CHSLD Wales Inc.
ANNUAL REPORT 2018-2019
ANNUAL REPORT OF THE
THE CHSLD WALES INC.
For the Fiscal Year
April 1, 2018 to March 31, 2019
ANNUAL GENEREAL MEETING HELD JUNE 27, 2019
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 the potential of each resident.
The CHSLD objective is 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, 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, The CHSLD Wales Inc. is a place where residents and family members are provided with compassionate care and support. Our Government is on a journey where our stakeholders and partners have committed to improve the quality of health care in our long-term care facilities province wide.
The information in this year’s Annual Report to the community are inspired by those we serve and those who serve, and by the compassion and care that make up the CHSLD Wales Inc. It was a busy year that included major renovations to the Norton wing as well as adapting to a partnership with the CIUSSS de l’Estrie CHUS for the rental of all our long-term beds. It’s still not perfect, but we believe we have made great progress and feel confident that soon, our need for friendly reminders will be a thing of the past.
I am pleased to report we continued to experience strong growth in the 2018-2019 fiscal year as we completed the second year of our Five-Year Strategic Plan. Our focus is on meeting the increasing demands for dementia and long-term clientele including; tailoring care and services to meet the increasing dementia clientele, improving milieu de vie for long-term care residents, becoming an employer of choice and ensuring clinical excellence. Providing superb and responsible customer service has been crucial to the success of this plan. The achievements of the CHSLD Wales Inc. can be attributed to the extremely talented members of our team who impress me every day with their insights and drive to achieve results for our residents.
We are thankful to our volunteer board members for their wisdom in helping to steer the direction of the organization. It is with considerable regret that I must acknowledge the departure of two of our board members, Peter O’Donnell and Susan Mastine. We thank them their years of dedication and insight. I am pleased that we brought on board three new members; Caroline Leonard, Yves Ferron and Norma Husk. We thank them for their commitment and welcome their sharing of expertise.
In closing I would like to thank our staff and Dr. Frazer for all that you do. Thank you to our community – our residents, family caregivers, partners, and the Wales Home Foundation and its donors – for your continued and committed support. To all, thank you for your active participation and engagement. We look forward to the year ahead where we will be planning our journey to
serve those who come to us in need.
Report from the Executive Director
Members of the Corporation, ladies and gentlemen, On behalf of the CHSLD Wales Inc. I am pleased to share with you the CHSLD Wales Inc. 2018-19 Annual Report. After a busy and successful year of learning and growth, we continue to look for ways to provide solutions that transform our local health care system by ensuring families that their loved ones receive the right care, at the right time in the right place. We have remained true to our mission and vision by taking a lead role in health care transformation and having a strong influence in the CHSLD community. Our incredible staff is what makes it possible to influence change and provide the best possible care for our residents and their families.
I am proud to announce that the Wales Home/CHSLD Wales Inc. received two outstanding recognitions 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 achievements bring the Wales Home’s total to 15 prestigious awards won 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 CHSLD Wales Inc. processed its annual satisfaction survey and the results appear satisfactory.
To make life interesting, the Government legalized recreational cannabis which meant that all organizations including ours, had to adapt their drug and alcohol policies. The Board of Directors authorized the use of cannabis for residents in the CHSLD smoke room 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 provide 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, exciters have been installed 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 existing server. The servers are independent of each other and 100% redundant. This will increase our systems reliability.
On January 1st, 2019, the new RAMQ rates for CHSLD beds were as follows:
Private room: $1910.40
Semi- private: $1596
The government also increased the personal allowance for each resident to $245 per month.
At the end of each fiscal year the CIUSSS does an analysis of the payment which is given to the CHSLD Wales Inc. to determine if we have been over or under paid according to the criteria stipulated in our contract. The CHSLD Wales receives a fixed monthly renumeration regardless of its occupancy. For the fiscal year ending March 31st, 2018, the CHSLD Wales Inc. owed the CIUSSS an outstanding balance of $66,711.97. As this was our first year end with our contract, the calculations were a little more complicated as the CIUSSS accepted to pay for the exonerations of the residents who do not pay their full rent and the professional salaries of our social worker and activity coordinator were not included in the calculations, therefore the outstanding balance was reduced from $113,628.42 to $66, 711.97.
