems were reviewed:
- Licensing
- Physical Facility
- Staffing
- Policies and Procedures
- Care and Supervision
- Hygiene and Communicable Disease
- Medication
- Nutrition and Food Services
- Program
- Records and Reporting, also
Resident Bill of Rights
The Licensing Officer's Reference Guide to Residential care Database Coding and
An abbreviated checklist for staff and resident record requirements

For further information please contact this Licensing Officer at:
Valerie Dairon, BScN, LO
Tel. 604-949-7710
Email; valerie.dairon@fraserhealth.ca

Contraventions
Previous Inspection - Contraventions observed on FIR #VDAN-A4TVUU have been corrected except for those noted on supplementary pages.
Current Inspection - Items reviewed comply with the Act, regulations & standards of practice except for those noted on supplementary pages.

Observed Violations
PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 31200 - RCR s.19(3) - If a licensee installs electronic devices for the purposes of transmitting or recording images of persons in care or members of the public, the licensee must display in a prominent place notice that electronic surveillance is being used.
Observation: Video monitoring equipment was observed in the ceiling at the front entrance. There was no notification displayed in the area to alert members of the public or residents.
Corrective Action(s): Please provide a plan to ensure that there is always appropriate notification displayed to alert PICs and the public to the use of video surveillance as per regulation above.
Date to be Corrected: Nov. 2, 2016

PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 31750 - RCR s.35(1)(b) - A licensee must provide the following appropriately furnished and equipped areas: (b) safe and secure locations for medications and the records of persons in care.
Observation: Only selected rooms from 211-250 were observed. Topical medications were observed in 3 rooms. the medications include, polysporin ung (non-prescription), prescription Sebrun shampoo, clotromazole ung., fucidin ung., and Preparation H.
Corrective Action(s): Please provide a plan to ensure that all medications are appropriately and securely stored.
Date to be Corrected: Nov. 2, 2016

STAFFING: 32110 - RCR s.40(1)(b) - A licensee must ensure that the performance of each employee is reviewed both regularly and as directed by the medical health officer under subsection (2) to ensure that the employee (b) demonstrates the competence required for the duties to which the employee is assigned.
Observation: Of 3 staff files reviewed, 2 staff had not had recent performance review. one was a new employee and was due for review next week. In discussion with the Director of Residential Services it was made clear that the performance reviews had not been brought up to date over the last 3 inspections. The reviews for the LPN/RN's have been reported to be completed. The Director has developed a schedule to complete the remaining reviews by the end of December.
Corrective Action(s): Please provide a plan that will ensure that the performance reviews are completed by the end of December as planned. Also, please provide a sustainable plan that will ensure that performance reviews are completed in a time frame as directed by facility policy moving forward.
Date to be Corrected: Nov. 2, 2016

POLICIES AND PROCEDURES: 33230 - RCR s.85(1)(b) - A licensee must do all of the following: (b) review and, if necessary, revise the policies and procedures at least once each year.
Observation: Of the mandatory policies per RCR 85 (2)(a through l) the last review dates were October 2014.
Corrective Action(s): Please provide a plan that will ensure that policies are reviewed and only if needed, revised yearly.
Date to be Corrected: Nov. 2, 2016

POLICIES AND PROCEDURES: 33350 - RCR s.85(2)(e) - Without limiting subsection (1) (a), a licensee must have written policies and procedures in respect of all of the following: (e) access to persons in care by persons who are not employees of the community care facility;
Observation: A policy providing guidelines for staff with relation to visitation and release of PIC's from the care of the facility was not observed. The Director of Residential Care states there is a "Release of Jurisdiction" form that has recently been developed. This will be added to the present visitor policy that simply describes sign-in procedure.
Corrective Action(s): Please provide a plan to ensure that the intent of RCR 85(2)(e to f)(ii) is met by policy.
Date to be Corrected: Nov. 2, 2016

