Common Care Issues when Living in Residential Care - Revision history

Nate Russell at 18:40, 3 June 2015

2015-06-03T18:40:49Z

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	Poor communication may indicate an environment in which respect for residents’ rights is not being given sufficient priority. ([[Chapter Four Legal Issues in Residential Care References\|15]])Residential care operators often become familiar with abuse or neglect issues because the regulations focus on these matters. Residents and families find that rights violations, in contrast often receive less concern and a lesser sense of urgency.([[Chapter Four Legal Issues in Residential Care References\|16]])		Poor communication may indicate an environment in which respect for residents’ rights is not being given sufficient priority. ([[Chapter Four Legal Issues in Residential Care References\|15]])Residential care operators often become familiar with abuse or neglect issues because the regulations focus on these matters. Residents and families find that rights violations, in contrast often receive less concern and a lesser sense of urgency.([[Chapter Four Legal Issues in Residential Care References\|16]])

	Family may experience considerable frustration when they have been dealing with a long-standing problem, then hear an operator or representative from the local health authority state that “this is the first we have heard of the problem. “Lack of time, inadequate problem solving skills, poor internal communication lines, lack of appropriately trained staff and inadequate dispute resolution processes can exacerbate common communication gaps in residential care. This eventually leads some family or friends to feel any effort is futile. In other cases, they begin responding in a negative manner, with situations becoming increasingly confrontational and adversarial. If situations deteriorate, even the skills commonly promoted as good advocacy (e.g. good note taking about the “who, what, when and where” of concerns, tape recordings can become perceived by the operator or authority as a sign this family member or representative is “trouble”).		Family may experience considerable frustration when they have been dealing with a long-<span class="noglossary">standing</span> problem, then hear an operator or representative from the local health authority state that “this is the first we have heard of the problem. “Lack of time, inadequate problem solving skills, poor internal communication lines, lack of appropriately trained staff and inadequate dispute resolution processes can exacerbate common communication gaps in residential care. This eventually leads some family or friends to feel any effort is futile. In other cases, they begin responding in a negative manner, with situations becoming increasingly confrontational and adversarial. If situations deteriorate, even the skills commonly promoted as good advocacy (e.g. good note taking about the “who, what, when and where” of concerns, tape recordings can become perceived by the operator or authority as a sign this family member or representative is “trouble”).

	The regulations specifically require that there is always a “charge person” designated if the Manager is temporarily absent. ([[Chapter Four Legal Issues in Residential Care References\|17]]) The regulations also require the Operator to keep a record of complaints made and concerns expressed, keeping these records for at least two years. ([[Chapter Four Legal Issues in Residential Care References\|18]])This section does not limit it to written complaints; verbal complaints should be noted. The Operator is also required to produce the record to Licensing on demand. ([[Chapter Four Legal Issues in Residential Care References\|19]])		The regulations specifically require that there is always a “charge person” designated if the Manager is temporarily absent. ([[Chapter Four Legal Issues in Residential Care References\|17]]) The regulations also require the Operator to keep a record of complaints made and concerns expressed, keeping these records for at least two years. ([[Chapter Four Legal Issues in Residential Care References\|18]])This section does not limit it to written complaints; verbal complaints should be noted. The Operator is also required to produce the record to Licensing on demand. ([[Chapter Four Legal Issues in Residential Care References\|19]])

Nate Russell: /* Renovations and Closure of Facilities */

2014-07-24T22:48:54Z

Renovations and Closure of Facilities

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	==Renovations and Closure of Facilities==		==Renovations and Closure of Facilities==

	Throughout the 2000s, a number of care facilities in British Columbia were closed or renovated. In many circumstances, this process happened in a way that left residents and families with little if any notice, distressed and feeling very uncertain about the residents’ future. The Residential Care Regulations require the Medical Health Officer to be informed about closures, but is silent as to residents or families to this information.([[~~Chapter Four Legal Issues in Residential Care~~ References\|47]]) The Ombudsperson’s Best of Care report recommended that health authorities promptly inform residents and families decisions about closure decisions.([[~~Chapter Four Legal Issues in Residential Care~~ References\|48]])		Throughout the 2000s, a number of care facilities in British Columbia were closed or renovated. In many circumstances, this process happened in a way that left residents and families with little if any notice, distressed and feeling very uncertain about the residents’ future. The Residential Care Regulations require the Medical Health Officer to be informed about closures, but is silent as to residents or families to this information.([[{{PAGENAME}}#References\|47]]) The Ombudsperson’s Best of Care report recommended that health authorities promptly inform residents and families decisions about closure decisions.([[{{PAGENAME}}#References\|48]])

