This facility is very closely associated with a larger facility next door, Queen's Park Care Centre (QPCC). Many of the records and practices for this facility were not available for review because they are maintained at QPCC. This document reflects the observations made at this site. Further required information will be reviewed at the QPCC site. Adjustments to this document will be made if necessary based on the inspection of the QPCC site.
William Rudd House is home to 12 long term care residents who are very independent. They are able to make decisions and leave the facility un-escorted or in groups.
Physical facility: The lighting level in the dining room is very low. This is reported to be at the request of the residents.
The hot water temperature measured at the resident kitchen sink, accessible to residents who are preparing their own breakfast and snacks, was recorded as 50.5 degrees Celsius. The regulation requires that water accessible to persons in care not exceed 49 degrees Celsius. The 50.5 degree temperature is marginally above the regulated requirement, but may be higher in other hot water outlets that are accessible to the residents.
Staff from maintenance department at QPCC was interviewed about the water temperatures available to residents. He indicated that he had put mixing valves on all the hot water available to the residents with the exception of the kitchen area. He stated he would add a valve to the kitchen sink area as soon as possible. Monitoring of the temperatures must still be conducted.
Please provide a plan that will ensure that the residents do not have access to water heated above 49.0 degrees C., and that there is a system to monitor the temperature of all hot water accessible to residents. March 15, 2018.
Resident file reviews demonstrated an absence of Immunization and Tb status in the file of a long term resident. The facility manager states that the residents were not required to have evidence of Provincial immunization and Tb screening at the time of their admission. Now that the facility is being regulated by Licensing under licensing regulations, they are prepared to meet the requirement going forward. There is controversy about meeting the requirement retroactively in files where the residents were admitted before the requirement became active. This issue will be reviewed with licensing management.
Staffing: Staff and volunteer records are not available at this facility and will be reviewed at the QPCC facility Human Resources department.
Staff training for implementation of the emergency plan and use of equipment training will be reviewed with staff responsible for emergency preparation at QPCC site.
Nutrition: This facility receives nutritional support from the QPCC dietary and kitchen staff and will be further reviewed at that site.
At this site, each resident has a personal menu plan developed with the dietitian as their first choice for meals. The second choice is represented by the posted menu. Milk and fruit juices are available in the fridge. Every morning the resident receives a fill of water in their personal water bottles that are kept with them through the day to ensure that fluids are always available.
The menu was reviewed for Week 2. The week's menus are posted at the entrance. Wednesday lunch, dinner and Thursday dinner were observed to contain only 2 food groups instead of the required 3 food groups (RCR 62(2)(a)). It is noted that beverages of fruit juice and milk are available for each meal though not listed on the menu. Dairy, milk, is accepted as the 3rd Food Group. A menu substitution list was not observed. There were 2 days that identified "Special Meals". Staff stated that these meals were decided by the residents and often were ordered in, e.g. Pizza. The staff was not aware of any method employed to record the choice for special meals. This will be discussed with the dietitian at the QPCC site. Dietitian will communicate with licensing to find find a solution before March 15, 2018.
Please provide a plan, recommended in consultation with the dietitian, that will ensure there is documentation that Nutrition as per , RCR 62(1-4), RCR 87(b)(c) and RCR 66(1) ... is adequate to meet the personal nutritional needs, based on Canada's Food Guide and the person in care's nutritional plan. March 15, 2018
It was not confirmed by record at the facility site, that staff attend continuing education regarding food service and nutrition care.
The residents have the opportunity to prepare their own snacks as well as breakfast every day.
Please provide the planning that ensures that as per RCR 65(2) the food is safely prepared, consumed and handled. March 15, 2018.
Records and reporting: The admission weight and height was not found in the care plan of the only file reviewed at this inspection. Staff was able to go back in computer records accumulated prior to 'meditech', to find the admission weight. It is recommended that admission weights of all residents be recorded in a manner that will not be purged at the time the care plan is thinned, and the chosen weight and height, if not the admission weight and height, is identified as a starting point thus making sure the record is continually available for inspection. March 15, 2018
The residents were observed socializing in groups and with staff. Laughter and animated conversations were observed. The staff were observed to interact with the residents respectfully and with humour. The lighting in the facility is observed to be dim, this was said to be by choice of the residents. A resident group was reported to be very active in the home. The resident rooms each have ground level exit doors to a small patio. The rooms are decorated to reflect the personality and choices of the residents.
Thank you to staff and residents for assistance with this inspection. |