Shadow Minister, Health Minister: Care Of Seniors

There has been a series of articles in the press this week highlighting concerns about the care provided to seniors. While I don’t agree with all of the information presented in the articles, I am sure that for the people involved the events were terribly traumatic and that they understandably feel they were not adequately served.

If a member of the public did not receive a response to their concerns from the National Office for seniors and the Physically Challenged [NOSPC], or they do not feel that their needs were met, I offer my sincerest apology.

From what I have been able to ascertain, the incidents highlighted all took place some time ago. While I can’t go back and change what happened, I can say that we have new staff at NOSPC who are dedicated, caring people who have the best interest of seniors and the disabled at heart. Although they have only been in place for a relatively short time, they have already had a positive impact on office operations.

In addition, knowing that staff at NOSPC would be retiring, we commissioned a review of the Office’s roles and responsibilities and staffing needs. I now have the completed report, which is being reviewed to determine additional changes needed.

What has become apparent is the need to clearly define those things for which NOSPC is responsible and those things for which it is not responsible.

Clearly, enforcement is one of NOSPC’s functions, and we have taken steps to ensure that effectiveness in this area is improved. Enforcement of the Residential Care Homes and Nursing Homes Act and Regulations is key to ensuring public and private care homes are held to a high standard. This is the reason we introduced a minimum of two unscheduled inspections a year at each home. If that high standard is not met and maintained, the home must be closed. The Senior Abuse Register Act must also be upheld to ensure that reports of senior abuse are properly investigated and that those who are convicted of senior abuse are properly recorded in the Register.

NOSPC also has a role to play in educating the public on how to select a care facility for their loved one. Families do this for their children when selecting a nursery school or child day care facility and they need to be encouraged to make the same effort when selecting care for their seniors. Families need to be involved and stay involved in the care of their children and seniors. The aim should be to have seniors stay in their own home, in a safe and supportive environment, where they can be close to those who love them the most, with outside support provided as appropriate.

NOSPC helps families to identify home care and other support services. They also assist with referrals to other Government agencies and charitable organizations.

NOSPC is also investigating the introduction of certification or accreditation for care homes. The Act and Regulations deal with bricks, mortar, staffing and qualifications, but don’t speak directly to more qualitative aspects of care such as the quality of meals provided and the type and appropriateness of activities. These are more subjective qualities that are typically assured by accreditation.

In reviewing the historical files, I have been struck by the fact that many of the senior abuse complaints that come to the NOSPC are often the result of family disputes. I encourage families to put aside their differences for the sake of solutions that serve the best interest of their senior. This would not only reduce the number of complaints received but also allow the Office to make the best use of its resources.

I want to take this opportunity to express my confidence in the current staff at NOSPC. They are working hard to ensure that people receive the best service possible. Again, I apologize if families don’t feel that their concerns were properly dealt with in the past. It must also be stressed that, due to confidentiality restrictions, it is often difficult for NOSPC to counter some of the claims made and the accuracy of those claims.

Although the press articles give the impression that all care homes in Bermuda provide sub-standard care, I can assure the public that this is not the case. There are many homes that are well run, have dedicated and caring staff members who work and provide care in a pleasant and home-like atmosphere.

In the weeks ahead, I will be appointing a new Seniors Advisory Council. The Council will include a broad cross section of the community who will serve as a policy resource for the Ministry and be tasked with finalizing a National Ageing Plan. As a community, we have to encourage and support collaboration, coordination and action across all sectors to address the opportunities and challenges of ageing.

I want also to acknowledge the advocacy groups that have come forward since I have been Minister to share their concerns and present their ideas on how seniors can be better served. Their insights have been very helpful, and their role will be vital as we work together to implement the Ministry’s vision of Ageing Well in Bermuda.

I’d like to end by noting that some good has come from this week’s media spotlight in that we have received more calls from members of the public who are concerned about the care that seniors are receiving – often in their own homes. The articles have certainly increased public awareness and reinforced the need to ensure timely communications with the individuals who raised the concern.

We are working hard to strengthen the effectiveness of the National Office and the quality of service it provides. It is through good service, working with families, that we can do best for our seniors. I am so far very encouraged by the spirit and commitment of the staff and the direction we are heading.

