CHSLD Wales Inc.
ANNUAL REPORT 2019-2020
CHSLD WALES INC.
For the April 1st, 2019 to March 31st, 2020
ANNUAL GENEREAL MEETING HELD AUGUST 27, 2020
The Centre d’hébergement et de soins de longue durée Wales Inc. is committed to
providing a safe, secure and “milieu de vie” environment that respects the
identity, dignity and privacy of seniors suffering from cognitive and/or physical
limitations. The missions of the CHSLD Wales and Résidence Wales Home are in
alignment, recognizing each resident's potential.
The CHSLD endeavours to offer optimal quality care and services while
encouraging seniors to function at their highest level possible by providing nursing
care, therapy, and activities through dedicated professionals and
Our values, exhibited by our dedicated employees and volunteers on a daily basis, are:
Compassion, Innovation, Integrity, Respect, and Teamwork
Executive Director and President's Report:
I think we can agree that the Wales does not sit idle for very long, and this past year was no exception; during the fiscal year, we experienced several unprecedented events. As you will see in the 2019-2020 CHSLD Wales Inc. Annual Report below, our dedicated and incredible staff and engaged volunteers deliver the leadership, knowledge, skills, and hard work that make providing the best care to our residents possible. Our commitment to add value to Québec's healthcare system is stronger than ever.
This year, the CHSLD Wales Inc. embarked on a new five-year Accreditation process with the Conseil Québécois d'agrément. The MSSS increased our CHSLD permit to ninety-six beds; the twelve additional beds are rented by the CIUSSS de l'Estrie-CHUS. The expansion to the Norton building is complete, and we are proud of the superior living environment for our current and future residents, and better working conditions for our employees. The CHSLD Wales continues to be optimistic that the Government will honour its commitment to fix inequities in CHSLD privés non-conventionnés that do not receive the same funding as the public sector.
We are proud that the Minister Responsible for Seniors and Informal Caregivers, Marguerite Blais, visited us this year. She was impressed with the Best Practices incorporated in the Norton expansion.
Improvements in technology have allowed us to upgrade security in our real-time location system to increase communication when residents exit the building. We have also revamped and redesigned our website, which provides our audience with valuable and easily-accessible information. These improvements provided additional security and helped with recruitment of those seeking a career in long-term care. Working with our Users' Committee, Planetree Committee, and Living Environment Committee allowed us to enhance quality and resident wellbeing, including revision of our resident and family Satisfaction Surveys.
While the improvements listed above brought their fair share of change to the CHSLD Wales, the year-end had more unexpected developments in store. On March 11th, 2020, a once-in-a-century journey began when the World Health Organization declared COVID-19 a global pandemic. The next several months were spent ensuring our facility was prepared and safe, and these precautions remain our priority. Strict regulations were established prior to Public Health recommendations. We are extremely grateful for the amazing work done by our Director of Health Services, who literally put an action plan in place overnight to support our residents' needs should they contract the virus while also keeping our team safe. Daily press releases, electronic bulletins, and conference calls with members of the CIUSSS provided channels for information-sharing and support. The current pandemic highlighted weaknesses within our health and long-term care infrastructure. The virus also demonstrated the Wales's amazing community support. There were so many acts of kindness and generous donations to our staff this past year. With deep appreciation, we thank each one of you for the support you provide. We are in this pandemic together and, collectively, we will get through this challenging time.
Brendalee Piironen & Glenn Brock
Executive Director & President
Satisfaction Survey Results 2019-2020
CHSLD Residents' Profile 2019-2020
Building and Grounds Committee Report:
As Chairperson of the Building and Grounds Committee, I am pleased to present a status report at this Annual General Meeting and, as usual, I greatly appreciate the opportunity to infirm stakeholders, although this year is a somewhat special experience due to the restrictions associated to the pandemic. I trust that many of our collaborators will take the time to read this report; please do not hesitate to submit questions. Over the past few years, we identified numerous daunting technical and financial challenges. We systematically addressed these disputes and made obvious progress, yet many questions remain in what we labelled our necessary "Transformation for the Next Century."
