Annual Report 2018-2019
ONE HUNDRETH ANNUAL REPORT
For the Fiscal Year
April 1, 2018 to March 31, 2019
RÉSIDENCE WALES HOME
(INCORPORATED JANUARY 1920)
ANNUAL GENEREAL MEETING HELD JUNE 27, 2019
The Résidence Wales home is a non-profit private organization which provides a
home with a continuum of care for seniors, based on the needs of the community.
We are committed to respecting the dignity of all seniors by providing them with a
clean, safe and secure homelike environment which promotes independence,
friendship and comfort for its residents and provides a welcoming atmosphere for
their friends and families.
The Résidence Wales Home accomplishes its mission with a valuable team of
skilled employees, volunteers, other health care providers and community
Our values, put forth by our dedicated employees and volunteers on a daily basis:
Integrity, Compassion, Teamwork, Innovation, and Respect
Report from the President
Governors, members of the Corporation, ladies and gentlemen, good afternoon and thank you for your attendance.
I am pleased to present the annual report of the Residence Wales Home which highlights the organization’s accomplishments and results during the 2018–19 fiscal year. As one Quebec’s largest not-for-profit providers of seniors’ care, the Wales Home has a
responsibility to provide services tailored to meet the needs of seniors in the community; aiming to help each person live as independently as possible. Understanding who we serve, to ensure we continue to meet their needs, is a high priority in our current strategic plan. It is with considerable regret that I must acknowledge the departure of two of our committee members, Peter O’Donnell and Susan Mastine. Both individuals have been invaluable to us in helping to open the right doors and provide the connections that inevitably translated into opportunities. The Executive Committee was pleased to welcome Carolyn Leonard, Yves Ferron and Norma Husk as new members this past year. Their skills and expertise in nursing, clinical management and engineering will enhance the Board’s depth of experience in these areas.
I would like to thank all our volunteers and members who participate on our numerous committees. A special recognition goes out to Marcien Gaudet as he has tirelessly given his time and resources to the CHSLD expansion, Shaw renovations and the upcoming future apartment project.
The Executive Committee is proud of its employees who work every day to create a caring community within the walls of our facility. Our staff is our greatest resource, and we could not live into our mission without their ongoing commitment. As we celebrate the many accomplishments of the past year, we also look forward to the possibilities that are before us as we continue to advocate for English speaking seniors across our province. On behalf of the Executive Committee we hope you enjoy our annual report, and we thank you for your ongoing support.
Report from the Executive Director
Members of the Corporation, ladies and gentlemen, I am very proud of our accomplishments this past fiscal year, which marked my thirteenth annual report as Executive Director of the Wales Home. The Wales Home has been transforming as a leader
in senior care; continuously partnering with individuals to ensure we are providing high quality care and services.
With the input of our Executive Committee, staff, residents, families and volunteers, and Wales Home Foundation, we accomplished a great deal this year to ensure our residents have the choice and protection they need to live with confidence and dignity in our retirement home.
Our key focuses over the past year was developing a market analysis and plans for future condo style living for independent seniors as well as converting Central, the oldest part of the building into a 12-bed intermediate care unit. I personally commend Marc Gaudet for his ongoing work and commitment to enhance this exciting forth coming project and for his patience in guiding us through this journey.
Wales Home is in litigation with Ideal Combustion regarding the 2015/2016 installation of a new central heating system. In 2017, both new boilers failed. Upon examination, our considered opinion was that the design delivered by Ideal Combustion is flawed. As a consequence, Wales Home refused to pay for the repairs. The repaired boilers failed a second time and Ideal Combustion then refused to repair the installation. They have since initiated a lawsuit against Wales Home for the first-time repair cost of these boilers. In rejecting this claim, Wales Home is counterclaiming against Ideal Combustion for the second-time repair and for correction of design flaws. In pursuit of defending against the claim by Ideal Combustion, an engineering expert report was commissioned. It concurs with our opinion. The amount of claim is approximately $30,000 and the counterclaim $150,000.
I am proud to share that the Wales Home/CHSLD Wales Inc. received two outstanding achievements this year; an award from the Fédération Québécoise du loisir en institution for Recreation and Quality of Life and an International Gold Designation from PLANETREE International. These two recognitions bring a total of 15 awards since 2011. Our accomplishments should not be taken lightly, as much hard work and dedication is given by our employees and volunteers for these recognitions.
In collaboration with the User’s committee, the Wales Home processed its annual satisfaction survey and the results appear satisfactory.
In October 2018, the Government legalized recreational cannabis. The Executive Committee of the Wales Home accepted to authorize the use of cannabis for residents in the smoke room or their apartment but prohibited its use elsewhere in the building and on the grounds.
The MAPAQ inspected the Wales Home kitchen and found two minor non-compliances which included a damaged cutting board, and condensation under the refrigeration unit and dust on top of the walk-in fridge. Immediate action was taken to rectify the non-compliances.
