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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
VDAN-ASGTF4

FACILITY NAME
Keary Street Home
SERVICE TYPES
140 Community Living
FACILITY LICENSE #
2582038
FACILITY ADDRESS
313 Keary St
FACILITY PHONE
(604) 522-4032
CITY
New Westminster
POSTAL CODE
V3L 3L2
MANAGER
Arlene Lagerstrom

INSPECTION DATE
October 24, 2017
ADDITIONAL INSP. DATE (multi-day)
October 25, 2017
ADDITIONAL INSP. DATE (multi-day)
October 27, 2017
TIME SPENT (HRS.)
8
ARRIVAL
02:15 PM
DEPARTURE
05:00 PM
ARRIVAL
10:00 AM
DEPARTURE
01:30 PM
ARRIVAL
03:30 PM
DEPARTURE
04:30 PM
INSPECTION TYPE
Routine
# CHILDREN ENROLLED

Introduction

An unscheduled routine inspection was conducted to assess compliance with the Community Care & Assisted Living Act (CCALA), the Residential Care Regulation (RCR) and the relevant Director of Licensing Standards of Practice (DOLSP). 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 inspection.
The following areas were reviewed:
· Licensing
· Physical Facility
· Staffing
· Polices & Procedures
· Care & Supervision
· Hygiene and Communicable Disease Control
· Medication
· Nutrition and Food Services
· Program
· Records and Reporting
As part of the 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 CCFL website at www.fraserhealth.ca/residentialcare for:
· Additional resources and
· Links to the Legislation (CCALA & RCR)
If you have any questions regarding this report feel free to contact me at 604 949 7710

Contraventions
Previous Inspection - Contraventions observed on FIR #KBOI-ACVN4U 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: 31090 - RCR s.16(3) - A licensee must ensure that the lighting, both natural and artificial, and temperature of a room intended for the private use of a person in care meets the needs and preferences of that person.
Observation: During review of the Policies ad Procedures, kept in the back door hallway it was noticed that the lighting was very low. It was not bright enough to accommodate the review of the documents stored in this area.
The LO entered a room with a PIC present, the lighting was dim and the lens was missing from the fixture leaving the bulbs exposed to the risk of breakage. New lifts had been installed in the ceiling and the lens would catch on the ceiling lift beam as it moved across the room when in use. the lens was missing from an under cupboard florescent, horizontally mounted above the counter to the left of the fridge. This leaves the florescent tube exposed to potential breakage in a food preparation area.
Corrective Action(s): Please provide a plan to ensure that all lighting issues will be addressed to ensure safe lighting levels for the use of staff and residents in their activities.
Date to be Corrected: Nov. 8, 2017

PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 31760 - RCR s.35(1)(c) - A licensee must provide the following appropriately furnished and equipped areas: (c) secure, safe and adequate storage areas for cleaning agents, chemical products and other hazardous materials.
Observation: The cupboard for hazardous materials straddles between the laundry room and the tub room. On the tub room side, the is a small access door that is not secured
Corrective Action(s): Please provide a plan that will ensure that all hazardous products are securely stored.
Date to be Corrected: Nov. 8, 2017

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: Performance reviews of staff are not observed to be conducted annually as per the policy.
Corrective Action(s): Please provide a plan that will ensure that there is consistency with the policy and the practice of conducting performance reviews.
Date to be Corrected: Nov. 8, 2017

POLICIES AND PROCEDURES: 33320 - RCR s.85(2)(b) - Without limiting subsection (1)(a), a licensee must have written policies and procedures in respect of all of the following: (b) the orientation of new managers and employees, including orientation respecting the policies and procedures of the community care facility, the regulations and the Act.
Observation: Policy for orientation of managers and employees to the regulations and the act revealed expectations for the manager orientation but no expectation of familiarity with the legislation for employees.
Corrective Action(s): Please provide a plan that will ensure that the intent of the above legislation is complied with.
Date to be Corrected: Nov. 8, 2017

CARE AND/OR SUPERVISION: 34740 - RCR s.81(4)(a) - A licensee must ensure that (a) the implementation of each care plan is monitored on a regular basis to ensure proper implementation.
Observation: A PIC was observed sitting in a "veil bed" in a dark room. the PIC was described as receiving some "stretch time and had just been given 'bowel therapy.' The care plan for this individual described 45 minutes per day of floor time. the manager stated this was not being done at present due to the presence of another new ambulatory resident and there was concern about how the two individuals would interact during 'floor time'. There was no indication in the care plan that the floor time should be discontinued.
Corrective Action(s): Please provide a plan that will ensure that the direction in the care plan is followed or revised.
Date to be Corrected: Nov. 8, 2017