	The Ministry of Health (Home and Community Care) Policy now has a special section on expectations of Operators and the health authorities when Operators or others are planning to close the facility.([[~~Chapter Four Legal Issues in Residential Care~~ References\|49]]) At least one health authority has identified that care facilities under a certain size (125 beds) are not economically viable, and consequently should be closed. ([[~~Chapter Four Legal Issues in Residential Care~~ References\|50]])This will be a very important consideration for current and future residents.		The Ministry of Health (Home and Community Care) Policy now has a special section on expectations of Operators and the health authorities when Operators or others are planning to close the facility.([[{{PAGENAME}}#References\|49]]) At least one health authority has identified that care facilities under a certain size (125 beds) are not economically viable, and consequently should be closed. ([[{{PAGENAME}}#References\|50]])This will be a very important consideration for current and future residents.


	{{REVIEWED \| reviewer = BC Centre for Elder Advocacy and Support, June 2014}}		{{REVIEWED \| reviewer = BC Centre for Elder Advocacy and Support, June 2014}}
	{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}		{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}

Nate Russell at 23:11, 23 July 2014

2014-07-23T23:11:50Z

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	{{Legal Issues in Residential Care: An Advocate's Manual TOC}}		{{Legal Issues in Residential Care: An Advocate's Manual TOC\|expanded = chapter4}}

	This chapter examines the wide array of legal matters that arise in the course of living in the care facility. The chapter is divided into two parts; the first deals with common care issues. The second part deals with six increasingly pressing legal issues – medications, control over visitors, abuse and neglect, resident harms, reporting responsibilities, and restraints.		This chapter examines the wide array of legal matters that arise in the course of living in the care facility. The chapter is divided into two parts; the first deals with common care issues. The second part deals with six increasingly pressing legal issues – medications, control over visitors, abuse and neglect, resident harms, reporting responsibilities, and restraints.

Nate Russell: Nate Russell moved page Common Care Issues When Living in Residential Care to Common Care Issues when Living in Residential Care

2014-07-23T22:25:46Z

Nate Russell moved page Common Care Issues When Living in Residential Care to Common Care Issues when Living in Residential Care

← Older revision	Revision as of 22:25, 23 July 2014
(No difference)

Admin at 15:50, 18 July 2014

2014-07-18T15:50:12Z

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	~~{{DEMOWARNING}}~~
	{{Legal Issues in Residential Care: An Advocate's Manual TOC}}		{{Legal Issues in Residential Care: An Advocate's Manual TOC}}

Admin: /* Staffing */

2014-07-10T21:04:38Z

Staffing

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	==Staffing==		==Staffing==
	[[File:~~Staff~~.jpg \| right \| frame \| link=\| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]		[[File:residential care.jpg \| right \| frame \| link=\| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]
	One of the common concerns expressed by family relate to the staffing level within the facility and in some cases, the training of the staff to deliver complex care. Many care facilities in British Columbia have a large proportion of part-time and casual staff. ([[Chapter Four Legal Issues in Residential Care References\|26]])Moreover, some operators contract out their care support and other services to other companies. The result is that residents may not have the same staff to regularly provide care.		One of the common concerns expressed by family relate to the staffing level within the facility and in some cases, the training of the staff to deliver complex care. Many care facilities in British Columbia have a large proportion of part-time and casual staff. ([[Chapter Four Legal Issues in Residential Care References\|26]])Moreover, some operators contract out their care support and other services to other companies. The result is that residents may not have the same staff to regularly provide care.