Due to the unreliability with our emergency call bell system, we hired our own Network Administrator-IT which allows for immediate service for all our networking systems. To improve our security, we replaced our existing Wi-Fi and installed additional access points which now provides proper coverage both inside and on the outside grounds of our building. With the tragedy of Gilles Duceppe’s mother freezing to death outside during a false fire alarm, we installed exciters at all exit doors which alert the staff each time a resident goes outside. We also built a second server room in the Norton expansion which will ensure constant service in the event of a shutdown with the current server room. The servers are independent of each other and 100% redundant. This will increase our systems reliability.
In 2019, the Wales Home lost its Municipal tax exemption because the CHSLD Wales Inc. is a “for profit” entity. We are trying to find a solution with government officials as the Wales Home is a not for profit organization is the unique shareholder of the CHSLD Wales Inc.
The MRC of the Val St-François is working on a circuit of heritage panels throughout the region to create a cultural and recreational trail. The Wales Home has been chosen as one of the two points of interest in the municipality of Cleveland. The project should be complete by the end of summer 2019. We wish to thank the late June Lester for her generous donation to the Wales Home ($521, 193) and the Wales Home Foundation ($519,997.30) totaling to date just over $1 million. Ms. Lester’s estate
has been invested in the Shaw renovations.
On March 5th, 2019, the Wales Home had its Certification inspection. The evaluator was very impressed stating that our facility was extremely well organized and had no recommendations.
In closing, I am confident that we will continue to provide quality care and a continuous assessment of health needs to all our residents in an efficient and cost-effective manner. Our residents are the reason we are here, and our overall goal is to provide a smooth continuum of care in a seamless system: a one stop healthcare for our English population!
Report from the Finance Committee
Members of the Corporation, ladies and gentlemen, It is with great pleasure that I report on the activities of the Finance committee for the fiscal year ended on March 31, 2019. The mandate of the Finance Committee is to watch over the financial affairs of the Corporation. As such, the Committee makes recommendations regarding the Corporation’s financial health, financial practices, and the availability or lack of funds.
The Finance Committee met three times during the fiscal year, two of the meetings were in collaboration with the Building & Grounds committee. The meetings focused primarily on budget and cash flow evaluation and the financial management of renovation and expansion projects. The Committee validated and approved all expenses. For the first time in many years, the Finance Committee was pleased to propose a positive budget to the Executive Committee and CHSLD Wales Inc. Board of Directors.
Prior to the CHSLD Wales Inc.’s funding contract with the CIUSSS de l’Estrie-CHUS, the Minister of Health sent a consultant to guide the management team of the Wales Home regarding the financial dilemma of the CHSLD Wales Inc. The consultant had the same recommendations as our management team; the sole solution was to obtain financial assistance from the government and expand the Norton building in order to meet the Voyer ratios. We are so pleased that we received financial assistance and the Norton expansion will soon be completed. One of the most important aspects of receiving the government funding is that it allows our CHSLD to charge residents the same monthly rents as the public sector, which significantly reduces costs for our residents.
The funding also allowed the CHSLD Wales Inc. to begin repaying its outstanding debt to the Wales Home, which has greatly improved cash flow. The CHSLD Wales Inc. has advised the government that we want the twelve additional beds to be included in the contract with the CIUSSS, as this increased funding is necessary to maintain the improved cash flow.
At the end of March 2019, all funds from the CIBC accounts for the Wales Home and CHSLD Wales Inc. were transferred to Desjardins. We continue to have the bridge loan with Desjardins for the CHSLD expansion and expect to sign the official loan in July 2019. Mr. Denis Paré was appointed as the Notary to manage the loan with Desjardins. We are very pleased to work with Ms. Anick Morin, from Desjardins, as she has made the transition very easy. We also would like to thank our Accountant, France Brousseau for her support and excellent work throughout this process.
The Finance Committee is very grateful for the financial support from the Wales Home Foundation. Over the last twenty-five years, the Foundation has provided monetary aid to residents who did not have enough funds to pay their rent while supporting operations and capital improvements. The Foundation financed such expansions and renovation projects as the Front of House, including increased dining facilities, a new shipping and receiving area, and improved waste management
centre which have proved to be excellent improvements. The Foundation has also pledged $100,000.00 to repair Central’s roof, which will be done in the current fiscal year, and $400,000.00 to add ventilation to Shaw and Manning wings, a project which is currently on hold due to insufficient electrical capacity. The improvements funded by the Foundation are essential for the Wales’s successful transition into the next century. We are very fortunate to have Marcien Gaudet as the Chairman of the Building and Grounds committee as his expertise ensures our projects are innovative and efficient.
The Finance Committee wishes to thank the Executive committee of the Wales Home, Board of Directors of the CHSLD Wales Inc. and the Wales Home Foundation for their confidence and support. The Finance Committee is confident that the Wales will continue to succeed in its accomplishments while providing superior quality care to seniors.
André Leblond, Chairman
Report from the Building and Grounds Committee
As Chairman of the Buildings and Grounds Committee, the opportunity to address our annual general meeting is greatly appreciated because it enables this report and your questions on the topic of noteworthy achievements involving infrastructure but also operations and numerous technical and financial challenges we have come to label as our required Transformation for the Next Century.
