Staffing for new long-term care facility questioned

Bonnie Belec
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Eastern Health says province will pay for extra nurses

The son of a man who lives at the Hoyles-Escasoni Complex says he was told the current staffing ratio at the long-term care facility will be maintained in a new facility when it opens next summer.

Eastern Health’s new long-term care facility is located in the east end of St. John’s.

But Jason Dawe wonders if the resident-to-staff level will be enough.

“There’s 375 residents at Hoyles and a maximum of 120 staff. There’s no way people there can keep up the pace in that kind of environment without breaking,” he told The Telegram Friday.

He said it takes two people to get his father out of bed, washed and dressed, and there are 30 other people on the wing — requiring various levels of care — waiting for the same kind of help. Few of them are able to get up and walk to the lunch room on their own, he said.

Add to that the increase of residents at the new facility, he said.

“I am saying that a ratio of 2.9 (residents) to one (staff) is certainly good looking on paper. I just don’t see that it’s a great idea,” Dawe said.

“They are caring for people with minimal staff. They probably would have enough under ideal conditions, but the second someone twists an ankle that ratio is gone in the toilet,” he said.

Dawe suggested the ratio should be lower and for Eastern Health to absorb the extra costs for the protection of those in long-term care.

In an emailed statement to The Telegram Friday, Eastern Health said it has received funding from the provincial government to provide nursing staff for the increase in the number of residents who will reside at the new long-term care facility.

Eastern Health and Hoyles-Escasoni administration have been holding information sessions for family members to help answer questions about the move to the new $150-million facility on Newfoundland Drive in St. John’s.

It will have the capacity for 461 beds. The Hoyles-Escasoni Complex has 375.

JJ Dray’s mother is a resident of Hoyles and attended a meeting Oct. 10 — not the same one as Dawe.

He said while the meeting was informative, providing details about such things as the layout of units, amenities, the process by which the residents were going to be moved, representatives didn’t address concerns about staffing levels.

“A gentleman asked a question about staffing in the new facility — something along the lines of ‘if there are staffing issues currently at Hoyles-Escasoni, what is Eastern Health going to do to help mitigate this issue in the new home, given there are 80-90 additional beds?’” recalled Dray.

“The moderator replied this wasn’t the time or place to have this discussion, and that it would happen at a later date. I interjected and said that I felt it was a pertinent issue, given this meeting was regarding the new home, and that proper staffing was an issue of concern for both residents and their families,” he said.

Dray said they repeated the meeting wasn’t the time or place to discuss it, and they carried on with the presentation.

“It was quite obvious to me this was a discussion they were not going to engage in,” he said.

 During the past few weeks there have been many stories written about staffing issues and how families of residents say it is affecting patient care at the Hoyles-Escasoni Complex.  

Stories have centred around family members, residents and workers who have expressed concerns about such issues as medications, the level of patient care, nutrition and under staffing.

The stories first came about when Eastern Health announced it had saved $22.7 million and reduced 230 full-time equivalents positions as of June 30 through operational improvement initiatives launched in May 2012.

In response to those stories, Eastern Health issued a statement Oct. 4 in which CEO Vickie Kaminski said, “When I announced our operational improvement initiatives I clearly stated at that time these initiatives would not have any impact on the quality and safety of patient, resident and client care. I believe we are achieving that objective.”

On Monday The Telegram obtained a memo written by the executive director of Glenbrook Lodge, Maj. Rex Colbourne, warning family members about the possible side-effects of staff shortages at that long-term care facility in St. John’s.

Eastern Health is continuing with initiatives which aim to save $43 million and reduce 550 full-time equivalent positions over two years.

Kaminski and Health Minister Susan Sullivan said staffing issues raised by family members, residents and unions are not as a result of this initiative.

However, they both acknowledge Eastern Health has “been experiencing a challenge recently in ensuring that we do have the required number of staff on a shift due to leave and recruitment issues which we are trying to address.”

Alice Kennedy, Eastern Health’s vice-president of long-term care, told The Telegram recently plans are in place to try to recruit more staff for the new facility.

“We are working on strategies to try to increase the number of people that are being trained and that is being done in consultation with education organizations and government, because we need — obviously if we are going to have more beds we’ll need more staff to operate those beds so we are certainly planning to try to, and looking at other alternatives, increase the number of staff to operate new beds,” she said.

Kennedy said Hoyles-Escasoni’s permanent, full-time positions are filled however, getting enough relief staff is challenging.

“But we are certainly working to hire more relief staff and we do have a significant number of relief staff already, but unfortunately we don’t have enough to meet the demands when we have high rates of absenteeism and leave,” she said.

The new long-term care facility  will consist of four buildings — two residential, which will also be equipped to provide extra space for recreation therapy, physiotherapy, occupational therapy and spirituality; a building for support services, such as dietary, laundry, infrastructure support, health technology and data management and a utility building.

It is in the process of being built on 17.8 acres of land, and will encompass about 38,000 square metres.

