Atherden Reviews Nursing Home Investigations

July 20, 2014

In the House of Assembly on Friday [July 18], Minister of Health, Seniors and Environment Jeanne Atherden spoke about her recent investigation into the quality of investigations into residential long-term care homes in Bermuda, determining opportunities for improvement.

Minister Atherden said, “Nursing Homes provide care to seniors or disabled persons who require a higher level of medical care and attention. As you can imagine, the level of staffing and the facility requirements for a Nursing Home are more stringent than for Rest Homes.

“Concern has recently been raised regarding the quality of care provided by some of our Homes, and those concerns warranted looking into. So that’s what I did. I did some digging, and I took the opportunity to visit some of the islands Rest Homes and Nursing Homes.

“I have learned that when homes are inspected, they are visited by a team of professionals which can include staff from NOSPC, the Environmental Health section of the Department of Health, a Community Health Nurse, the Bermuda Fire Service, a Government Nutritionist and sometimes an occupational or physical therapist.

“The inspections are thorough and document, in writing, the findings of the inspection team. I have reviewed a number of the inspection reports and I can confirm that they record positive and negative outcomes. Where a home is deficient, the Administrator is given a deadline for making improvements and follow-up inspections should take place.”

Minister Atherden’s full statement follows below:

Mr. Speaker, as Honourable Members are aware, my Ministry has responsibility for Seniors which includes the provision of residential long term care in Bermuda. The Residential Care Home and Nursing Home Act 1999 and the Regulations of 2001 set out the standards of care to be provided by these homes.

A residential care home, which is defined by the Act, is often referred to locally as a “Rest Home”, so that’s the term I’ll use. Rest Homes typically provide independent living or assisted living accommodations for persons 65 years and older or for disabled persons.

Nursing Homes provide care to seniors or disabled persons who require a higher level of medical care and attention. As you can imagine, the level of staffing and the facility requirements for a Nursing Home are more stringent than for Rest Homes.

Concern has recently been raised regarding the quality of care provided by some of our Homes, and those concerns warranted looking into.

So that’s what I did. I did some digging, and I took the opportunity to visit some of the islands Rest Homes and Nursing Homes.

Mr. Speaker, I’d like to take this opportunity to share some of what I found (the good and the bad) and to provide Honourable Members with a bit of information on what I, as the Minister responsible for Seniors, am planning for the future.

Mr. Speaker, the National Office for Seniors and the Physically Challenged (NOSPC) is currently responsible for inspecting and registering all Residential Homes and Nursing Homes.

I have learned that when homes are inspected, they are visited by a team of professionals which can include staff from NOSPC, the Environmental Health section of the Department of Health, a Community Health Nurse, the Bermuda Fire Service, a Government Nutritionist and sometimes an occupational or physical therapist.

The inspections are thorough and document, in writing, the findings of the inspection team. I have reviewed a number of the inspection reports and I can confirm that they record positive and negative outcomes. Where a home is deficient, the Administrator is given a deadline for making improvements and follow-up inspections should take place.

I have asked NOSPC to review their documentation and especially their follow-up inspections to make absolutely certain that deficiencies are addressed. Plus, I have asked that NOSPC’s procedures for following up on complaints and concerns be expanded to ensure timely communication on the status of the investigation so that those who raised the concern are kept in the loop regarding the resolution.

Mr. Speaker, the three most senior staff at the National Office are all retiring this year, so we are viewing this as an opportunity to review the role and responsibilities of the National Office – which, in my view, have never been clearly set out.

Management Consulting Services has been asked to review the organizational structure and role of NOSPC which is currently responsible for seniors and Bermuda’s disabled population as well as the management and operation of Orange Valley and the Opportunity Workshop.

We will also be reviewing a number of reports and recommendations which were developed on the management and operation of residential care in Bermuda. We need to take a close look at how Sylvia Richardson, Lefroy House, the Continuing Care Unit and the Alzheimer’s Unit at the Hospital are managed to ensure that we take advantage of combined purchasing power and the possibility of sharing staff between facilities.

Although these reports were not implemented at the time, I’m going to go over them to see if they contain recommendations that I want to take forward.