This report aims to inform on current undertakings, albeit already perhaps quite visible to everyone passing by Wales Home and thus reasonably well known, to provide some valuable accountability in regard to past commitments, and to include some insight into future initiatives.
Achievements during the past year might be considered as the obvious continuum of a profound transformation and effective renewal process that started with the front-of-house project. This past year witnessed the bulk of work required to construct the Norton CHSLD expansion, now a prominent building exposure along with its attractive landscaping. This also enabled renovations to the existing facility that are projected for completion by the first of October.
You might recall the scope of work from previous announcements and some of you have already visited the new space. The project includes 42 new larger private bedrooms with private washrooms. These are all fully barrier-free and handicapped-accessible, fitted with patient lifts, the best available beds, large windows for beautiful views of the countryside. They are configured for optimum efficiency of work by caregivers and conducive to delivering a superior quality of care.
By the first of October and once associated renovations to the existing are completed, these and 42 new bedrooms will enable us to transfer our 15 residents from Central and will include 12 additional beds thus increasing our CHSLD population capacity from 84 to 96 residents, located on three levels rather than at four locations and this will improve operational efficiencies.
This new construction enabled us to eliminate some existing bedrooms with shared facilities and thus to increase the space for dining and living rooms, cognizant that we will now accommodate nine additional residents at each floor level. As well for each floor level, a previous semi-private room will be converted to palliative care. A large solarium overlooking the valley countryside promises to be a great source of envy by other CHSLDs and greatly appreciated by residents as well as their families.
This expansion was built to superior thermal performance standards, including greater comfort tripleglazed windows, exhaust air heat reclaim, and environmentally-friendly geo-exchange for space heating and cooling. It is noteworthy that so far we have increased our overall building footprint by 30% but have hardly increased our cost for energy beyond the reality of fuel price increases and electrical rates.
This ventilation system design includes a higher supply rate of fresh outdoor air, superior air filtration, humidification, and artificial cooling for a healthful environment. This will minimize complications to respiratory health. This will reduce resident thermal stress by not delivering warm summer outdoor air to bedrooms. The existing will be modified to correct such deficiencies and to the same design standard as for the new expansion. Indoor air quality, comfort, and a healthful environment will be significantly improved.
To be clear, our critically essential and much appreciated CHSLD Government funding agreement is strictly for operational costs, caregivers, nursing, and for similar services. It does not provide for any capital investments. Wales Home has invested some 4 million dollars in the recent front-of-house project, 8 million dollars for this current Norton CHSLD expansion/renovation project, and 2 million dollars so far in the renewal of Shaw/Manning residences. This 14-million-dollar overall investment to date was made possible by way of a mortgage loan, the Wales Home Foundation, and generous donations of every scale, for which residents, families, and stakeholders are most grateful.
These are very complex technical undertakings within a fully functional facility and impose a need for tremendous dedication from everyone, well beyond the already challenging call of duty. I would be remiss not to not mention the great and unrelenting effort by Brendalee Piironen and Patrick Nolan to name a few, along with generous contributions by support staff to achieve an effective reliable planning process upon which success relies so much. Wales Home owes them greatly. Let us offer our expression of gratitude. The quality of their efforts is essential to a superior result with no regrets and this translates into superior quality and value at reduced construction costs. Our Architect (Jubinville), and our Engineers (IME) have also delivered skillfully. We expect nothing less. We are likewise grateful to our builder Alex Lessard whose conscientious efforts we greatly appreciate along with all of the suppliers and sub-contractors who have contributed. They compose a formidable team that has delivered excellent value to Wales Home. Ours has been a remarkable success story.
The past year has not only witnessed the delivery of our Norton CHSLD as an expanded (to twice its floor area) and fully renovated facility but during the same time witnessed the renewal of half the residential units at Shaw/Manning residences on levels 1 and 2. This program involves larger bedrooms, private washrooms, some private showers, barrier-free handicapped accessibility, new windows, and new finishes. The patience of residents and staff in accommodating this process is greatly appreciated. We are halfway completed.
Because an AGM offers an essential focus on the past year’s achievements and this report has already mentioned energy consumption, let me inform of how pleased we are of related environmental achievements. We always believed that our new materials receiving and waste management facilities would return great operational benefits. As an example, we can report that instead of one bin of wastes to the landfill every week, we now only need one trip every ten weeks. This simply makes good business sense. Our composting practices are well established and function well. Our improved purchasing, handling, and storage of food and operating goods translates into superior quality at reduced cost. Our management team functions more effectively and efficiently. Visitors are envious of our therapy department. The front-of-house project has been a very successful project and the Norton expansion/renovation promises likewise. Early responses are very positive. Results fully meet
with our expectations.
This report is pleased to provide some insight for the next year (What Next ) and into the future. The completion of Norton by the first of October will vacate Central where 15 CHSLD patients currently reside. Mindful that this portion was built in 1921 and is almost a hundred years old, Wales Home intends to undertake a thorough renewal of this space to the same technical standards as the new Norton CHSLD expansion, with larger private bedrooms, private barrier-free fully handicappedaccessible washrooms, improved bathing facilities, and patient lifts wherever practicable. You might recall that the front-of-house project, in anticipation, delivered a larger solarium for this group of rooms. This project for renewal of Central will deliver 12 rooms intended as Resource Intermédiaire (RI) rooms for residents in need of increased care but not at CHSLD level. We consider this a top priority for Wales Home.
