The BC Care Providers Association (BCCPA) today introduced new health and safety guidelines to better protect staff and residents at senior's care facilities across the province These staffing guidelines and the lack of funding from the provincial government in the recent budget are expected to lead to some providers reducing the number of new admissions in care facilities as early as this month.
BCCPA released the guidelines today as part of a supplemental submission to the BC Ombudsman's systematic review of senior's services.
"Establishing guidelines for health and safety based on workload measurement will provide our members with an important tool they can use to make placement decisions that put health and safety first," said Ed Helfrich, CEO of the BCCPA. "This resident safety grid will match staffing levels to standards of care and be a transparent tool that facilities can use to monitor the quality of care that residents receive."
The draft guidelines measure seven care factors and are compatible with the Minimum Data Set (MDS) and Resident Assessment Instrument (RAI) tools currently being used in most BC care facilities. They are based on workload management models initially developed with the BC Ministry of Health and successfully implemented by individual facilities in the province for the past 10 years.
There have been two independent reviews conducted by statutory appointed agencies in BC to examine the delivery of residential care and service to the fragile elderly:
- The Auditor General's October 2008 report concluded that the Ministry of Health Services is not adequately fulfilling its stewardship role in helping to ensure that the home and community care system has the capacity to meet the needs of the population.
- The BC Ombudsman is currently conducting a review of services to seniors who reside in care. Her report is expected in the coming months and our Association has pledged to work with her 100%. Recent media reports suggest the Ombudsman has been "overwhelmed" by the number of people that have contacted her about this issue.
In addition to helping facilities ensure adequate staff is in place to achieve acceptable standards of care, the guidelines will allow care providers to evaluate the increased workload of new referrals and determine whether or not they are able to accept complex cases.
The guidelines utilize a "resident safety grid" based on five staffing categories:
- 2 hours of care/resident/day
- 2.5 hours of care/resident/day
- 2.8 hours of care/resident/day
- 3 hours of care/resident/day
- 3.2 hours of care /resident/day
"Adopting residential care health and safety guidelines in our facilities across BC will allow more informed decision-making and make client assessment easier," said BCCPA President Christine Nidd. "The fact is many of our members are being forced to refuse some new admissions now. These guidelines will be another tool they can use to help them make these difficult admission decisions that put the safety of patients and staff first."
BC's Adult Care Regulations require a facility to ensure accommodation only to those persons for whom safe and adequate care can be provided. It is estimated that facility funding in BC ranges from just over $110 to $230/resident/day. Staffing levels within BC senior's care facilities also vary from 2 hours of direct care/patient/day to 3.2 hours. Recent figures suggest the average ratio in the Fraser Health region is just under 2.3.
In addition to creating resident safety profiles and complimenting Inter-RAI MDS, the proposed guidelines:
- reinforce the need for 3.2 hours of care/resident/day as preferred standard of quality care & 2.8 hours of direct care/resident/day as baseline standard
- adopt BC's complex care groupings & Cognitive Performance Scale/Global Deterioration Scale to measure cognition
- limit new admissions in the two more complex care groupings "A" and "E" unless the facility is fully staffed
- do not include therapists, dieticians, recreation or considerations for facility layout & design
The proposed measures reflect the input received from the Association's members and health stakeholders in a series of workshops that took place across the province last month. An implementation manual will be distributed to participating facilities.
"Research shows that the level of staffing in a care facility has a direct correlation with positive outcome measures and quality care," concluded Mr. Helfrich. "We know a facility with six care aides/shift cannot provide comparable care to a similar site with 10 care aides/shift. Our goal has to be to raise the level of staffing for a consistent standard in all facilities - not just a few."
Established 32 years ago, the BCCPA represents over 125 independently owned organizations that provide quality community care and services to more than 10,000 BC seniors. Today's announcement supports the goals of the BCCPA Action Plan which was completed last year.