Mr. Speaker, before her untimely passing, Mrs Louise Jackson was instrumental in assisting the then Minister of Health and Seniors with the establishment of a Seniors Advisory Council. The Council, with the assistance of a Policy Analyst from the Ministry, worked with focus and dedication to develop an Ageing Plan for Bermuda.

I am currently reviewing the outline of that Plan which urges that our ageing demographic be considered when any and all policies are being developed. We speak about “Health in all Policies”, and we need to include “Ageing in All Policies” as well.

I have to stress, Mr. Speaker, that the proposal is not just about what the Government can and should do for Seniors. It is also about what young people need to do to plan for their old age.

We shouldn’t grow old expecting someone else to take care of us. We have to plan and prepare. We have to make sure that we save, contribute to our pensions, modify our homes to meet our needs as we grow older, and ensure that we maintain our health insurance coverage even when we retire.

Finally, Mr. Speaker, this country needs to make plans for those among us who do not have the resources necessary to cover their own costs in their old age. Not everyone can remain in their own home as they grow older, so there will always be a need for residential care facilities.

But we need facilities, not just for the elderly, but also the “young disabled” – those young people who may suffer from physical, mental or cognitive disorders and need special care. There are also young people who, through accidents and injury, become disabled and require long term residential care.

Let me be clear, Mr. Speaker, this care is expensive to provide, and someone has to pay – whether it be the individual or the Government.

So, the decisions that have to be made are difficult, but they are also important. I want to explore ways that we can partner with the private sector to develop new care homes and to make those that are already operational less expensive.

Thank you, Mr. Speaker.

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Comments (4)

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  1. Marge says:

    The health minister needs to check out these so called rest homes!!!!
    Thank you Terry Lister for bringing this up in the HOA.

  2. Catalyst says:

    FACT: 70% of persons in rest homes and/or nursing homes are on Financial Assistance.

    FACT: Financial Assistance’s maximum payout for nursing home care is something like $4900 per month per person.

    FACT: The cost to run a nursing home at the level deemed acceptable by the general person is about $8000 per person.

    Thus, you have homes having to cut costs / take shortcuts / offer something slightly substandard simply because they don’t have the funds.

    Until government is able to increase the benefit payable to nursing homes, which would require a change in policy, then you will continue to have the care standard that we have today. And we know that the government is not in a position to raise this benefit by $3000 per person.

    This policy does not encourage the private investor because he quickly discovers that the cost of care exceeds that which government is prepared to pay. So the cycle continues.

    Good luck on this Minister. The review is way overdue and I particularly applaud the consideration of the mentally and physically handicapped who after 21 have no options for residential care and are left with strapped families unable to provide adequate care either.

  3. Curious says:

    I think a law needs to be passed to penalize people for abandoning their loved ones in these homes. They are all nice when they bring their loved one to the home. They say all the right things. Then you NEVER see them again. They get mad if you call them for supplies. And let’s not even get started on getting them to pay their portion left after Financial Assistance pays. SMH

    I’m tired of people taking about the Homes when the families aren’t doing their part either. As an owner myself, I agree with Catalyst. Operational cost is through the roof especially when the families don’t pay their portion. And what are we to do? Kick the resident out??? Then there would be talk about how Homes are wrong for kicking out seniors. SMH

    Who wins????

    • Common Sense says:

      It is seriously unfair for “Curious” to castigate all the families who put their loved ones in care and do little else for them. There are elderly people in Bermuda who find themselves with a partner needing full time caregiving, which they are physically and financially incapable of providing, and have no other family to assist them. There are mothers who are trying to raise their children while also trying to look after an elderly parent who needs full-time caregiving – and some of these mothers are now without employment.

      Caring for an elderly family member, and in some cases caring after two elderly parents can put enormous strains on the rest of the family, particularly where all the responsbility rests on one individual who is expected to be all things to all in their family.

      We need to be aware that there are families who reach a stage where they simply cannot manage to look after an elderly parent or family member. In addition to providing rest homes and nursing homes we need to concentrate some of our resources on providing much needed resources to assist those unpaid family caregivers who reach the stage where they cannot cope by themselves. Such assistance will usually be far more cost effective than placing people in rest homes or nursing homes.