Difference between revisions of "Directing Residential Care Concerns to Health Authorities"

Directing Residential Care Concerns to Health Authorities (view source)

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 ===Volume===
 The PCQO received about 5000 care quality complaints in 2011/12 and over 4500 in 2012/13.  Optimistically this decrease may represent improvements in systems. However it may reflect frustration over whether or not the process is effective.  Less than 2% of the complaints  ( 90 cases in 2012/13) received by the PCQO were reviewed by the Patient Care Quality Review Board.
+==Community Care Licensing Offices==
+Community care licensing offices are staffed by licensing officers and overseen by medical health officers. Licensing officers are responsible for ensuring that residential care facilities licensed under the CCALA meet the requirements of that Act and its regulations. Licensing officers carry out the routine inspections for care facilities.
+Anyone who is concerned that a facility is not meeting the CCALA requirements can complain to the licensing office for that area. By law medical health officers must investigate every complaint that alleges that a residential care facility licensed under the Act is not fully meeting the legislated requirements.  In practice, however, the responsibility for conducting these investigations is delegated to licensing officers who are employees of the health authorities. The duty of the licensing office for the inspections is owed to the public, as opposed to individuals.
+====Advocacy Points====
+Residents, families or others concerned about the care in a residential care facility may have difficulty expressing their concern in a way that makes sense or appears to fall within the jurisdiction or the responsible body or authority. Advocates can help by
+* Identifying that the licensed facility is not fully meeting the legislated requirements, and where possible,
+* Identifying specific areas where the requirements are not being met by reference to the CCALA or the Regulations.
+The Act gives medical health officers and their delegates (the licensing officers) the authority to examine any part of a facility and to inquire into and inspect all matters concerning its operations, employees or residents. Medical health officers can also require operators to produce records. Currently health authorities receive very few formal (licensing) complaints relative to the number of licensed facilities and beds.
+The Ombudsperson has criticized the fact that private hospitals are not required to be regularly inspected like residential care facilities, and has made recommendations to the health authorities on this matter.  Fraser Health now states it is conducting these regular inspections for private hospitals.
+====Complaints against Private Hospitals====
+The  CCALA does not apply to facilities governed by the Hospital Act. Licensing officers are not authorized to investigate complaints about those facilities. As a result, older adults residing in facilities  governed  by the  Hospital Act  have fewer options for pursuing complaints than older adults who live in CCALA facilities, even though they have the same care needs delivered by similar persons  in similar circumstances.
+===How Licensing Complaints Are Investigated===
+A Guide to Community Care Facility Licensing in British Columbia outlines the Ministry of Health’s draft policy on investigation of licensing complaints. The health authorities have also developed their own policies to guide licensing investigations as well.
+When a person complains that a facility is not complying with the CCALA or the Residential Care Regulations , licensing officers are expected to document and respond to the complaint in a timely and appropriate fashion. The specific steps that the licensing officer uses are:
+# determine whether the concern falls within their jurisdiction, and contact the agency that funds the facility, if applicable. [If the complaint involves a possible criminal matter, the licensing officer is expected to contact the police.]
+# determine the nature of the complaint and its urgency, including whether anyone in care is at risk and, if so, to what degree.
+# prepare an action plan, notify the facility operator of the allegations, and investigate.
+When conducting investigations, licensing officers must decide whether, on the balance of probabilities, an operator has contravened the  CCALA or its Regulations. In order to do so, licensing officers collect and analyze evidence.
+This may involve conducting a “non-routine” inspection of the facility in question and interviewing those involved in the allegation. Licensing officers are expected to document all of these steps.
+Violations are categorized under one of ten  categories: Care and/or supervision; Hygiene and communicable disease control; Licensing; Medication; Nutrition and food services; Physical facility, equipment and furnishings; Policies and procedures; Program; Records and reporting; and Staffing.
+If a licensing  officer concludes that a contravention has occurred, the officer must then decide whether to recommend that the regional medical health officer take any steps to adjust the facility’s licence (conditions, suspend or cancel). Medical health officers have the authority to attach terms and conditions to a licence, suspend or cancel a licence. Terms and conditions are requirements above and beyond those of the Act or Regulations.
+:“Terms and conditions may be used when a licensee needs more direction than the statutory requirements to ensure that the health or safety of persons in care is properly maintained.”
+Some examples of licensing conditions include
+* requiring a facility to develop a plan to ensure appropriate care,
+* requiring a facility to improve its documentation,
+* temporarily suspending a facility’s ability to admit new residents,
+* requiring a facility to increase the hours of its on-site manager,  and
+* requiring the facility to have a new manager.
+Compliance with terms and conditions is required to continue to operate the facility. Terms and conditions are written on the facility licence and posted at the facility.  The operator can request reconsideration (or seek an appeal) when terms and conditions are attached to the license.
+===The Approach: Education and Progressive Compliance===
+According to the Ministry of Health, the purpose of community care licensing is to prevent risk of harm. This is accomplished through working proactively with applicants for a community care facility licence, assessment of applicants, ongoing monitoring of the facilities, risk assessment, and inspection of licensed community care facilities.    New facilities are automatically considered high risk because they do not have a track record.
+By law, the most recent routine inspection record is required to be accessible to residents and families.  However, the publicly available records are written and coded in a way that is not useful to the public to determine either the nature of the violations or how serious they are.
+==Local Ethics Committees==
 {{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}}
 {{Legal Issues in Residential Care: An Advocate's Manual Navbox}}

Difference between revisions of "Directing Residential Care Concerns to Health Authorities"

Directing Residential Care Concerns to Health Authorities (view source)

Revision as of 23:36, 24 June 2014

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