We will need to interrupt the renewal of resident rooms at Shaw/Manning for the one-year duration of work at Central because we are not able to accommodate essential decanting while the renewal of Central is underway. We will utilize this opportunity to install a ventilation system at Shaw/Manning that we consider essential to a healthful environment. We expect to undertake this work through the winter of 2019/2020.
We also wish to expand the laundry so as to improve working conditions and functional efficiency, mindful that our laundry load is increasing and that the current workspace is inadequate. Laundry carts and supplies need to be parked in the adjoining corridor, which is inadvisable if not unacceptable. This expansion will provide an opportunity to construct an outdoor staff lunch and coffee break lounge. As well, we wish to construct a solarium expansion to the Central living room along with a rear courtyard terrace that would also be wheelchair accessible from door 6 at Shaw/Manning.
Your Executive Committee has authorized some conceptual design work for a major autonomousliving project of 40 apartment units including amenities that promise to be quite exciting as a complement to existing Wales Home facilities. Details will be announced in the near future. An application for permission to construct will soon be submitted to authorities.
These are exciting times for Wales Home and this Committee has been active. We greatly appreciate your generous support.
Marc Gaudet, Chairman
Satisfaction Survey Results 2018-2019
RESIDENTS’ PROFILE 2018-19
Members of the Corporation, Ladies and Gentlemen, Planetree is an international organization which is based on a person-centered approach to health care, services and management that focuses directly on the well-being of the resident, family,
employees and community.
On May 17th, 2018 the Wales Home received the announcement that it had earned Planetree Gold Certification for Excellence in Person Centered Care at the international level. There are presently 83 Gold certified health care institutions in the world. Wales Home is the only Gold Certified long term care facility in Quebec.
Brendalee also applied for recognition on two innovative best practices: The Therapeutic Garden for which we were FINALISTS, and the Wellness Room for which we won a Planetree Global Person- Centered Innovation Award. This award honors superior performance and innovations to inspire other organizations to greater heights in person-centered healthcare.
The Wales Home also nominated the Executive Director, Brendalee Piironen for the 2018 Scholar Award from Planetree International. This award honors individuals whose works and deeds inspire healthcare providers to greater heights in person-centered healthcare.
Following these exciting announcements, the Executive Committee authorized The HOME Team, the Wales Home’s person-centered advisory council, to allow the employees to nominate who would attend the International Planetree conference in Boston and receive the awards in person. Individuals were asked to nominate a colleague they felt embodies the Planetree principles and would represent the Wales Home well. Many nominations came in and when they were reviewed, 5 individuals came out strong making it very difficult to chose. The Executive Committee agreed to send all 5 nominees as each represented both clinical and nonclinical employees, as well as different departments, along with the Planetree Coordinator and the Executive Director.
On June 12th, 2018, eight Planetree members from France visited the Wales Home – they were impressed with our facility and services. Discussions on services, working conditions, and clinical practices were shared.
The Executive Director Brendalee Piironen and the Director of Health Services Vicky Gingras attended Réseau Planetree Francophone’s Annual General Meeting and sharing of best practices on June 13, 2018 in Beloeil, Québec. During the meeting, Réseau Planetree Francophone acknowledged Brendalee for her contribution to person-centered care by offering her a special mention for the quality of her leadership. Brendalee was asked to participate in a round table – question period. At the end of the day, members present (100) were asked to nominate the person who inspired them the most, Brendalee was chosen and received a Planetree token as a gift. Planetreee has since contacted Brendalee and asked if the Wales Home would be willing to host next year’s annual sharing of best practices and Annual General Meeting. Brendalee accepted the invitation with honor.
A beautiful Planetree Gold Celebration was planned by Brendalee Piironen at the Richmond- Melbourne golf course on September 22nd, 2018, where all employees, board members and one guest were invited. Many were in attendance and enjoyed a beautiful catered afternoon with speeches from Planetree representatives and Wales Home Board members, as well as door prizes. The nominators of the chosen attendees of the Boston conference were asked to prepare an audio
segment describing why they chose the colleague they did, and it was then made into a video to be
shared with all who were in attendance.
Kim Bailey-Planetree Coordinator, Rebecca Gilchrist-LPN, Amanda Gunter-Administration, Catherine Nadeau-Patterson-Caregiver, Maude Payer-Nurse/Supervisor, Brendalee Piironen-Executive Director, and Hailey Wilson-Veilleux-Food Services attended the International Planetree Conference in Boston from October 7-11. This year’s theme was #Careboss, which is defined as, 1: An individual who cares for and about others (Everyone is a caregiver), 2: A person who is the boss of their own
Days were filled with keynote speakers and master classes. The proposal for Brendalee to present a breakout session was selected from a pool of several hundred applicants who submitted to present at the conference. The title of her conference was, Employees Know Best: The Importance of Employee Involvement in Decision-Making. The Wales Home group was proud to see her have such an important input at this International Conference.
