Review of staff training in personal-care homes no longer provincial priority Manitoba Health drops ‘core standard’ for inspectors despite heavy turnover, use of uncertified aides By: Dylan Robertson Posted: 7:00 PM CST Monday, Dec. 6, 2021 Last Modified: 8:04 PM CST Monday, Dec. 6, 2021 Updates

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Manitoba Health has curtailed inspecting how well personal-care home staff are trained, at a time of unprecedented staff turnover and an increased use of uncertified aides, the Free Press has learned.

“It’s just looking for an accident to happen,” said Manitoba Nurses Union President Darlene Jackson.

“We’re really getting little traction in Manitoba right now, with anything to do with long-term care.”

Her union was reviewing Manitoba Health inspection reports, and noticed that none of the 22 reviews of existing care homes conducted in 2021 had looked at staff education.

That’s because the department has stopped all regular inspections, which follow a longer checklist than unannounced reviews.

Yet for years, Manitoba Health has listed the staff-education component as one of its five “core standards” for inspectors to prioritize “at each visit,” along with things such as how drugs are dispensed, and the use of restraints.

The staff-education standard compels operators of personal-care homes to organize training for every new hire, and have them sign off on having completed the course and understood its content.

The operators must also evaluate all their training programs each year, “to ensure that they are current and meet the learning needs of the staff.”

Those requirements remain in place, and were part of the province’s 2020 review of most care homes. But this year, Manitoba Health confirmed it’s not on the priority list.

“Because there are so many things happening in long-term care facilities right now to do with the pandemic, that ongoing staff education is so important.”
– Nurses Union President Darlene Jackson

“In-service education was not a focus of the 2021 standards reviews,” a spokesperson wrote.

The province said it deliberately chose to stick with unannounced inspections for 2021, as they’re more nimble, and have inspectors focus on “on PCH pandemic response and critical clinical-care standards” with a “consideration of the disruption to normal (pre-pandemic) PCH programming and routines, as well as the increased strain on staffing resources.”

The spokesperson wrote that “efforts are made at both regional and site levels, to ensure that educational opportunities remain available and accessible to PCH staff” but did not specify what those entail or provide examples.

The last time Manitoba Health inspectors verified whether a personal-care home had up-to-date training was early November 2020 — except for during the approval of a new care home — Boyne Lodge in Carman — in June, before it opened.

“Manitoba has had some of the worst outcomes during this pandemic, and we have seen devastating tragedies in personal-care homes. We should be doing everything we can to protect seniors and ensure (staff) have everything they need to do their jobs well.”
– Uzoma Asagwara, health critic for the NDP

“I don’t think it’s acceptable,” Jackson said.

“Because there are so many things happening in long-term care facilities right now to do with the pandemic, that ongoing staff education is so important.”

A month ago, the Free Press reported that the province drastically cut back its own educational sessions for staff on abuse and how to report mistreatment.

The Protection for Persons in Care Office, which investigates allegations of wrongdoing in personal-care homes and hospitals, did just six of the presentations in the first 12 months of the COVID-19 pandemic, compared with an average of 41 sessions in the previous five years.

Jackson noted that Manitoba has deployed nearly 900 uncertified health-care aides in the past year, rushing to fill gaps in personal-care homes when non-nursing staff get burned out or must isolate after COVID-19 exposures.

The job involves a weeklong crash course at Red River College Polytechnic, and the staff are meant to do menial jobs such as flipping mattresses, though unions say they’re now being relied on to feed and bathe residents.

“These individuals have very, very basic training and no further education, which is scary,” Jackson said.

The Opposition NDP agreed, saying the PC government should have a plan to staff up and do full inspections, instead of stopping that work.

“We can’t skip steps, and this decision to me seems a lot like a cut, and a removal of a step that would ensure people in personal-care homes are receiving the best care possible,” said Uzoma Asagwara, health critic for the NDP.

“Manitoba has had some of the worst outcomes during this pandemic, and we have seen devastating tragedies in personal-care homes. We should be doing everything we can to protect seniors and ensure (staff) have everything they need to do their jobs well.”

The nurses union is concerned that the policy changed with no public notice, and argued the review of standards stemming from the deadly COVID-19 outbreak at the Maples Personal Care Home last year should be expanded to include training, instead of narrowly focusing on outbreaks.

“Our biggest concern is a lack of transparency (for) the public,” said Jackson.

“Why does it require an investigation by the media into this, for this government to actually take action?”

dylan.robertson@freepress.mb.ca