Panel appointed to improve long-term care in N.S. after woman's death

Nova Scotia's health minister has appointed an expert advisory panel to find ways to improve long-term care in the province, a move that comes following the recent death of a woman whose infected bedsore went untreated.

Randy Delorey has tapped Janice Keefe, chair of the Nova Scotia Centre on Aging; Dr. Greg Archibald, a family doctor, wound-care expert and Dalhousie University professor; and Cheryl Smith, a nurse practitioner with an education focus on dementia care.

The minister told reporters Wednesday in Halifax the three were selected based on their backgrounds as well as consultation with people connected to long-term care.

"I think they strike a very good balance and will work well together."

The group has been asked to report back to the minister with recommendations by Nov. 30. According to a government news release, their work is to include:

• Identifying evidence-based solutions to improve quality of care in long-term care facilities.
• Recommending appropriate staffing levels, staff complement and skill mix for long-term care facilities.
• Advising on the recruitment and retention of long-term care staff.

Beds not a consideration

That process is to include a focus on proper wound care, patient and worker safety, and the appropriate care and protection of vulnerable people.

One thing not on the list for the panel to consider is the number of long-term care beds in the province. The Liberal government has not opened any new beds since coming to power in 2013, although new beds were recently announced for the Cape Breton Regional Municipality.

Delorey said the focus of the panel's work is "the quality of care … irrespective of the number of beds within the system" and that recommendations should be "research based."

"This is a focus on quality of care, which is something that would apply regardless the number of beds in the system," he said.

"I've asked them [for] a fairly detailed list of important recommendations to come forward with a relatively short time period to perform that work."

The minister said the number of beds is an important and "very complex" question and one his department continues to work on.

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NDP Leader Gary Burrill said that makes no sense.

"I cannot see how the question of the adequacy and competence and quality of care in Nova Scotia can be addressed without addressing the fact that 20 per cent of the hospital spaces in the province are filled not at the moment with hospital patients but with long-term care residents waiting for a place that isn't there for them." 

Burrill's party plans to introduce legislation when Province House resumes sitting later this week that would call for mandated patient-staff ratios. The announcement of the panel doesn't change those plans, he said.

"There is solid research indicating that when you have legislated minimum standards for care in long-term care facilities, you have fewer problems."

'Serious flaw' in panel's focus

Tory health critic Eddie Orrell called it a "serious flaw" for Delorey to not ask the panel to consider the number of beds. He said it's clear there aren't enough.

"We can see that by the number of people who are waiting in hospital or at home [for a long-term care space]."

Orrell said he hopes the government implements whatever the panel recommends as quickly as possible.

The state of care at long-term sites in the province has been in the news the last few months following the death of Chrissy Dunnington after a severe infection related to a gaping bedsore on her backside. The case prompted police involvement.

At the time, Delorey pledged to improve the situation and ordered a provincewide inventory of residents with pressure wounds or bedsores. He said regular updates on those numbers and site inspection reports would eventually become public.

On Wednesday, Delorey could not say when that public reporting would begin.

Delorey said the issues with wound care are part of what's driving the work of the panel, but so is improving the work environment in long-term care sites and the safety of both staff and residents.