For the fiscal year ending March 31st, 2019, the CHSLD Wales Inc. has an outstanding balance owed to the CIUSSS in the amount of $28,203.00. This year, the CIUSSS refused to reimburse the exonerations of residents who do not pay their full rent as it is not included in our contract, had this been the case the CIUSSS would have owed the CHSLD Wales Inc. over $12, 000.
We are now in our fifth and final year of our 2015-20 Accreditation with the CQA. We will soon prepare for our new five-year plan – we hope that our new process is as successful as our past. As we prepare for the future needs of our aging population, the government granted our request to increase our CHSLD permit from 85 to 96 beds. The next step is to have the CIUSSS include funding for the additional beds in our current contract. We feel that the request will be positive as there is a long wait list for long term beds in the Estrie.
I would like to acknowledge the many dedicated volunteers including our Ladies Auxiliary, Board members, Pastoral providers, members of numerous committees including Planetree, User’s and Living Environment which help make our CHSLD great! Our Committees provide our residents and family members with a platform to discuss and resolve issues that arise from the resident’s perspective. It is vital that residents and their family members voice their ideas, opinions and concerns with the goal of improving the patient experience at CHSLD Wales Inc.
On behalf of the Board of Directors, I would like to sincerely thank the employees who care for our residents with respect and compassion every day. I would also like to acknowledge the dedication and hard work of the management team, the continued support of the Foundation and the commitment of Dr. Frazer and our volunteers.
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 Buildings 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 triple-glazed 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-ofhouse 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 handicapped-accessible 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
CHSLD Residents' Profile 2018-2019
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 care.
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
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. Considering the CHSLD Wales provides public renumeration, recruitment and retention proved to be more demanding than we anticipated. The board approved an increase in shift premiums to $1/hour for evening and $2/hour
for night shift.
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.
Members of the Corporation, Ladies and Gentlemen, The past fiscal year has been one of continuous improvement in terms of quality of care and services in order to ensure the comfort, the 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 personal 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 unregular, having sometimes five to six employees covering one full time position, and the working hours very variable, causing lots of 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, residents and employees. We wanted to be overstaffed for the summer 2019 and make sure all employees would be replaced on 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 position 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, insuring 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 Caregiver and a full-time LPN on evenings on Norton 1, as well as a full-time replacement for Head Nurses and Supervisors. The process has been longer then 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 established.
In-Home training of a Caregiver
After our presence to the Salon Priorité emploi 2019 in March, we were staffed enough to try the in-home training of a Caregiver. We have met a future LPN student that wanted to start working as a Caregiver while waiting to start their course. That person showed a high level of compassion and a profound desire to work with the elderly and we knew their values would fit the Wales. After completing their PDSB course in a private school, the person was paired with a regular Caregiver with the exact schedule for a period of five weeks. The process was a complete success as we had the perfect match. The employee even applied on a regular position that was granted to them just lately.
At the Wales Home, we are always looking forward to receiving 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 time.
As every year, Edith Bourassa, physical rehabilitation therapist, supervised a rehabilitation stage for six first-year 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 parts. 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 years old student spent their summer with the activity department and helped getting residents outside among all other contributions. From September through 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.
In September, the CHSLD Wales Inc. welcomed a total of 9 caregiving students from the Lennoxville Vocational Training Center (LVTC) for a period of 5 weeks where they experienced all shifts routines, on days, evenings and nights. They accepted to be paired on a night shift since this is what awaits them at the end of their classes. They enjoyed the teamwork of the employees at the CHSLD Wales and were grateful to see the reality on all different shifts.
During winter, Champlain College came for a stage with six first-year nursing students. They were mostly on Norton 3 as basic care and communication with residents are the biggest objectives during the first year of nursing.
Among all those stages, we also gave regular tours to first year students of different schools 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 had 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 evaluation. 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 Alain updated all the resident’s file and we had the chance to update their work documents and tools prior the visit to fit better their Professional Order’s requirements. The results of the evaluation were very positive, and he 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, accompany them to appointments and participate or conduct activities that occurs throughout the day.
In September 2018, the Activity Department received the award Loisirs et Qualité de Vie from the Fédération Québécise des Loisirs en Institution (FQLI) in recognition of the activities provided to the residents. All employees of the CHSLD Wales inc. 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 price 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 resident’s 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.