Admin: /* Staffing */

2014-07-10T21:02:49Z

Staffing

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	==Staffing==		==Staffing==
			[[File:Staff.jpg \| right \| frame \| link=\| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]
	One of the common concerns expressed by family relate to the staffing level within the facility and in some cases, the training of the staff to deliver complex care. Many care facilities in British Columbia have a large proportion of part-time and casual staff. ([[Chapter Four Legal Issues in Residential Care References\|26]])Moreover, some operators contract out their care support and other services to other companies. The result is that residents may not have the same staff to regularly provide care.		One of the common concerns expressed by family relate to the staffing level within the facility and in some cases, the training of the staff to deliver complex care. Many care facilities in British Columbia have a large proportion of part-time and casual staff. ([[Chapter Four Legal Issues in Residential Care References\|26]])Moreover, some operators contract out their care support and other services to other companies. The result is that residents may not have the same staff to regularly provide care.

Admin: /* Risk Taking */

2014-07-10T21:02:16Z

Risk Taking

← Older revision		Revision as of 21:02, 10 July 2014
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	===An example from falls prevention===		===An example from falls prevention===
			[[File:Risk prevention.jpg \| right \| frame \| link=\| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]
	Falls are a common concern in residential care facilities, and happen with considerable frequency, as a result of many interrelated factors including frailty, medications, staffing and environmental factors,([[Chapter Four Legal Issues in Residential Care References\|40]]) as well as cognitive impairment. In some cases, family will ask (“strongly request”) staff to take stronger efforts to help reduce the risk of a resident falling. They may erroneously believe that if staff restricts the resident’s movement (“make her stay in bed”) or if they use physical restraints, this will prevent falls.		Falls are a common concern in residential care facilities, and happen with considerable frequency, as a result of many interrelated factors including frailty, medications, staffing and environmental factors,([[Chapter Four Legal Issues in Residential Care References\|40]]) as well as cognitive impairment. In some cases, family will ask (“strongly request”) staff to take stronger efforts to help reduce the risk of a resident falling. They may erroneously believe that if staff restricts the resident’s movement (“make her stay in bed”) or if they use physical restraints, this will prevent falls.

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	* develop a better understanding of the issues (e.g. the resident’s risk to take certain risks, the harms from the restriction), as well as		* develop a better understanding of the issues (e.g. the resident’s risk to take certain risks, the harms from the restriction), as well as
	* the best practices in the area (e.g. ways that the facility works to reduce risks of falls through environmental means, through rehabilitation and mobility preservation).		* the best practices in the area (e.g. ways that the facility works to reduce risks of falls through environmental means, through rehabilitation and mobility preservation).

	~~[[File:Risk prevention.jpg \| right \| frame \| link=\| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]~~

	===Leaving the facility===		===Leaving the facility===

Admin: /* Risk Taking */

2014-07-10T18:02:36Z

Risk Taking

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	==Risk Taking==		==Risk Taking==
	~~[[File:residential care.jpg \| left \| frame \| link=\| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]~~
	One commonly asked legal issue in residential care is: “Which personal risks are residents ‘permitted’ to take?” The issue revolves not only about the perceived risks for the individual (or sometimes other residents), but also is about the efforts taken to mitigate risks and who has the final say in the various “risk” decisions.		One commonly asked legal issue in residential care is: “Which personal risks are residents ‘permitted’ to take?” The issue revolves not only about the perceived risks for the individual (or sometimes other residents), but also is about the efforts taken to mitigate risks and who has the final say in the various “risk” decisions.

Admin: /* Risk Taking */

2014-07-10T17:48:50Z

Risk Taking

← Older revision		Revision as of 17:48, 10 July 2014
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	* develop a better understanding of the issues (e.g. the resident’s risk to take certain risks, the harms from the restriction), as well as		* develop a better understanding of the issues (e.g. the resident’s risk to take certain risks, the harms from the restriction), as well as
	* the best practices in the area (e.g. ways that the facility works to reduce risks of falls through environmental means, through rehabilitation and mobility preservation).		* the best practices in the area (e.g. ways that the facility works to reduce risks of falls through environmental means, through rehabilitation and mobility preservation).

			[[File:Risk prevention.jpg \| right \| frame \| link=\| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]

	===Leaving the facility===		===Leaving the facility===