Last year, this report aimed to inform on current undertakings in the CHSLD that were well underway, to provide valuable accountability regarding past commitments, and include insights into future initiatives. Achievements this past year are an obvious continuation of this profound change and the effective overall renewal process we often talk about, but we can once again claim notale conclusions, since we completed the Norton expansion and renovations. This undertaking was quite complex, involving resident relocation, but we are pleased with the results and grealy appreciate the excellent collaboration of staff and construction workers. For those of you who are new or need a short reminder, the overall Norton process is outlined below.
The construction of forty-two new, larger private bedrooms with personal washrooms and a dramatic solarium on each Norton unit overlooking the valley enabled us to increase our CHSLD operation by twelve beds from the previous eighty-four beds to our current ninety-six. We secured an increase in our CHSLD license. We could have simply built the associated minimum twelve beds but by forty-two rooms, albeit at a larger investment, we now operate these ninety-six beds at three floor levels rather than the previous four locations; this division increased work efficiency. This choice also allowed us to substantially increase the number of private bedrooms and washrooms. The fourteen new rooms per unit made relocating residents possible and enabled extensive renovations to the dysfunctional serving kitchens and significant expansions to the living and dining rooms. These rooms also enabled us to replace the ventilation system on each unit to prevent the spread of respiratory viruses; we are extremely grateful this work was completed ahead of the pandemic. We recently purchased HEPA filter units to further improve air quality and minimize risk in strategic locations. On Norton 1, we increased window sizes facing the courtyard and corrected chronic moisture infiltration. One important objective with the ventilation system was also to deliver cooled outside air to bedrooms; this summer was the first test. We recognized a significant improvement but are not satisfied; we can do better. Regretfully, we realized that a design and installation flaw prevents the desired cool air delivery. Consequently, the dehumidification and cooling benefits to bedrooms is not as great. This imprefection will be corrected as soon as possible. When the Norton expansion and renovation was complete in late fall 2019, CHSLD residents from Central were relocated to Norton and Central was emptied for renovations.
Consequently, the major undertaking this past winter was Central's renewal, along with a solarium and terrace expansion to the Main Living Room and a Laundry enlargement and a dedicated rooftop terrace for employees. This rejuvenation process required extensive demolition due to our commitment to larger private bedrooms and personal, wheelchair-accessible washrooms could not be accommodated by the hundred-year-old layout of shared bedrooms and small shared washrooms. The new configuration made room for twelve Norton-standard bedrooms and will be recognized as secure intermediate care rooms for residents requiring additional care but who fall short of CHSLD requirements. We took this opportunity to improve outside air ventilation to the Living Room, Lobby, and administration offices beyond the front-of-house. The solarium expansio enabled a large basement-level storage room that will be useful for therapy and medical equipment. We had to interrupt the Shaw/Manning renewal for renovations to occur on Central but are now able to resume with pandemic guidelines in mind. Undertaking the restoration of a one-hundred-year-old facility involves risk of surprises and escalations in work scope. For example, zoning and piping for the existing fire protection sprinkler system had not be appropriately configured, so we had to replace the overall order for Central, but we knew that going into the project. Even though the rear courtyard redevelopment was quite dear to many, we chose to exclude this work until Central renovation costs were finalized. As Central came in under budget, we initiated the design process and intend to proceed with rear courtyard redevelopment this fall. Plans include stonework and landscaping for Norton residents' visual benefit. Wheelchair-accessible paths will lead throughout the courtyard with benches, swings, and a fountain.
During the Central renovations, we more than doubled the Laundry room, enabling technical investigations to respond to the need to improve work efficiency. We retained a specialist to assist us in investing in new laundry equipment.
The previous Norton renovations, completed ten years ago, saw the Wales switch to electric heating and left the facility dangerously short of electrical service capacity with next to no emergency reserve. Given that our generator is forty years old, the Foundation will fund essential infrastructure upgrades, including a larger-capacity generator that is set to be installed this winter.
Our tall, free-standing masonry chimney is at risk of collapsing and is essentially non-repairable. We are in the process of purchasing new, prefabricated chimneys; demolition of the existing chimney will occur by the end of 2020.
An engineering specialist reviewed our potable water installations and waste liquid treatment facilities, which is a prudent and timely undertaking due to our proposed expansion. His examination raised no concerns.
