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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
CRAU-CF2P6T

FACILITY NAME
PAH Foundation Lodge (The)
SERVICE TYPES
110 Hospice
130 Long Term Care
FACILITY LICENSE #
DANN-A4NR6Y
FACILITY ADDRESS
15575 16A Ave
FACILITY PHONE
(778) 545-6200
CITY
Surrey
POSTAL CODE
V4A 1T2
MANAGER
Andrew Fairbairn

INSPECTION DATE
June 02, 2022
ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
10.52
ARRIVAL
09:30 AM
DEPARTURE
04:31 PM
ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# OBSERVED IN CARE
118

Introduction

This is a unscheduled routine inspection to assess compliance with the Community Care and Assisted Living Act (C.C.A.L.A.), the Residential Care Regulation (R.C.R.) and the relevant Director of Licensing Standards of Practice (D.L.S.P.). Evidence for this report was based on the Licensing Officer's observations, review of the facility records, and information provided by the facility staff at the time of the inspection.

The following areas were reviewed:

- Licensing
- Physical Facility
- Staffing
- Policies and Procedures
- Care and Supervision
- Hygiene and Communicable Disease Control
- Medication
- Nutrition and Food Services
- Program
- Records and Reporting

As part of this routine inspection a facility risk assessment tool is completed and a copy is provided. The risk assessment includes non-compliance identified during the routine inspection, and a 3 year historical review of the facility's compliance and operation.

Visit the Community Care Facilities Licensing website at https://www.fraserhealth.ca/health-topics-a-to-z/long-term-care-licensing#.XUHwhWyos2z for:

- Additional resources, and
- Links to the legislation (C.C.A.L.A. and R.C.R.).

Contraventions
Previous Inspection -
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: 31100 - RCR s.17 - A licensee must ensure that water accessible to a person in care, from any source, is not heated to more than 49° Celsius.
Observation: A random review of the hot water temperature at ensuite washroom sinks gave the following readings:
* 54.5 degrees Celsius
* 54.2 degrees Celsius
Corrective Action(s): Please ensure water accessible to a person in care from any source is not heated to more than 49 degrees Celsius. On June 4, 2022, the Manager put in a maintenance request to address the hot water temperature.
Date to be Corrected: June 4, 2022.

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: The facility has video cameras and currently there is no signage posted indicating that there is video surveillance.
Corrective Action(s): Please ensure signage is displayed in a prominent place that electronic surveillance is being used.
Date to be Corrected: July 22, 2022.

STAFFING: 32320 - RCR s.68(4) - A licensee must ensure that all employees comply with the policies and procedures of the medication safety and advisory committee.
Observation: In review of the hospice documentation regarding the following were observed, for example:

- Opiod PRN (as needed) medication administration records, the "evaluation" section for some medications did not have a result/outcome. Specifics of where the gaps were noted, were provided at the time of the inspection.

- Medication Administration Records had dates medication(s) were administered and no staff initials documented. Specifics of where the gaps were noted, were provided at the time of the inspection.

In review of the long term component documentation there were also in various locations of the medication administration records for PRN (as needed) medications with no result/outcome noted. Specifics were provided at the time of the inspection.
Corrective Action(s): Please ensure all staff comply with the policies and procedures of the medication safety and advisory committee.
Date to be Corrected: June 17, 2022.

POLICIES AND PROCEDURES: 33280 - RCR s.85(1)(d) - A licensee must do all of the following: (d) ensure that policies are implemented by employees.
Observation: In review of the documentation for hospice, there was a person in care's record that did not have information documented for the kardex. Specifics were provided at the time of the inspection.

In review of the documentation for long term care, the post fall documentation on page 2 had information not documented (e.g., Was ambulance called)(Words to this effect). Specifics were provided at the time of the inspection.
Corrective Action(s): Please ensure all staff implement the applicable policies such as the "charting" policy.
Date to be Corrected: June 17, 2022.

