Health authority CEO admits oversight of Maples care home wasn’t enough By: Danielle Da Silva Posted: 12:23 PM CST Friday, Nov. 13, 2020 Last Modified: 9:49 PM CST Friday, Nov. 13, 2020 Updates

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The early probe into a deadly COVID-19 outbreak at Maples Personal Care Home has revealed possible breaches in infection control, insufficient record keeping and an admission that oversight of the residence by health officials “wasn’t enough.”

Winnipeg Regional Health Authority chief health operations officer Gina Trinidad said Friday its patient relations team is conducting a safety review at Maples to identify gaps in resident care and determine grounds for declaring critical incidents.

On Nov. 6, the situation at the home — which has a COVID-19 outbreak involving 198 cases, including 134 residents — became critical. The condition of a dozen residents began to deteriorate quickly and paramedics were called to the site and provided care to residents for hours. Eight residents died in a 48-hour period.

“I will be candid. We have identified a number of issues that concern us,” Trinidad said. “In particular, reported breaches in required infection and control measures, most notably related to proper personal protective equipment usage.

“In addition, we have identified issues with proper recording of resident hydration and nutritional information, and the other area of concern is the need to stabilize staffing.”

Since the events of Nov. 6, the WRHA has stationed a rapid response team at Maples Personal Care Home, at 500 Mandalay Drive. A member of its senior health leadership has been on site full time since Tuesday to oversee the operation of the home. Support aides from the Canadian Red Cross were to be deployed to the residence Saturday.

“I will be candid. We have identified a number of issues that concern us.”
– WRHA chief health operations officer Gina Trinidad on Maples Personal Care Home

Trinidad said the arrangement will continue until the region has “confidence in the safety and well-being of residents.”

Operator Revera Inc. has provided inaccurate information to the authority about staffing levels at the home. It was short-staffed for several hours during last weekend’s tragic events, when only seven of the scheduled 19 health-care aides were at work.

WRHA chief executive officer Vickie Kaminski said the health authority has relied on personal care home operators, including Revera, to raise issues in managing patient care and COVID-19 outbreaks. Its representatives do not regularly visit homes. It will however conduct standards reviews and review significant incidents, she said.

“Those are the mechanisms that we’ve had in place, and unfortunately, it wasn’t enough in that instance. We needed to actually take a more responsive role and get on site and have our own eyes and ears on the ground in the personal care homes to bring those to our attention,” Kaminski said.

The health authority’s review is in addition to the investigation ordered earlier by Health Minister Cameron Friesen to determine what occurred at the home, assess the current situation and provide recommendations.

On Friday, Friesen announced that Lynn Stevenson, a former associate deputy health minister in B.C., and a registered nurse (with a doctorate in organizational change), will review operations at Maples. Her final report is expected in January.

Earlier this year, Stevenson was involved in a review of a COVID-19 outbreak at a facility in Halifax, which included 360 cases and the death of 53 residents.

The news about in-person oversight by the WRHA and an investigation at the home offered little comfort to Eddie Calisto-Tavares. Her father was diagnosed with COVID-19 on Oct. 27 and died at Maples on Wednesday.

“For me, it’s pure incompetence and negligence, pure and simple,” Calisto-Tavares said. “It was not if COVID got in, it was when COVID got in. They should have had staff. They should have done training. They should have done drills to deal with the pandemic.”

Shortly after the outbreak began on Oct. 21, Calisto-Tavares worked with Liberal MLA Jon Gerrard to lobby the health minister to intervene and add staff at the home. She was given special permission by operator Revera to provide care for her 88-year-old father Manuel as dozens of staff had to go into isolation.

“I’m so angry. I have a few things that I still need to do. I need to bury my dad on Tuesday but I’m not going to let them get away with this because there are so many residents there who don’t have family nearby.”
– Eddie Calisto-Tavares

“I was there through all this nightmare,” Calisto-Tavares said Friday. “I’m so angry. I have a few things that I still need to do. I need to bury my dad on Tuesday but I’m not going to let them get away with this because there are so many residents there who don’t have family nearby.

“We need to make changes. We need to make permanent changes,” she said. “We can’t continue to allow this to happen.”

Friesen said Stevenson’s investigation will look at what happened at Maples and provide recommendations on how to “strengthen the care for residents” and restore families’ confidence. Preliminary findings are expected by mid-December so immediate action can be taken at Maples, Friesen said.

Asked if he regrets not directing the health authority to intervene at Maples earlier, Friesen said the province has increased restrictions through the pandemic response system and has worked with personal care homes throughout the pandemic.

“There are no easy answers, but there are answers needed and we are committed to getting them,” Friesen said.

Kaminski said 25 of Winnipeg’s 38 personal care homes are dealing with COVID-19 outbreaks.

To date, 357 residents have tested positive for COVID-19; 189 have recovered; there have been 68 deaths. Also, 187 staff have tested positive; 64 have recovered. No staff member has died, Kaminski said.

Currently, the health authority is present full time at St. Norbert Personal Care Home and Golden Links Lodge. Several other facilities have been prioritized for urgent intervention and support. On Wednesday evening, the health authority co-ordinated staff from Victoria General Hospital to assist at St. Norbert.

“What this situation over (last) weekend has certainly highlighted… is that there is certainly a need to ensure that there is that verification of the actual situation and what’s happening on the ground. (We need) to be readily able to activate assistance if the personal care homes are feeling that they need some help and support in their outbreak management response,” Trinidad said.

— with files from Carol Sanders

danielle.dasilva@freepress.mb.ca

Danielle Da Silva
Reporter

Danielle Da Silva is a general assignment reporter.

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