Despite pandemic uncertainties, your Board of Directors stayed the course for residential projects announced last year. The first phase will provide forty-one apartments of various formats, sizes, and costs, along with amenities including a swimming pool, spa, terraces, fitness centre, two-lane bowling alley, lounge, thirty-five-seat cinema, and a large multi-purpose room. The Foundation agreed to fund these remarkable comforts, making this wing an exciting place to live. The second phase will reflect market study responses but will likely provide an additional fifty-four apartments for ninety-five total. We intend ot offer twenty-one phase one units as life-lease agreements and twenty units as rentals. The pandemic slowed our progress but architectural construction documents are complete and the tendering process is well underway. A Board of Directors meeting on August 13th will decide whether to proceed with the project.
These are exciting times for the Wales and this Committee is very active. We greatly appreciate your generous support.
Marc Gaudet, Chairperson
Director of Health Services's Report:
This year, Pharmacie Familiprix Philippe Leng lent us three medication carts. These carts lock via electronic coding and are therefore much more secure than our previous medication carts. LPNs must log in with their personalized code to access the cart's contents, which facilitates narcotic tracking.
We were informed that the Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie-CHUS) will no longer authorize Functional Autonomy Measuring System (SMAF) evaluations done by our Social Workers for residents needing to be transferred from the Home to the CHSLD. These assessments must now be completed by the public sector.
This year's influenza campaign was even more successful than last year. Seventy-five residents were immunized for an eighty percent inoculation rate. Fifty-seven employees and twelve volunteers were also vaccinated. The indicators as compared to the 2018-19 fiscal year are located at the end of this report.
We still receive admission inquiries from social workers, even though our health services are paid by the Government. After each query, we inform the individual that our admissions are processed through the Mécanisme d'accès. This process has proven difficult, but we are confident that each request brings us more publicity so that healthcare facilities will eventually know our procedure.
This year, we increased clinical hours across multiple sub-departments. We added one day in Activities, one day in Therapy, and two and a half days in Social Work. I would like to thank one of our Activity Coordinators, Carol Ann McElrea, one of our Physiotherapy Technologists, Nadia Boissonneau, and Alain Therrien for accepting these extra hours! Our residents are incredibly well cared for under their capabilities.
In early March, COVID-19 rocked many industries worldwide, and healthcare was certainly hit the hardest. On March 12th, we decided to close the facility to visitors and quickly implemented self-isolation regulations. We acted efficiently and put most measures in place before provincial Government rules. Our expectations are strict but effective; we have not had any positive COVID-19 cases among our residents or employees. Several Management and Administration agents listen to Government press conferences daily to stay abreast of the situation. We are profoundly grateful for and proud of our employees for their constant compassion and dedication to the CHSLD Wales and its residents during this challenging time.
2020 marks Florence Nightingale's 200th birthday. Nightingale was a nursing pioneer who popularized and revolutionized the field and formed the foundation for modern nursing care. 2020 is also a landmark year for nursing as we celebrate the Year of the Nurse. While the Wales is one year shy of its hundredth birthday, we too feel that the 2019-20 fiscal year was profound in many ways and I know that our founder and first donor, Mr. Horace Pettes Wales, would be proud of our accomplishments and continnued excellence that are his legacy.
Vicky Gingras, Director of Health Services
Influenza Vaccination Campaign 2019
Human Resources Department's Report:
In June 2019, the Human Resources Department was restructured. Executive Director Brendalee Piironen absorbed the Human Resource Director duties, I assumed the Human Resources Officer - Employee Relations Coordinator and Hiring Manager role, Amanda Gunter became the Human Resources Officer - Staff Scheduler and Orientation Coordinator, and Joyce Jolin became the Human Resources Officer - Clinical Scheduler and Occupational Health and Safety Coordinator. Unfortunately, I departed in October 2019 on sick leave; as such, Carolyn Leonard stepped down as Board of Directors Member and was hired as a Human Resources consultant to replace me while I was away.
The CHSLD expansion in September 2019 led to three new Food Services positions and fifteen clinical positions: eleven caregivers, three clinical aides, and one head nurse. New positions were covered internally, creating an external recruitment need to compensate.