MEDICATION: 36130 - RCR s.70(4)(a) - A licensee may permit a person in care to self-administer medications if a plan for self-medication is (a) approved by the medication safety and advisory committee and the medical practitioner or nurse practitioner who prescribed or ordered the medication.
Observation: Please refer to section 70 (4)(b) of the Residential Care Regulation.
Corrective Action(s): As above.
Date to be Corrected: June 17, 2022.

MEDICATION: 36140 - RCR s.70(4)(b) - A licensee may permit a person in care to self-administer medications if a plan for self-medication is (b) included in the care plan of the person in care.
Observation: In review of the documentation and in discussion with the Hospice staff, there is a person in care who is self medicating with the medication at the bedside, however this is not noted in the person in care's care plan and there is no indication this was reviewed (and approved) with the Medication Safety and Advisory Committee and reviewed with the Medical Practitioner.
Corrective Action(s): Please ensure a person in care who self adminsters medication(s), that the Medication Safety and Advisory Committee has approved this and the Medical Practitioner is involved. Finally, please include the plan for self medication administration in the person in care's care plan.
Date to be Corrected: June 17, 2022.

RECORDS AND REPORTING: 39460 - RCR s.87(b) - A licensee must keep a record of the following matters respecting food services: (b) menus and menu substitutions.
Observation: There is no formal substitution list that was available for review during the inspection.
Corrective Action(s): Please ensure a record of the substitutions to the menu is kept.
Date to be Corrected: June 10, 2022.


Comments

Medication Safety and Advisory Committee:
- There are minutes related to the Medication and Safety Council and the members of the committee are from different sites. The Medication Safety and Advisory Committee should be addressing things on a site specific basis. The Manager will address this by September 12, 2022.
The Residential Care Regulation makes reference to the following:
Division 4 — Medication
Medication safety and advisory committee
68   (1)A licensee must appoint a medication safety and advisory committee consisting of at least the following persons:
(a)the manager or a person designated by the manager;
(b)the supervising pharmacist appointed under subsection (2);
(c)if one is employed by the licensee, the health professional responsible for the immediate supervision of health care services provided in the community care facility.
(2)A licensee must appoint a supervising pharmacist to
(a)serve on the medication safety and advisory committee,
(b)inspect the areas of the facility where medications will be stored, and
(c)consult with employees respecting medication interactions and other problems related to medication.
(3)The medication safety and advisory committee must establish and review as required
(a)training and orientation programs for employees who store, handle or administer medications to persons in care, and
(b)policies and procedures in respect of
(i)the safe and effective storage, handling and administration of the person in care's medications, in compliance with the Pharmacy Operations and Drug Scheduling Act, and
(ii)the immediate response to and reporting of medication errors and adverse reactions to medications.
(4)A licensee must ensure that all employees comply with the policies and procedures of the medication safety and advisory committee.

Policies and Procedures:
- There is a committee composed of staff from the different facilities that review the policies and procedures. The Residential Care Regulation section 85 makes reference to specific policies and procedures that are required by legislation to be reviewed and/or revised once a year. The Manager will follow-up with the committee to see if the way the meetings are held and carried can take into consideration review and/or revision of the required policies and procedures required by legislation. The Manager will address this by September 12, 2022.
Persons in care records:
- In review of the hospice persons in care records, there was one document for admission assessment with no year noted, however it could be assumed it is 2022 given the admission date. Please reinforce thoroughly documenting such things as dates where required. The Manager will address this by June 17, 2022.
Due to the Covid-19 pandemic, the findings were reviewed and discussed with the Manager at the time of the inspection. This inspection report, and risk assessment was written off-site and then emailed on June 8, 2022 to the Manager for review and to finalize the report and risk assessment once they were in agreement to the wording. As a result of the pandemic, signature for the Manager is not included. If there are further questions related to this routine inspection, please contact your Licensing Officer.

Action Required by Licensee/ManagerAction Required by Licensing Staff
Take corrective action to bring facility into compliance, Provide a written response to LicensingFollow-up Inspection Required
Due Date
Jun 10, 2022
Approximate Follow Up Date
28 Jul, 2022

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