On the final night, all 7 proudly went on stage representing all the Wales Home employees to receive the Planetree Gold Certification for Excellence in Person-Centered Care and the Planetree Global Person-Centered Innovation Award for the Wellness Room. Brendalee accepted her Scholar award. Everyone came home motivated and changed and excited to share what they had learned with their colleagues. At the November 29th, 2018 employee meeting, each of the 7 who attended shared something they personally were moved by. A Thank you video was also made by the 7 who felt so grateful to have attended the conference and sent it to the Board of Directors to demonstrate their appreciation for their participation.
On January 30th, 2019, a larger HOME Team was established with the new Coordinator, Kim Bailey. This Team participated in a Compassion Retreat training offered by Planetree Quebec that will eventually be the Wales Home’s 2.0 retreat for all employees, once the majority of employees have attended the first important retreat which introduces everyone to the Planetree philosophy. The HOME Team Charter was reviewed and edited to better reflect the Wales Home at this time.
It had been decided by the HOME Team previously, that the Wales Home’s 5 Values and their definitions should be reviewed and printed on the walls on the main floor off the main lobby. “Respect” was already printed and displayed. The Team decided to replace Excellence with Compassion as they felt if all other values were upheld, excellence would be achieved. Compassion is a very important word in the Planetree community. There can be no person-centered care without compassion. The Team developed definitions for Compassion and Integrity with respect to the work done here at the Wales Home. They will be printed and installed in the hallway next to “Respect”. Teamwork and Innovation are the 2 values left to discuss.
The HOME Team strongly believes it is important to support the Wales Home employees with fun and inspiring activities. The Gratitude Ritual was initiated to encourage everyone to take a minute at the end of their day and think about what they were grateful for during their particular shift at work. They were then asked to share their gratitude by writing it on a post-it note and sharing it at designated areas on the floors. The walls quickly became very colorful and it was uplifting to see the appreciation for each other and the residents we care for. The post-its have now been collected and made into Planetree shapes in the different break rooms in the Home.
The HOME Team acquired 7 Planetree “pass it on” Compassion tokens to share with the people that make up the Wales Home community. The idea is to present the token as a recognition to someone you feel makes a special difference in the lives of the residents, family members and/or colleagues. It can be awarded to an employee, a family member, a resident or a volunteer. After someone receives it, the idea is to pass along the token to someone new that makes a compassionate impact on the lives of those around them. Recognizing someone’s passion for compassion with a small token is a gift for the person receiving it, but also for the individual offering it. We hope this inspires everyone involved.
Again, this year we would like to thank the Planetree HOME Team for working together on implementing the Planetree values into our facility. We also wish to express our gratitude and extend our congratulations to all the Wales Home employees, residents and family members who have embraced the Planetree philosophy.
Ladies and gentlemen, members of the corporation, We had a challenging year within our human resources department with the departure of three key positions including Director of Human Resources, Director of Health Services and our Planetree Coordinator.
For eight months Maxime Loiselle acted as Director of Human Resources followed by Garry Guillette for three months. Most of the year focused on recruitment, and our payroll system. Recruitment and retention proved to be more demanding than we anticipated. Our turnover rate was 23.63% with 31 employees leaving, 2 retiring, and 6 being dismissed. However, of the 52 employees hired throughout the year, 38 stayed making our retention rate 73.08%. As for the payroll system, I regret to share that we spent too much energy and time switching our pay system from Desjardins to ADP and then back to Desjardins.
On a positive note, we hired HR consultant, Ms. Monique Harton, to help find the right person to fill the HR position. Vicky Gingras was also hired as our Director of Health Services and focused on ensuring we became fully staffed and our Occupational therapist, Kimberly Bailey, accepted the role as our Planetree Coordinator.
Throughout these many changes, we remained committed to our strategic improvement plan. One of the main objectives being to become an employer of choice by improving working conditions and increasing employee satisfaction. As such, we administered an employee satisfaction survey. The results showed that 100% of employees were using the new lockers and breakrooms and the satisfaction rate for these new spaces was at 70%. Work satisfaction and employee morale were at 76% and 65% respectively. To continually improve employee satisfaction, we also installed suggestion boxes in the break rooms in order to encourage active participation and feedback from employees.
I would like to thank all our employees for their continued hard work and devotion. I look forward to the upcoming year and all that it will bring.
Human Resource Assistant
Human Resources Indicators
Note regarding to the staffing indicators:
75% of the employees are accountable to the CHSLD and 25% to the Residence.
Ladies and Gentlemen, Members of the Corporation, The past fiscal year has been one of continuous improvement in terms of quality of care and services in order to ensure the comfort, well-being, and quality of life of residents, as well as promoting their autonomy. We are fortunate to have competent employees, who are humane, respectful, and dedicated to the residents, and conscious of continuous improvement. The last year was very challenging regarding human resources and without an HR Director for most part of the year, the Director of Health Services and the Executive Director were involved in most of HR processes: manpower shortage and the need to improve stability on all the units was omnipresent.
Offering safe, competent, and ethical care is always a priority. The 2018-19 HS annual objectives revolved around:
• standardizing and harmonizing health care practices
• hiring clinical personnel to ensure proper replacements on units
• improving stability of employees on all units (working hours, postings, etc.)