The turnover rate for the 2019-2020 fiscal year was nineteen percent with twenty-five employees leaving for personal reason, three retiring, five dismissed, and two on prolonged sick leave. Of the fifty-five employees hired throughout the year, thirty-two remain at the Wales, making our retention rate sixty-three percent.
The emergence of COVID-19 at the end of the fiscal year had a huge impact on our workforce. In March alone, five employees left their positions and pregnant workers could no longer perform their regular duties. Additionally, as per government regulations, Administration employees worked from home for the last two weeks of the fiscal year. The Wales remunerated its employees with applicable COVID-19 premiums set forth by the government. Any staff members having travelled or shown symptoms were asked to self-isolate and get tested for the virus. Since residents must physically distance and could no longer eat in the Main Dining Room, we created several new Food Services positions to ensure proper aid. These new duties were filled internally. Despite these challenges, overtime did not increase during this period. I would like to thank our employees for their continued hard work and dedication through this unprecedented time.
Throughout the year, the CHSLD Wales hosted approximately thirty stagiaires. These students were studying a variety of programs including caregiving, nursing, therapy, psychology, and special care counselling. Unfortunately, some stages were cut short due to COVID-19.
Finally, Courtney Grainger was brought on full-time as our Fundraising and Communications Coordinator. Thanks to Courtney, we have been able to drastically increase the visibility of our job postings via our various social media accounts. For example, some job postings were viewed by approximately 8,000 people across Facebook, Instagram, and LinkedIn. Furthermore, with the updated Wales website spearheaded by Courtney, we now have an average of thirty weekly visits to our career section.
Human Resources Officer - Employee Relations Coordinator and Hiring Manager
Human Resources Indicators
*Note regarding to the staffing indicators:
75% of the employees are accountable to the CHSLD and 25% to the Residence.
Planetree Committee Report:
Planetree is an international organization that is based on a person-centred care approach to healthcare, services, and management, focusing directly on resident, family member, employee, and volunteer wellbeing. In October 2018, the Wales received Planetree Gold Certification for Excellence in Person-Centred Care at the international level. There are presently ninety-seven Gold-Certified healthcare institutions worldwide. The CHSLD Wales Inc. is the only Gold-Certified long-term care facility in Québec.
On June 11th and 12th, 2019, the Wales hosted Réseau Planetree francophone's Annual Meeting. The event was launched with a tour of our facility; three groups totalling twenty-eight people toured the Résidence Wales Home and CHSLD Wales. Members from the Réseau shared Best Practices after their meeting. Executive Director Brendalee Piironen presented on the importance of involving employees in the decision-making process. Fifty participants from Québec and New Brunswick attended the event.
New updated definitions of two of the Wales's five core values, Innovation and Teamwork, were finalized, printed, and posted as wall decals in the Main Floor hallway. The other three values, Respect, Integrity, and Compassion, were previously posted. These additions thus complete our Wales Value Wall.
One of our Planetree Committee Members, Hailey Wilson-Veilleux, initiated a team-building exercise to bring Wales staff together outside of work for events, celebrations, and clubs. Along with her coworkers, Hailey also organized fun theme days and activities at the Wales. Her eagerness has been well-received by many employees and appreciated by residents when they bear witness to our activities.
Our seven Passion for Compassion tokens and postcards have continued to circulate. The idea is to present the token as a symbol of recognition to someone you feel makes a special difference in the lives of residents, family members, and/or colleagues. Tokens can be awarded to an employee, a family member, a resident, or a volunteer. After someone receives one, they must pass along the token to someone new. Recognizing compassion in others is a gift for both the recipient and the giver. We hope that this cycle continues to inspire.
Planetree Québec organized a Virée exploratoire whereby members could visit two Planetree Gold-Certified facilities in New England. Two Wales employees, caregiver Brigitte Lussier and Food Services employee Noah Allan were chosen for this three-day trip and returned with many inspirational ideas that could be integrated at the Wales.
A Wales Planetree plaque was designed and installed in our entrance bearing the Zig Ziglar quote, "What you get by achieving your goals is not as important as what you become by achieving your goals." We would like to recognize Mr. James Thompson and his company, Williams Recognition Ltd., for conceptualizing our ideas and creating something beautiful of which we can be proud.