Organizations: The Telegram, Hoyles-Escasoni Complex

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Recent comments

  • ratio
    October 27, 2013 - 20:05

    ..eastern health are already aware of this problem now ,if they are saying wait until the new complex....until then just try and use the same diaper,however once that complex is open....the skies will open.....everyone on hold for now...joke...

  • Martha
    October 27, 2013 - 15:14

    Why is there no Speech-Language Pathology service listed as available? It is lacking in long-term care!

  • Dave Power
    October 27, 2013 - 12:12

    In response to this article and in particular to Mr. Dray's comments about staffing I would like to add some very pertinant facts about the meeting on October 10th which we also attended. This meeting was one of several held by Hoyles Escasoni and Eastern Health specifically to present an update on the completion date of the new facility and to discuss and seek input from family memebers as to how they would see the move progress and to identify any specific needs or concerns of the families of the residents to be moved. It was a very informative and specific presentation that allowed those in attendance to ask questions and have input about the move to Pleasantville. This was not a meeting intended to discuss staffing issues. When the issue arose the presenters made it quite clear that this was a seperate issue and they had internal meetings scheduled to prepare for and address such issues. When one member of the audience persisted to make this an issue myself and a few others voiced our concern that this matter had absolutely no relevance at this particular meeting and when the presenters made it clear that they would get back to us about staffing issues at a later date there was a round of applause from the audience that we could get on with the issue at hand. I will be the first one to be outspoken about such matters but the meeting that night was about the move in June not staffing and for anyone in attendance to try to railroad discussion towards staffing issues was unnecessary and wasteful of everyone's time. I have had 2 family members staying at Hoyles Home over the last 3 years and the care they have received, including food, bathing, social activities, level of care etc., has been very good. I suggest that if anyone has a concern or problem with the level of care their family member receives, food etc., they should simply see the unit supervisor or contact the home management to express their concern and it will be looked after immediately. I know this from the few times, especially at the beginning of our family members stays, that we had to adjust to the changes as did the staff and our requests were addressed immediately with kindness and professionalism. To take the personal issues of residents and family members to the public domain through newspapers etc. without first speaking to management and staff at the home who would have addressed any concerns immediately is simply self serving to gain public recognition for whatever reasons and simply ignorant towards the many other residents, family members and staff of the home who are there every day providing the best level of care they possibly can. To suggest otherwise is not fair and shows poor communication skills for those who choose to debate such matters in public. My sister in law had salmon on Thursday for her supper with mashed potatoes, green peas, vegetable soup, tea and boston cream cake with fresh fruit. Not a bad menu in my books. The meals are always of good healthy quality even if there are a few spagettios on a plate once in a while with other healthy choices and some residents ask for them specifically. Leave the residents, families and staff of Hoyles Home alone. Let the residents enjoy the short time most of them have left and the staff to continue to provide the great quality of service and food that they receive. Oh, and by the way, the new facility looks great and because of the excellent planning and preparation that the management and staff are putting into making this move as seamless as it can possibly be we are looking forward to assisting in any positive way possible.

  • John
    October 26, 2013 - 22:52

    Remember now, this is from the government who loves telling everyone that times are BOOMING in NL. If things are so great why can't they make some of the relief staff permanent and get closer to a solution for this problem.

  • daughterofresident
    October 26, 2013 - 18:10

    2.9 residents per may be that on paper but the reality is more like 6-8 residents per staff. Just sayin'....

  • Graham Bursey
    October 26, 2013 - 17:46

    Lets hear Dunderdale and Sullivan dance all around this situation and tell us how cutting millions of dollars and hundreds of people actually improves service.

  • Marie
    October 26, 2013 - 15:13

    Yes there is major proplems with the long term care under eastern health. Patients are being treated like dirt. If they treated their pets like they do these people they would be charged with animal crulty and brought to court. That is what need to be done here. Charge them with elder abuse and see how quick they change. Someone needs to not only speak up for these people but needs to take action to prevent it.

  • Cathy
    October 26, 2013 - 11:36

    It's what families want to know but no one is talking... Using the same caregiver - patient ratio in the new facility is a recipe for disaster. The new facility's layout is completely different from the Hoyles Escasoni.

  • robroy
    October 26, 2013 - 11:17

    I am willing to bet the 2.9 ratio includes bn. which now does no hands on resident care lpns who does minimal care and pcas and if they base it on 24 hours after 8 pm to 8 am there are two and even one person on the floor for the night Imagine one staff on a floor alone only to have someone to releave for breaks alone. Tell me how residents and staff are safe if there is only one staff on a floor

  • chris
    October 26, 2013 - 05:18

    The ratio of pt 's to staff is that based on 12 or 24 hour shift and is it the staff that are directly involved with the physical care of these patients .. Those are the numbers that we need to know. As these patient numbers increase more staff will be needed especially if our aging and obesity population making the work of these staff even more demanding and add to that confused and aggressive patients and that could take these ratios and make them very unbalanced.