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 proceed 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 music 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 pastoral and spiritual-care worker to make 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 CHSLD Wales Inc., it’s an 82% vaccination rate. The 18% refusal rate were coming from either residents or their family members for different personal reasons. During winter, we ended up having two Quarantine in the CHSLD but none with confirmed influenza cases. The first Quarantine was on Norton 1. After a fast increase of infected residents with flu symptoms and two hospitalisations with deaths, the Santé Publique did an investigation of those two files after the Director’s of Health Services request. Both residents were infected with a Bacteria that cause Pneumonia. The residents with ongoing symptoms were tested and treated with antibiotics. The Pneumovax vaccine, a once in a lifetime shot protecting against that Bacteria, was offered again to all residents who didn’t received it in the past. The Quarantine was efficient as the Bacteria did not spread on other floors. Later that winter, Norton 2 was on a preventive Quarantine, but for a shorter period and with lighter flu symptoms that passed progressively.
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 the 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.
A stretcher was purchased with the contribution of the Ladies Auxiliary to cover the CHSLD Wales needs. One was already available on the residential side but too far in case of emergencies on Norton wings. The stretcher is available for use but remains in the DHS’s office until the renovations are done to prevent congestion of the living environment.
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 loaning them to the CHSLD Wales Inc. He fortunately accepted to renew them this year and to loan 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 staff 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 devotion. Each and everyone are the foundation for success of the Wales Home and the well-being of all the residents.
Director of Health Services
Risk Management Committee Report
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 incidentsaccidents, ensured that support measures were provided to victims and relatives, and the incidents and recommends 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.
Numbers of required quarantines were lower in the CHSLD with only 2 compared to 3 last fiscal year.
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 on CHSLD Wales inc.: 436 falls for the fiscal year compared to 300 in 2017-2018. However, it is mostly associated with specific residents having a high reoccurrence of falls, increasing the statistics, and 81.4% of the falls (355 out of 436) had non associated injuries. Only 7 falls required a visit to the Hospital for an evaluation, 2 happened to have a fracture, 99 had cuts, bruises, etc. and 21 ended up with pain but no marks.
The results are also reflecting the CHSLD Wales as being a restraint free environment. 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.
Medication errors lightly decreased: 314 errors in the CHSLD compared to 349 last year. Omissions represented 49.4% of the errors (155 out of 314,) mostly of pills found by the care providers, whether on floor or on resident’s clothing for example. Most of these omissions occurred on Norton 1 in the CHSLD, where there is a high level of dementia. After reoccurrence, measures were taken for the residents to be supervised when necessary, keeping in mind that the Wales Home 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.
Vicky Gingras, Director of Health Services
Risk Management Indicators
Restraint Average: 3% of CHSLD residents used a restraint.
Vigilance and Quality Assurance Committee Report
Members of the Corporation, Ladies and Gentlemen, The mandate of the Vigilance Committee is to ensure the quality of services and respect of individual and collective rights. The Vigilance Committee has the responsibility to ensure the follow up of the recommendations from the Complaints and Quality of Services Commissioner. The committee also ensures that the Board of Directors adequately carries out its responsibilities in regards to service quality, respect of users’ rights, and the prompt treatment of complaints.
Since the last annual general meeting, we met five times: May, August, October, December 2017, and February 2018. At each meeting, members received reports from the Risk Management Committee and the Complaints and Quality of Services Commissioner. Members reviewed dissatisfactions, and any new regulations or recommendations pertaining to Accreditation and Certification requirements. Every dissatisfaction was reported, action was taken and was solved. We assumed that is probably why there are almost no real complaints reported. Chantal Lessard, the Complaints Commissioner, did not need to attend the meetings and ask Brendalee Piironen to give report for her. No real complaints were reported over those five meeting. The Director of Health Services gave us complete reports related to the risk management committee. Topics of discussions included the activity tracker tool which encourages everyone to be involved in ensuring residents stay active, complimentary therapies, brochures have been created and information is available on the computer in the library. The Director of Health Services updated members on the NOLIDA project - No One Lives or Dies Alone. Report was given on number of infections that has been decreasing over the past 2 years, namely due to the washing of hands of all residents living in the CHSLD before and after meals and the availability of hand sanitizer outside of the residential dining room prior and during flu season. All projects and topics were all meant to increase the wellness of the clientele.