• standardizing working hours throughout the building
• pursuing implementation of complementary therapies (music, light, and massage therapy)
• risk management and infection prevention
Hiring and improving stability
Last year’s biggest goal was to improve stability on the floors for both employees and residents. The replacements were irregular, having sometimes five to six employees covering one full time position, and the working hours very variable, causing numerous puzzles when working short or when finding replacements. Improvement was needed in order to provide a safer living environment, higher quality level of care, and better follow ups and communication between family members, residents and employees. We wanted to be overstaffed for the summer 2019 and make sure all employees would be replaced for their vacation period without being afraid of overtime hours when working their regular schedules.
Employees were consulted in a special committee to make sure we were answering both the needs of the residents and of the employees. Their priorities: full-time positions for stability; more regular working hours; replacement of vacation or sick leaves to be given to one employee instead of breaking the shifts to multiple employees.
The working hours on all floors were revised to make sure it was reflecting the needs and the reality of the residents, keeping the employees requests in mind to improve the working environment as well. The working hours are now the same throughout the building, ensuring easier replacement and more functional shift changes. The reports are easier to transmit as people are coming in at the same working hours instead of every 30 minutes.
The whole Nursing schedule was also revised to make sure all positions and replacements (maternity and sick leave) were given. All employees on stable floors were confirmed their position and five (5) days a week postings were prioritised for stability reasons as well. Besides the existing ones, new positions were created: we added a full-time replacement for Head Nurses and Supervisors. The process has been longer than expected due to the lack of manpower. In order to proceed with the replacements, we needed to hire new employees first. We were able to attract many new employees of high quality that were reliable, compassionate, and devoted. At the end of the fiscal year, we ended up giving permanent or long-term replacements to 10 Caregivers, 9 LPNs and 2 RNs, besides confirming all existing positions to regular employees. This will now be an ongoing process and postings for positions or replacements will be done right away to maintain this stability that was hard and long to establish.
Caregivers replacing Night LPN in the Wales Home
In 2003, the act to amend the Professional Code and other legislative provisions in the field of health (commonly called the Law 90) took effect. This law allows to reflect the evolution of the skills of these professionals and to make their practice as autonomous as possible. After meetings and discussions with the CLSC from the Val-St-François, the Director of Health Services was authorised to start trainings for Caregivers to give medication on the residential floors, which is in agreement with the certification process. We chose to train last-year Nursing students or Caregivers that were working as Registered Nurses in another country, therefore having the skills and knowledge to proceed with the administration of medication. This helped us get through the lack of LPNs wanting to work nights during last year’s crisis.
At the Wales Home, we are always looking forward to accepting students for their stages or internship. Not only these stages are bringing us new compassionate employees, those students are also sharing their experience lived between our walls to others and express how great it is to be working in the Wales environment. It is important to be known by schools and to offer warm and sincere welcome to students as they are the future for the Home, and all employees here are offering them a great stage experience at all times.
As every year, Edith Bourassa, physical rehabilitation therapist, supervised a rehabilitation stage for six firstyear nursing students. They were here for six consecutive Mondays and enjoyed their experience. Ms. Bourassa also supervised two distinct stages of last-year students in physical rehabilitation therapy. These are integration stages as the students are done all their courses, both theoretical and practical portions. The first student started in January for a period of seven weeks, and the second followed just after, in March, for the same period.
Partially subsidized by Young Canada Works, a 14-year-old student spent their summer with the activity department and helped getting residents outside among all other contributions. From September through to December, the activity department also had two third-year Special Care Counselling students for their internship, five days per week. The residents were really attached to them and some were very emotional when they left.
Among all those stages, we also gave regular tours to first year students of different school in nursing or caregiving. They visited a public facility and then came to the Wales Home and expressed the differences they notice between the public sector and the Home: more time allotted to residents, ease of communication and presence of management team, feeling of being treated like persons and not numbers, family-like environment and person-centered care, among many others.
Therapy and Social worker
Since our part time employee in physical rehabilitation therapy had to leave the Wales Home for personal reasons, we proceeded to an external posting. We are grateful to have Nadia Boissonneau with us three days a week since February. Edith Bourassa, our full-time therapist, is also a PDSB and a CPR trainer. Ms. Boissonneau is available for extra days of work to replace Ms. Bourassa when we need her to do in-home training for employees.
With the contract with the CIUSSS for the CHSLD beds, the residents from the Wales Home that required more care needed to be assessed by the CLSC prior to their transfer in the long-term care unit. We ended up waiting for weeks to have the assessments done although we had an on-site social worker with the capacity to do those evaluations. After consulting with the CIUSSS, they agreed to train our social workers (Véronique Guay, currently on maternity leave, and Alain Therrien, her replacement) with theirs to make sure they had the same guidelines to process the assessments. Since June 2018, our social workers are proceeding with minimal delays to the SMAF (OEMC) evaluations of the residents. It is making the transfer process to the CHSLD Wales Inc. a lot faster and smoother, providing a more secure environment to the residents in need of more care.