On December 13th, Réseau Planetree Québec hosted a Recontre virtuelle des membres to share Best Practices. Our Director of Health Services, Vicky Gingras, presented on behalf of the Wales. Her presentation titled "Initiatives ayant apporté joie et bonheur dans nos journées de travail" demonstrated that working in healthcare, while sometimes stressful and demanding, is fun. She presented employee, Planetree Committee, and Management initiatives that have brought joy, laughter, and moments of pleasure into our everyday life at work and throughout the year. The list gives quite an impression of the unique contributions towards a pleasant work environment. There are many interesting and inspiring presentaitons from other Réseau members as well.
We regreat that Howard Stimson resigned as Planetree retreat facilitator but are pleased that Hailey Wilson-Veilleux accepted to replace him. This year, the Planetree Committee met six gtimes and we hosted five Planetree retreats to familiarize employees with its philosophy. The Planetree Committee would like to acknowledge Management's regular employee recognition and appreciation with kind monthly gestures like donuts, chocolates, smoothies, ice cream treats, barbecues, and much more.
I would like to thank the Planetree Committee members for working together and promoting Planetree throughout or facility. I also wish to express my gratitude and extend my congratulations to the Wales employees, residents, and family members who have embraced the Planetree philosophy.
Risk Management Committee Report:
The Risk Management Committee is a group, required by law, that reports risk administration and plays an essential role in implementing safe care and environments. In compliance with current laws and regulations such as the declaration and disclosure of incidents and accidents, the RMC identifies and analyzes danger, ensures that support measures are provided to residents and family members, and presents occurrences and subsequent recommendations to the Wales Vigilance Committee. AH-223s, report forms for incidents and accidents, are registered with the SISSSS, an online safe-care information system dedicated to compile form data.
The number of required quarantines was consistent with last year at two. Norton 1 was closed from January 9th to 20th, including the disinfection period; Norton 2 followed suit in February. The quarantine was caused by a norovirus that was very virulent, but symptoms did not last more than twenty-four hours. Luckily, we had no quarantines or outbreaks related to flu-like symptoms. We are hopeful that the ventilation system's renewal has a positive effect on air quality and infection prevention. This year's incidents and accidents consist mostly of falls and medication errors.
There were fewer falls this year in the CHSLD with 246 compared to 436 last year. A large portion of these falls account for a handful of residents who are prone to repeated falls. Seventy-nine percent of falls resulted in no injuries, while nine percent of residents experienced pain with no mark and twenty-one percent sustained cuts and/or bruises. One resident was sent to the hospital post-fall and two falls resulted in fractures.
These effects reflect the CHSLD Wales Inc.'s restraint-free environment. Falls are analyzed and action plans for each resident are implemented according to their needs and specific situations involving the Physiotherapy Technologists, the Occupational Therapist, and, if needed, the Doctor.
Medication errors decreased this year with 163 compared with 314 last year. Omissions represent forty-eight percent of these errors; most often, employees find pills that the resident neglected to take. Most omissions occurred on Norton 1, where residents are typically mobile and have dementia. After recurrence, measures are implemented so medications are directly administered, meaning the LPN supervises the resident until pills are ingested. This method is not automatically practiced due to the Wales's objective to maintain residents' autonomy for as long as possible.
I would like to take this opportunity to thank the employees, especially the Risk Management Committee's Members, for their remarkable efforts to ensure reisdent and employee safety. Nursing practices change to meet the residents' and family members' needs; the Wales will continue to research and implement Best Practices to make sure those alterations happen swiftly and safely.
Risk Management Indicators
Vigilance Committee Report:
The Vigilance Committee ensures quality of services and respect of individual and collective rights. The Comittee is responsible for follow-up of the Service Quality and Complaints Commissioner's recommendations. The Committee also guarantees that the Board of Directors adequately carries out their responsibilities regarding service quality, respect of users' rights, and the prompt treatment of complaints.
