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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
CRAU-C86NXT

FACILITY NAME
Peace Arch Hospital ECU
SERVICE TYPES
401 Long Term Care (Hospital Act)
FACILITY LICENSE #
LBAA-962LQ8
FACILITY ADDRESS
15521 Russell Ave
FACILITY PHONE
(604) 541-5837
CITY
White Rock
POSTAL CODE
V4B 2R4
MANAGER
Imaan Toor

INSPECTION DATE
October 25, 2021
ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
10.25
ARRIVAL
09:30 AM
DEPARTURE
04:45 PM
ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# OBSERVED IN CARE
148

Introduction

This is a unscheduled routine inspection conducted 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/residential-care-facilities/resources-for-residential-care-licensees#.YXyLA60Uo2x for:

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

Contraventions
Previous Inspection - Not Applicable
Current Inspection - Items reviewed comply with the Act, regulations & standards of practice except for those noted on supplementary pages.

Observed Violations
LICENSING: 30240 - RCR s.61 - A licensee must regularly monitor the physical environment of the community care facility, and the care and services provided by it, to ensure that the requirements of the Act and this regulation are being met.
Observation: In review of the care planning system it was noted for a person in care that their fall risk assessment is in-place, however there is no date documented. On November 3, 2021, the Manager responded that the Team Leads for each care floor have communicated the expectations to the care staff.

Admission documents were not fully completed such as Identification of Decision Maker and the Licensing Officer was made aware these should be completed within 1 week of admission.
Corrective Action(s): Please ensure the care and services provided by the community care facility is regularly monitored to ensure that the requirements of the Community Care & Assisted Living Act and Residential Care Regulation are being met.
Date to be Corrected: October 29, 2021.

PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 31290 - RCR s.22(1)(b) - A licensee must ensure that all rooms and common areas are (b) maintained in a good state of repair.
Observation: During the physical plant inspection of the building, the following were noted, for example:

- Hand rails with painted coming off in various locations.
- Elevator door and person in care bedroom door trims with scuff marks/paint coming off.
- On the first floor outside a staff's office on the left side the bottom rail that is installed throughout the facilty the "end" cap is not in-place.
- The kitchen servery counter tops noted to being showing wear and tear.
- One of the two elevators (for example the elevator nearest each care unit entrance) with one piece of the floor that has come off near the front of the elevator.

In discussion with the Manager, the Manager also completed with other staff a walkthrough of the building and noted:

- That the elevator door trims/person in care door trims including wall hand rails the paint has come off/there are noted scuff marks.
- Persons in care bedrooms counter tops with the laminate is starting to come off.
- Hallways with holes in various locations at the base of the wall where the baseboard meets the wall and this needs to be caulked.
- Kitchen serveries counter tops need to be replaced and that there are cupboards with handles missing.
- 1 tubroom in the corner against the wall has bubbled.
Corrective Action(s): Please ensure all rooms and common areas are maintained in a good state of repair.
Date to be Corrected: January 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: A review of two of the medication rooms indicated that there were a few PRN (as needed) medication entries noted with no result/effect documented.
Corrective Action(s): Please ensure that all staff comply with the policies and procedures of the medication safety and advisory committee.
Date to be Corrected: November 1, 2021.

CARE AND/OR SUPERVISION: 34220 - RCR s.56(1) - A licensee must ensure that a person in care who leaves a community care facility for a temporary purpose has in his or her possession written documentation indicating the person in care's name, the community care facility's name and emergency contact information.
Observation: In discussion with the Manager and staff member providing persons in care written documentation indicating the person in care's name, the community care facility's name and emergency contact information is not being done on a regular basis.
Corrective Action(s): Please ensure that a person inc are who leaves the community care facility for a temporary purpose has in his or her possession written documentation indicating the person in care's name, the community care facility's name and emergency contact information.
Date to be Corrected: October 29, 2021.

CARE AND/OR SUPERVISION: 34630 - RCR s.81(3)(b) - A care plan must include all of the following: (b) an oral health care plan.
Observation: In review of the care planning system, a person in care did not have a oral care plan in-place.
Corrective Action(s): Please ensure persons in care have a oral health care plan in-place where required.
Date to be Corrected: November 1, 2021.