Professional orders are doing random evaluations of their members every now and then to ensure quality and consistency of their members. Last summer, Alain Therrien was informed he would be evaluated in September. Before she left for her maternity leave, Véronique Guay and him updated all the resident’s file and we had the chance to update their work documents and tools prior to the inspection to fit better their Professional Order’s requirements. The results of the evaluation were very positive, and Mr. Therrien received a great feedback.
Volunteers and Activity department
The Wales Home is very pleased to have over 200 volunteers giving their precious time to the residents and caring for them. In collaboration with the activity department, they are giving one on one time with the residents, accompanying them to appointments and participating in or conducting activities that occur throughout the day.
In September 2018, the Activity Department received the award Loisirs et Qualité de Vie from the Fédération Québécoise des Loisirs en Institution (FQLI) in recognition of the activities provided to the residents. All employees of the Wales Home help ensure the best possible quality of life for all residents, and it is in their name that Carol-Ann McElrea and Marie-Christine Clément-Savage accepted the award. This prize reflects our teamwork and how we strive to meet the needs and preferences of the residents by putting in place inspiring initiatives to liven up the living environment. The activities are designed not only to meet residents’ needs and preferences, but also to stimulate their body and mind. We provide a mix of activities that allows each resident to use their full potential and live unique experiences.
The Activity department also applied for and received a grant through the FQLI in the amount of $831 to buy new equipment that encourage physical activities such as a shuffleboard, dart games, tossing nets, and others. Among others, the FQLI also provided the CHSLD Wales with sensory balls as well as foam frisbees and alphabet balls.
In March 2019, the Wales Home hosted a Murder Mystery dinner in collaboration with Doc McCoy Productions. All 125 tickets were sold, and the event was a success. All proceeds from this event went to the Activity Department to provide more music therapy. We are pleased to have a gifted music therapist by the name of Patricia Hortop-Benson, who provides amazing music and singing sessions on the floors. With her voice and her musical notes, she communicates with the residents in a magical way. She helps release contractures; she calms temper; she reduces anxiety. We wish she was here every day.
Through the United Church of Canada Foundation, the United Church of Richmond obtained a grant to provide a pastoral and spiritual-care worker to visit, provide bereavement care, conduct funerals, or give palliative care support to seniors primarily at the Wales Home. For one-year, reverend Wayne Beamer worked at the Wales Home every Wednesday from 10:30 am to 4:30 pm and had an office in the Chapel on 4th floor. Reverend Beamer enjoys dinner among the residents in the main dining room on Wednesdays.
Vaccines are very fragile to temperature fluctuation and are considered ineffective when the cold chain is broken. Unfortunately, during the 2016-2017 vaccination season, the cold chain was broken numerous times due to temperature variation of the fridge: the vaccines were kept in a counter domestic fridge in a closed, small, non ventilated storage room. It is our responsibility, under our contract with the Santé Publique, to preserve and store the vaccines according to the standards. Therefore, the Wales Home ended up paying a fine of $547 for the loss of those vaccines.
This is a problem we haven’t met for this fiscal year as the Ladies Auxiliary, with all their generosity, provided the Wales Home and the CHLSD Wales Inc. with a medical fridge that maintains stable temperatures under all circumstances. Temperature verification was done according to the recommendations twice a day during all the vaccination period and no fluctuation outside of the allotted limits occurred.
Vaccination for the flu season was a success this year as none confirmed cases of influenza (flu) arise. In the Wales Home, 88% of the residents received their flu shots, 12% refused it for personal reasons.
Edith Bourassa, the Wales physical rehabilitation therapist, provided PDSB capsules throughout the year to train employees with the up to date technics to reduce risk of injuries for both residents and employees. Ms. Bourassa is also a cardio-pulmonary resuscitation (CPR) instructor and contributed to the training of the employees.
Trainings from the CEVQ (Centre d’Excellence sur le Vieillissement de Québec) on Behavioral and Psychological Symptoms of Dementia were given to help employees dealing with aggressive behaviors. It gave them tricks and tools to intervene with the residents to reduce and prevent these behaviors. In May, the Townshippers’ Association in collaboration with the LVTC held a conference at the Wales Home for Caregivers who care for family members at home who suffer from dementia.
In support to their leadership requirements, Supervisors and Head Nurses also attended a full day training on conflict management, offering them tools for mediation process at work in situation of conflicts.
The medication carts on all units were getting old and falling apart. They were requiring a lot of temporary fixing by our maintenance staff and were heavy and hard to transport, risking injuries to the personnel. Mr. Philippe Leng from Familiprix Richmond, was lending them to the Wales Home. He fortunately accepted to renew them this year and to lend a total of six brand new medication carts. The 7th cart for Central floor will be replaced later after the renovations of that unit are complete, once we can evaluate the needs. The Carts are digital, are auto re-locking and each employee accessing them has its own personal pin code. In the case where there would be missing medication or narcotics, the Director of Health Services can access a log to find out who accessed the cart between the counts to search for explanation of the situation. This makes the storage of medication even more secure, while assuring safe and ergonomic equipment to all employees.
