Difference between revisions of "Legal Frameworks of Residential Care"

Most of the staff members who provide direct care in residential care facilities are care aides/ health care attendants, licensed practical nurses or registered nurses. They gain their experience through formal training and work experience. Care aides have the least formal training in the health care system and registered nurses have the most.  

RCAs employed in any residential care facility that directly or indirectly receives public funds are required to register with the BC Care Aide & Community Health Worker Registry. The RCAs working at facilities in the private and not-for-profit sectors are encouraged to register as well, especially for those planning to work in the public sector in the future. The Ministry of Health is looking to expand the Registry to cover private care facilities in the future. Employers register to access the registry information on care aides.

The Registry system is described in more detail in Chapter Four “Legal Issues When Living in Care Facilities” and Chapter Five “Rights, Remedies and Problem Resolution”. Registered care aides can be “de-registered” and lose their right to work in any public health care setting in British Columbia if they are found to have abused or neglected residents. The definitions of abuse relied on are those in the Adult Guardianship Act, Part 3. Currently there is no provision for addressing issues that relate to the overall competency of the worker (for example, poor quality care or”fitness to practice”). At present, the registry system itself does not come under any specific law. However, investigations of abuse are subject to principles of natural justice.

Licensed Practical Nurses and Registered Nurses both come under the Health Professions Act. Their respective regulatory bodies or associations provide oversight and discipline where required. Registered nurses for example, must be registered with the College of Registered Nurses of British Columbia.

Existing and prospective staff, as well as volunteers and students working residential care facilities are required to undergo initial and follow up criminal records checks as required by the Criminal Records Review Act.

In 2011, the BC Ombudsperson determined that the two separate legislative frameworks for residential care resulted in unfair differences in the care and services that seniors receive, as well as the fees they pay.  The Ombudsperson recommended that the Ministry of Health harmonize the residential care regulatory framework. In the alternative, the Ombudsperson recommended that if the government chose to continue to maintain the two regulatory regimes, it should ensure that residents in  the Hospital Act facilities are protected by the same standards afforded under the Residential Care Regulation, and that the Hospital Act facilities are subject to the same active oversight and inspection requirements. That has not happened yet.

* Community Care and Assisted Living Act   This Act and its related Residential Care Regulation  govern approximately 70 per cent of residential care facility beds in British Columbia. Together they set the mandatory minimum health and safety standards in these facilities, as well as the requirements for staffing, food service, medication administration and other matters.   

In general, this set of regulations establishes the minimum standards of the care facility, the requirements for staffing,  admissions, care and care plans, nutrition, medication, the use of restraints, and “reportable incidents”. It requires the operator to have written policies and procedures in place in relation to care and supervision of persons in care, including falls prevention.  

The regulations cover communication, access to telephone, and privacy.  These regulations also set out the physical requirements for bedrooms, bathrooms, common areas and work  areas, as well as more detailed specifics such as the temperature of water,  and signalling devices. The RCR also sets out records management requirements.