Results of the 2018 satisfaction surveys were shared with the committee members.
At the risk of repeating myself, I truly appreciate having Mrs. Armstrong, Mrs. Wilson and Mrs. Fortier on our committee. I want to thank my fellow committee members for their support and express my appreciation to each of you.
Louis-Marie Decoste, Chairman
Users’ Committee Report
Ladies and Gentlemen, Members of the Corporation, In compliance with section 209 of the Act Respecting Health and Social Services (Article 209, LSSSS), the Users’ Committee was created to defend the collective rights and interests of the CHSLD Wales Inc. and Résidence Wales Home’s residents. This report encompasses the fiscal year ending March 31st, 2019, and identifies the measures taken by the Users’ Committee to fulfill its role assigned by the Act.
The Users’ Committee held eleven meetings during the year ending March 31st, 2019. The gatherings were attended by the Committee’s eight members and invited guests, including the Executive Director, the Activity Coordinator, and the Human Resource Coordinator. The meetings’ goals were to promote residents’ rights and improve the quality of services and security. At each meeting, members communicated dissatisfactions that were brought to their attention and solutions were discussed at the subsequent conference.
In June, the Committee moved to shorten the Satisfaction Survey to two back-to-back pages to simplify analysis and improve response rates. The evaluation questions would be based on the ten Planetree components. Members also chose to enlarge the font and add an additional sheet for general comments. The results indicate residents are pleased with the care and services received despite the obstacles posed by renovations, and especially commend Food Service employees for their continuous good work.
In October, the Committee organized a comedy show on users’ rights in collaboration with the Activity Department. This event was enjoyed by all last year as well and was thus a repeat success.
Irene Decoteau and Charles Goodfellow resigned from the Committee; the Committee wishes to thank them for their service and support.
In December, the Committee voted against practice evacuations wherein residents must exit the building. Instead, all CIUSSS-mandated routine evacuations will be done by crossing two fire doors.
This arrangement poses less risk for residents, as going outside increases the chance of falls and traffic issues.
The Users’ Committee’s roles, responsibilities, and mandate were published twice per year in the resident newsletter, the Chatter, a physical copy of which is distributed to all users. The Chatter is also sent electronically to many family members. Twice per year, during the Resident/Family meetings, the members of the Users’ Committee were introduced to all in attendance. Once again, the Committee’s mandate, responsibilities and user’s rights were discussed.
The Committee acknowledges each member’s great work; together, the representatives make a difference in CHSLD Wales Inc. and Résidence Wales Home residents’ lives.
Complaint and Quality Commissioner Report
The goal of the complaint examination system is to improve the quality of services while ensuring respect for Users’ rights. To reach this goal, residents must foremost understand their rights and recognize the circumstances of real life situations that might have an impact on their rights. These are the reasons underlying the importance of explaining Users’ rights as outlined in the Act on Health services and Social services.
The goal is to increase awareness about individual rights. Consequently, this awareness may increase the number of complaints filed; however, the impact anticipated also depends on the quality of services already delivered in an establishment and the staff’s commitment to respect residents’ rights. At the Wales Home, quality of services and respect for residents are part of everyday life.
People don’t only have rights; they also have responsibilities. They are responsible for sharing the information with others and making all the necessary efforts to respect these rights for others in a shared commitment. This is the only way to protect individual rights, respect for oneself and others and improve the quality of living.
This year’s report is divided into two chapters. The first one explains the mandate of the service quality and complaints commissioner and briefly describes the complaint examination procedure. Chapter two presents the activity report on the examination.
In this document, the use of the professional title Service Quality and Complaints Commissioner also applies to the title of Assistant Services Quality and Complaints Commissioner.
MANDATE OF THE SERVICE QUALITY AND COMPLAINT COMMISSIONER
The Commissioner reports to the Board of Directors of the CHSLD Wales Inc. and is the only person with the mandate to apply the complaint examination procedure. The Board of Directors must preserve the Commissioner’s independence in the exercise of his duties.
The Commissioner has the mandate to investigate complaints from Users of the CHSLD Wales or from their legal representative. The Commissioner also has the power to intervene when Users’ rights are not respected.
Complaints from private residences are under the responsibility of the Bureau des plaintes et de la qualité des services of The Centre intégré universitaire de santé et de services sociaux de l’Estrie-CHUS. At the heart of the mandate, the Commissioner investigates complaints or reported situations having an impact on Users’ rights, answers questions about the complaint examination system or provides assistance and consultations as required. A definition of each category is presented below.