RECORDS AND REPORTING: 39320 - RCR s.83(4)(a) - Subject to subsection (5), a licensee, other than a licensee who provides a type of care described as Hospice, must (a) ensure that each person in care is weighed at least once each month.
Observation: Weights for all PICs were observed to be absent after April 2017. There was no reason for the absence of weight record provided in the documentation. The manager states that the weigh scale has been broken since April. BC Housing was notified. Six months without weights for the residents is far to long, as this is a significant component of monitoring the nutritional status of the persons in care (PICs)
Corrective Action(s): In the event that weights cannot be achieved on site, the Licensee is responsible to determine an alternative means to meeting the intent of the legislation.
Please provide a plan to ensure that appropriate monitoring of the weight of each PIC occurs on a consistent basis as determined by the regulation.
Date to be Corrected: Nov. 8, 2017


Comments

During this inspection all systems were reviewed. The staff records were observed to be incomplete for the newest staff. The manager, stated that the Licensee is keeping many of the records at head office. Licensing is aware of a trend to retain many of the staff records at head offices throughout the industry. A spreadsheet of the required documentation is being accepted by licensing officers during inspection. Items such as references, work history, immunization and TB, certificates, performance reviews, expiry dates for first aid, food safe and CRC etc. (a list was provided to the manager) can be "ticked" as having been attended to by staff at head office. The spreadsheet should be maintained on site for the purpose of inspection. At today's inspection a staff file was reviewed and was missing most key documents. Please provide the staff record information in a timely manner for this inspection. Should there be any contraventions associated with the staff records, these will be followed up in a Follow-up to the Routine Inspection.

During review of the staff records, it was observed that the "office" is contained in a small armoire in a large sitting room. The room is supposed to be used for visits with PICs and families or friends. It is now filled with large pieces of equipment and furniture. The manager states that a renovation is being planned for this administrative space.

This facility is still identified in Health Space as being managed by Arlene Lagerstrom. The new manager, Jennifer Farrell, has been in place since March 2017. There is no known submission of the change of manager documentation. The manager's name is not posted prominently. Please ensure that as per RCR 8(3)(a)(b) - if a manager of a community care facility resigns, or is or expects to be absent for at least 30 consecutive days, the licensee must
(a) notify the medical health officer
(b) replace the manager either by hiring a person who, or using a hiring process that, is approved in writing by the medical health officer
Please provide a plan to ensure the correct documentation of the manager of the facility is in place and the license and the manager's name is displayed.

Internal incident reports were reviewed. One report contained an medication error which occurred after the medications of a PIC were poured by one staff and that staff instructed another staff to administer the medication. There was an error between pouring and delivering the medication to the correct PIC. On questioning, the manager stated that the staffs received a medication administration review and a meeting with a supervisor. As a result of this incident, the manager reported that the whole company provided a medication review for all staff.

The minutes of the inspection by the pharmacist were reviewed. There was no comment in the minutes about review of medication errors, the response and reporting of medication errors, nor the policies and procedures, of medication administration. The manager stated that there was another MSAC committee operated by the nurses. This committee reviews many of the issues referred to in the RCR as the role of the pharmacist.
Please provide a plan that ensures that the model chosen for review of medication administration system in the facility is consistent with the Residential Care Regulations; 68(1)(a-c), 68(2)(a-c), and 68(3)(a)(b)(i-ii) or meets the intent of these regulations. Nov. 8, 2017

The laundry room was reviewed. There is no slip resistant surface on the floor. the manager states that none of the regular PIC's enter the laundry room. At this inspection there is a respite PIC who is ambulatory and is assisting with his own laundry. There are other respite PIC's who stay at the facility intermittently and their ambulatory status is not known. It was recommended that there be a non-slip surface applied to the laundry area.

This facility has a quiet atmosphere. The style of decoration is very home like, relaxing and welcoming. There are some staff who have worked at this site a long time. They state they really enjoy what they do.

I would like to thank the residents and the staff for their contributions to this inspection.


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 08, 2017

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