RECORDS AND REPORTING: 39010 - RCR s.49(2) - A licensee must record the height and weight of each person in care on admission.
Observation: In review of the care planning system, it was noted for a person in care that their height and weight on admission was not documented.
Corrective Action(s): Please ensure all persons in care have their height and weight documented on admission.
Date to be Corrected: October 29, 2021.

RECORDS AND REPORTING: 39126 - RCR s.77.1(1)(b) - Subject to subsections (2) to (4), a licensee must keep, for each person in care, a record showing the following information: (b) in the case of an adult, the consent for that person in care to be admitted or to continue to be accommodated in the community care facility, given in accordance with section 21 or 22 of the Health Care (Consent) and Care Facility (Admission) Act or section 50.1 of this regulation, as applicable;
Records respecting admission
77.1
(2) Subsection (1) (b) and (c) does not apply to a person in care who is in a program described in section 2 (1) as Child and Youth Residential or is receiving a type of care described in section 2 (2) (d) as Community Living
(4) Subsection (1) (c) applies only in respect of an assessment report provided on or after November 4, 2019
Observation: In review of the care planning system, it was noted that the admission consent for a person in care was not on file.
Corrective Action(s): Please ensure consent for persons in care to be admitted is noted on persons in care records where applicable.
Date to be Corrected: October 29, 2021.


Comments

Persons in care records:
- The immunization form for persons in care part B to be completed by the facility was not complete for two persons in care. Please ensure documentation is thoroughly completed where required.
Care plans:
- A recreation initial assessment was completed for a person in care, however it was not signed. It is the facility's process that such documents be signed. Please let your Licensing Officer know when this has been addressed.
- With regards to recreation care planning, there seems to be different ways this is being documented on the different care floors. A discussion took place with the Recreation Manager and the site Manager to ensure consistency in practice and documentation is relooked at for the entire site. The Recreation Manager is meeting with their staff on October 26, 2021 and will reinforce the importance of consistency in practice and documentation. Further discussion took place with the Manager that short term care plans are still be utilized for persons in care who have been at the site for awhile now. Please review internally your systems for consistency and documentation where required. Please let your Licensing Officer how you plan to address this.
- Wound care treatment and flow sheet documentation is in-place with strategies documented to address the wound(s). On November 3, 2021 the Manager followed up with the Team Lead on the care floor to ensure the care staff incorporate wound care as part of the care plan and this was completed. In addition, the Clinical Nurse Educators have communicated to the nursing staff to incorporate wound care planning to the care plan. It is best practice to incorporate strategies to deal with wound care into the care plan and to ensure there is a system for it to be reviewed and/or modified as part of the overall care plan.
Physical Plant:
- The hot water temperature measurement at one ensuite washroom sink was 49.4 degrees Celsius. Given this is not far off from the legislative requirement, it is acceptable. During the February 11, 2020 routine inspection it was noted a few temperature reading greater than 49 degrees Celsius. It is strongly recommended to review this internally to ensure the temperature is maintained at 49 degrees Celsius at all sources of water accessible to persons in care in the building.
- Access to outdoor areas on the first floor, the site has received quote(s) for installation of key pads. In the interim, the site is implementing the use of zip ties on the doors leading to the outdoors. On one door there was a zip tie and what appeared to be white coloured bandaging. The Manager will follow-up on this to ensure staff are utilizing zip ties only. Please let the writer know how this will be addressed.
- The second floor patio is kept locked. The Manager stated before persons in care can access the patio space, an assessment is completed to ensure safety. In review of the patio space with the Manager, there is a small railing and then an arched railing behind the initial railing. There are planters and other furniture on the patio as well at the time of the inspection. Discussion took place regarding ensuring that the health and safety of persons in care is ensured when accessing outdoor space. The Manager will assess this space and submit a plan to the Licensing Officer as to how it will be utilized ensuring health and safety of all persons in care. Please note: If issues arise with the plan put forth, please ensure appropriate measures are implemented to ensure the health and safety of all persons in care.
Due to the Covid-19 pandemic, the findings were reviewed and discussed with the Manager at the time of the inspection. The corrective dates to address each contravention are noted and a comprehensive written response to this report is also required in-writing by November 15, 2021. This inspection report, and risk assessment was written off-site and then emailed on November 3, 2021 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
Nov 15, 2021
Approximate Follow Up Date
25 Feb, 2022

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