Making things work better for the people of Bermuda is a big part of this Government’s mission. As Minister of Health, Seniors and Environment, it is my particular responsibility to make sure we deliver for our seniors. I take this responsibility very seriously and will continue to report to Bermuda on challenges and progress as we move forward.

The good care of Bermuda’s seniors is a Government priority, the Minister of Health, Seniors and Environment the Hon. Jeanne Atherden said today.

Minister Atherden reiterated changes she has brought forward in recent months to make sure seniors get the quality of life and protection they deserve. These include:

• Staffing changes at the National Office for Seniors and the Physically Challenged [NOSPC] to ensure the office carries out its responsibilities in an effective and timely manner. Minister Atherden said she has been impressed by the commitment of the new staff to the welfare of seniors and to strengthening the performance of the office.
• The implementation by the NOSPC of a new inspection regime to make sure the operators of rest homes and nursing homes uphold standards of care each and every day; and
• Following a series of care home visits at the start of the summer, the Minister initiated a review all aspects of the NOSPC, from vision and mandate to mission and staffing. That review was received last week and its recommendations will be used to make sure the Office fulfils its mission to ensure proper care and protection for the Island’s seniors.

“All of these changes are designed to make sure existing standards of care and protection are upheld and to raise standards wherever necessary,” the Minister said.

The changes initiated by the Minister were brought forward as a result of Government concerns with the operations of the NOSPC, which was strongly criticized in a series of stories by The Royal Gazette for failing to ensure proper protection for seniors.

Under the new inspection regime for Rest Homes and Nursing Homes, the operators of homes were notified during the summer that there would be at least two unscheduled visits each year and one scheduled visit, which is linked with the annual registration process. Since June 2014, NOSPC staff have made at least one unscheduled visit to each of the 19 homes. In all, 25 unscheduled visits have been made in that period.

“The implementation of these unscheduled visits has had a noticeable impact on the state of the residential homes,” the Minister said. “While we have improvements still to make, we have definitely seen a positive change.”

Minister Atherden also noted that the NOSPC’s Coordinator for Seniors had initiated regular monthly meetings with the administrators of residential care homes. These meetings give NOSPC the chance to discuss issues and review service standards.

“Along with unscheduled visits and administrator meetings, the Ministry, NOSPC and Age Concern have been working together to discuss the implementation of a system of accrediting care homes in Bermuda,” the Minister said. “Accreditation will provide residents, their families and the public in general with an assurance that each home has reached a recognised quality of care standard. Linking the legal requirement to Register care homes with an accreditation standard will produce long-term benefits.”

When it comes to selecting a rest home or nursing home, the senior and their family have the right and the responsibility to choose the home that will be the best fit for their needs. However, when there are more applicants than beds, as is the case with the Government operated homes, Sylvia Richardson and Lefroy House, there must be a system for assessing and prioritizing placement. This is the role played by the Community Assessment and Referral Team (CART) which reviews applications and recommends placement in the Government homes.

“As Bermuda’s population ages, it becomes even more important for us to plan for the future,” Minister Atherden said. “We have to educate the young and middle aged on the importance of planning for their retirement and old age. We need to promote the concept of Active Ageing and the benefits of seniors ageing at home, and only transition to residential care when really necessary. We need to ensure that we have sufficient long-term care capacity, and at a quality and price that is accessible.

“This is a big challenge; one that will take a community-wide effort to bring about. To that end, I will be appointing a new Seniors Advisory Council. The Council will include a broad cross section of the community who will serve as a policy resource for the Ministry and be tasked with finalizing a National Ageing Plan. As a community, we have to encourage and support collaboration, coordination and action across all sectors to address the opportunities and challenges of ageing.”

The Minister reiterated that improvements have been made at the National Office for Seniors and the Physically Challenged, and that she has confidence that further improvements will continue to be made. By tightening controls and upholding standards we make sure that seniors get the care they need.

The Minister concluded: “I will continue to work hard to strengthen the effectiveness of the National Office, to ensure that, as a Government, we make things work better for our seniors and that we deliver for our seniors.”

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