The responsibilities of the Commissioner also include other activities such as:
- Application of the complaint examination system and ensuring communication with the Vigilance Committee;
- Promotion of the complaint examination system;
- Promotion of the independence of the Commissioner’s role;
- Promotion of the Code of Ethics of the Wales Home;
- Recording and publishing an annual report.
Power of intervention
The complaint examination system allows the Commissioner to investigate any situation in which User’s rights are not respected. This power of intervention may occur in one of two ways:
- Report: A person, other than a User or representative who reveals a situation that may disregard the rights of a User or of a group of persons
- Own initiative: The Commissioner may decide to investigate when they a situation may cause prejudice to a person or a group of persons without receiving a verbal or written report
INVESTIGATION OF A COMPLAINT OR AN INTERVENTION
1. First level
• registers all complaints from residents/Users or family members and can assist to file a complaint;
• examines all pertinent facts to better understand the problem;
• intervenes in the most appropriate manner and without delay when informed that a resident/User is subject to reprisal of any sort;
• informs the person making a complaint of the results of the analysis of the situation. Conclusions are explained to the persons concerned that may be accompanied by recommendations.
A complaint concerning a professional practicing in an institution, bound by a service agreement, will be transferred by the service quality and complaint commissioner to the medical examiner. Such professionals are: a physician; a dentist; a pharmacist, or a medical resident.
Private practices of physicians, dentists or pharmacists are not covered by the complaint examination system. Consequently, the Wales Home is not under the obligation to designate a medical examiner since the physician and the dentist give services on a private basis. Should a complaint be addressed towards the physician or the dentist, it would be transferred to their respective association (Collège des médecins du Québec or Ordre des dentistes du Québec).
2. Second level
The complaint examination system allows a person, who is dissatisfied with the Commissioner’s conclusions (first level), following the investigation of the complaint or after the 45 days delay stipulated in the Act, to complain to the Public Protector.
Complete or incomplete investigations
The investigation of a complaint or intervention may be incomplete due to different reasons such as:
• Abandoned or ceased by the User
• Refused or rejected after a summary investigation
When investigations are completed, corrective or improvement measures may be recommended.
Individual or systemic measures
Individual measures allow the correction or improvement of a situation concerning a person who is dissatisfied. Systemic measures allow the improvement of the quality of services on different aspects of the organization having an impact on all users.
Concluded or closed files
A file is “concluded” when the conclusions are transmitted to the person registering a complaint. A complaint must be concluded within a delay of 45 days, as stipulated in the Act. A file is closed when the corrective measures or recommendations are implemented.
The following section presents the Commissioner’s activities on the application of the complaint examination system.
COMPLAINTS AND INTERVENTIONS – OVERVIEW
Complaints and interventions represent the motives of dissatisfaction regarding the services received or expected by the clientele. Each file can contain more than one motive of dissatisfaction. Therefore, the number of motives to investigate is equal or higher than the number of files.
As shown in table 1, there was one official complaint and no intervention files opened in 2018-2019.
TYPES OF MEASURES RECOMMENDED
Recommendations may allow for individual or systemic corrective measures.
For the year 2018-2019, as indicated in the table 2, the complaint did not generate any recommendation or action.
ASSISTANCE AND CONSULTATION
There was no assistance request in 2018-2019.
As shown in Table 3, the activity in 2018-2019 was to present the 2017-2018 annual report at the Annual general meeting.
Bill 115 — an Act to fight maltreatment of seniors and other persons of full age in vulnerable situations was implemented on May 30, 2017. The goal of this law is to better protect older people and their families against abuse including facilitating reporting of abuse and implementing a national framework agreement to fight against abuse. The law states that every seniors’ home in the province, both public and private are required to adopt and implement a policy to fight elder abuse. Under Bill 115, all healthcare providers and professionals have an obligation to report abuse and would be protected against reprisals and granted immunity from proceedings after making a report in good faith to the Quality of Services and Complaints Commissioner. Lastly, this law regulates the use by a user or his representative of surveillance mechanisms, such as a camera, in long-term care facilities. In 2016, The CHSLD Wales Inc. adopted a policy on elder abuse.