I am pleased to present this 2019-20 Annual Report. The Vigilance Committee met four times in this fiscal year, in May, August, October, and November. At each meeting, members were provided with risk management, complaints, and dissatisfaction reports and an update on Accreditation and Certification. The Complaints Commissioner does not attend meetings, but she sends her report to the Executive Director.
The Director of Health Services, Vicky Gingras, provides Risk Management reports for both the Résidence Wales Home and the CHSLD Wales Inc. Major topics discussed include the following:
- Training on AH-223 (incident/accident) forms was offered throughout 2019
- Indicators on infections, falls/injuries, and medication errors are reviewed by this Committee after each Risk Management meeting
- The DHS expects that medication errors will reduce once the CHSLD residents are on the three Norton units and that we no longer have CHSLD care on Central
- The DHS worked on getting more precise indicators on patch errors; we now have pink tape that is applied on the skin beside the patch to facilitate location when changing.
- The DHS asked that residents at high risk of falling, who use personal sensory alarms (PSAs), be moved to rooms closest to the nursing station to reduce the response time generated by long corridors on the Norton units
- The Executive Director presented the updated CQI (Continuous Quality Improvement) timeline at two of the Committee meetings, detailing the remaining documents to be revised or completed in the five-year timeline of 2015-2020. Management is on schedule based on this timeline
Dissatisfactions for both the Résidence Wales Home and the CHSLD Wales Inc. were reviewed at each meeting. Discontents were reported, action was taken, and issues were immediately resolved. This quick response is likely why there was only one official complaint reported this year to the Service Quality and Complaints Commissioner.
I regret that Louis-Marie Decoste stepped down as Chairman this year, but I am grateful to have been nominated as his replacement. Louis-Marie accepted to remain a Committee Member and continues to attend regular meetings. We also recruited a new member, Mrs. Beverly Goodfellow, who is a resident here.
Carolyn Leonard, Chairperson
Users' Committee Report:
In compliance with Section 209 of the Act Respecting Health and Social Services (Article 2019, LSSSS), the Users' Committee was created to defend the CHSLD Wales and Résidence Wales Home residents' collective rights and interests. This report encompasses the fiscal year ending March 31st, 2020 and identifies the Users' Committee's implemented measures to fulfill its roles assigned by the Act.
The Users' Committee held fourteen meetings during the fiscal year. The gatherings were attended by the Committee's eight members and invited guests, including the Executive Director and the Activity Coordinator. The meetings' goals were to promote residents' rights and improve services and security quality. At each gathering, Members communicated dissatisfactions that were brought to their attention and solutions were discussed at the subsequent conference.
In April, a special meeting was held at the Executive Director's request to review the upcoming employee Performance Appraisal questions. The group also analyzed and shared very positive Satisfaction Survey results in May.
The Minister Responsible for Seniors and Informal Caregivers, Mrs. Marguerite Blais, visited the Users' Committee on May 27th, followed by a tour of the CHSLD. Members noted that Mrs. Blais is compassionate and was quite impressed with the Wales.
Throughout the fiscal year, the Committee's President and two of its Members regularly met with new residents to ensure their transition into their recent home was as seamless as possible and discuss the Users' Committee's role. In July, the group voted to purchase a laptop to use with the projectors in the Main Living Room. This acquisition will facilitate activities.
In December, the Committee was visited by an MSSS official during a surprise inspection. Questions were answered satisfactorily.
The Users' Committee's roles, responsibilities, and mandate are published twice per year in the resident and employee's newsletter, a physical copy of the resident's newsletter is distributed to residents. The Chatter is also sent electronically to many family members. Twice per year, during the Resident/Family meetings, the Users' Committee Members are introduced to those in attendance. Once again, the Committee's mandate, responsibilities, and users' rights are discussed.
Users' Committee Members:
- Keith Baldwin, President
- Judy Laberee, Vice-President
- Elaine McElroy, Secretary
- John Luxton, Treasurer
- Dianne Burgess, Member
- Angus Goodfellow, Member
- Dorothy Huff, Member
- Lena Ross, Member
The Committee acknowledges each member's great work. Together, the representatives make a difference in CHSLD Wales Inc. and Résidence Wales Home residents' lives.
Keith Baldwin, President
CHSLD Wales Inc. Governors, 2019-20