New and Updated Policies and Procedures
The Health Services department revised seven policies and procedure in order to adapt them to the certification renewal of the Wales Home. As policies and procedures are up to date, it is important for management to ensure that the current practices are meeting the standards and requirements.
In closing, I would like to personally thank all the employees of the Wales Home for their involvement, compassion and evotion. Each and everyone are the foundation for success of the Wales Home and the well-being of all the residents.
Director of Health Services
Members of the Corporation, Ladies and Gentlemen, The risk management committee (RMC), is a mandatory committee, which is accountable for all risk management reporting activities, and plays an essential role in implementing a culture of safety and safe care. In compliance with current rules, laws and regulations such as declaration of incidents-accidents and disclosure, the RMC identified and analysed the risks of incidents-accidents, ensured that support measures were provided to victims and relatives, and the list of incidents and recommendations were provided to the Vigilance Committee of the Wales Home. All AH-223 (incidents and accidents forms) were registered with the SISSS, an information system on safe care which is a web application dedicated to the capture of data from those forms.
Based on the review of the incidents and accidents that occurred over a period of one year, events pertained mostly to falls and medication omission errors.
Falls were increased in the Wales Home: 116 falls for the fiscal year compared to 96 in 2017-2018. However, it is mostly associated with specific residents having a high reoccurrence of falls, increasing the statistics, and most of the falls (62%) had no associated injuries. Only 8 falls required a visit to the hospital for an evaluation, 4 happened to have a fracture, 30 had cuts, bruises, etc. and 14 ended up with pain but no marks. The results are reflecting the change in clientele: the Wales Home is having more residents with higher SMAF level, meaning with lower autonomy and requiring more care. All falls were analyzed and action plans for each resident were implemented according to their needs and specific situations, involving the physical rehabilitation therapist and/or the occupational therapist and their physician.
Improvement is observed pertaining to medication errors: 120 errors compared to 191 in 2017-2018. Most errors were mainly omissions (81.6%), such as pills found by the care providers, whether on floor or on resident’s clothing for example. After reoccurrence, measures were taken for the residents to be supervised when necessary, keeping in mind that the Wales Home’s objective is to maintain a high level of autonomy. I would like to take this opportunity to thank all the members of this committee and all employees for their remarkable effort to ensure the safety of the residents and employees. Nursing practices are changing to meet the needs of patients and families. The Wales Home will continue to research and implement best practices to make sure those changes happen safely.
Director of Health Services
Risk Management Indicators
One of the largest volunteer groups at the Wales Home is the Ladies’ Auxiliary.
There are 16 members, including the Executive Committee. The Auxiliary holds three meetings per year; in June, December and April. The main purpose of the Auxiliary is to raise funds through different activities, while allocating all revenues to various departments of the Wales Home, to the benefit of the residents.
One of the most prevalent activities that originated from the Ladies’ Auxiliary is the Friday afternoon tea. At present 16 tables decked with tablecloths and classic cups and saucers are set up in the living room each Friday afternoon with the exception of December, July and August. Different community groups serve home baked treats and many cups of hot tea. The residents enjoy music at some Friday teas and the living room is filled to capacity. This is also done five times a year in the infirmary at Christmas time, Valentines, Easter, in the strawberry season and in the fall. The Ladies will go to Norton one, two and three, as well as Central and often there is music involved. Monthly birthday parties are also organized by community groups and/or the Ladies’ Auxiliary on the third Wednesday of each month. This equally involves baking and tea, plus birthday gifts and games.
The Auxiliary oversees the hospitality Tuck Shop, which is open from 1:00 to 2:30 p.m. on Tuesdays and Fridays. Schedules are made and handed out to volunteers who are interested to take a turn in the shop. The stocking of the Tuck Shop is done frequently by purchasing outside what is needed. The Shop makes a profit of about $2600.00, which includes tax rebates amounting to $470.67 this year. All profits are eventually returned to the benefit of the residents.
Another of the Ladies’ Auxiliary activities is the Christmas shopping for residents of each floor and apartments. $1100.00 is allocated from Auxiliary funds to help defray some of the expenses. With help from volunteers, the shopping for this event starts as early as October.
Our main fundraiser is our May Bazaar. Three weeks prior to the date of the Bazaar, the living room fills up with all sorts of donated articles for the silent auction. We are very happy to report that $11,803.85. was raised this May. The total amount raised for this fiscal year, which ends March 31, 2019, totalled $14,687.40 (see details below).
At the annual meeting in June, the Auxiliary decides how the funds raised should be spent to produce the greatest benefit for the Wales Home residents. In the past book year, $5000 paid towards medical equipment expenses, $6000 to the activities coordinator to help organize entertainment for the residents and $3,163.36 for two propane gas BBQ’s to be used for residents, employees and visitors.
These are the big expenses. Some of the smaller items the Auxiliary pays for include the flowers hanging by door #6 and Auxiliary Bake sale raised $287.55 extra money for the Zoo Therapy.
All of this is possible because of the dedication of our members and members of their family and friends, and many community volunteers. Anyone is welcome to join our group. Just call the Wales Home or the activity coordinator Carol-Ann.
Jane Carson, Treasurer