MEDICATION: 36100 - RCR s.70(1) - A licensee must ensure that only medications that have been prescribed or ordered by a medical practitioner or nurse practitioner are administered to a person in care.
Observation: An unlabelled tube of Polysporin was observed in a beside drawer.
Corrective Action(s): Please ensure that all medications are prescribed as Regulation above, and provide a plan to ensure compliance.
Date to be Corrected: Nov. 2, 2016

RECORDS AND REPORTING: 39010 - RCR s.49(2) - A licensee must record the height and weight of each person in care on admission.
Observation: Of 2 PIC files reviewed, there was no admission weight observed for 1 PIC. Please ensure that each PIC record contains the admission height and weight. In the absence of this record please provide and identify as such, the oldest known weight and height for the record.
Corrective Action(s): Please provide a plan that will ensure that the admission height/weight, or the oldest known height/weight is retained in all files.
Date to be Corrected: Nov. 2, 2016


Comments

The Financial system was not reviewed at this visit as the accountant works off-site.
The staff records that were reviewed, one RN's file revealed only a recertification for CPR. The facility staffs an RN per shift, the care aids are not expected to provide first aid. There was a question about the quality of the first aid renewal when only CPR is recertified. The RCR 43(1)(a) requires that an employee with valid (current)first aid is accessible at all times. There is concern that the CPR recertification does not meet the CCFL requirements as described in the RCR schedule C. Licensing will confirm this and report back to the Director of Residential Care.
Also, in staff and PIC records was evidence of immunization, but it was unclear whether the evidence referred to flu vaccination or whether as per RCR 49(1) is was related to the required BC Immunization and Tuberculosis programs. Please ensure that the requirements of the BC Immunization and Tuberculosis program is followed for residents and staff.
The Manager of Support Services stated that on October 18, 2016, the Fire Department was present to observe a fire drill. One care unit was observed for evacuation to an indoor safe space. The manager stated they do not do fire drills monthly. The Emergency Binder and the Policy and Procedures Binder were both reviewed. A guideline to direct staff on the frequency of staff training in implementation of emergency plan and use of equipment was not apparent. It appears that there is no prescriptive direction in the CCALA or RCR for frequency of training. This matter will be further reviewed with the Director of Residential Care.
This facility has completed a project to reduce risk for falls. There is physiotherapy involvement to improve strength and balance for residents at risk. The staff have participated in continuing education and training. The Director of Residential Care identified that there are residents who were previously wheelchair dependant and are now walking. The statistics shown to the LO show significant reduction in injury in the previous 2 quarters.
Review of the facility Policy and Procedure binder as well as the new medication policy binder provided by Rexall Pharmacy confirms that policies for Monitoring Medication Administration are in place.
The Nutrition Monitoring Policy was not found in the policy binder and the new dietitian was not able to produce, and confirmed she had not reviewed the policy. There were several audits of the nutrition services observed as monitoring activities, as well as a schedule for follow-up audits for the year. The dietitian stated she will review the policy to confirm it is consistent with the nutritional practices at present.
According to the dietitian, this facility is very good at completing monthly weights. The review of one unit showed 100% compliance. There was one PIC who has not been weighed due to health issues, but whose weight is being monitored visually. There are active measures being pursued to find a way to weigh this PIC.
The recreation programming appears very active. During the inspection, activities were constantly changing, such as perogy making, bowling, choir, group activities, sing songs on several units and the residents were coming and going in large numbers with/without staff assistance in order to participate.
This facility appears clean, well maintained and organized. The staff were all very friendly and willing to help with this inspection. I'd like to thank all the staff and residents for their assistance during this visit.



Action Required by Licensee/ManagerAction Required by Licensing Staff
Take corrective action to bring facility into compliance, Provide a written response to LicensingNo action required
Due Date
Nov 02, 2016

Click here for FAQ About Inspections.
Click here for a description of each "Category" of violation displayed.