While all eyes were turned to the CHSLD, 11 intermediate resources of quebec, these facilities receiving patients more autonomous, were each more than a dozen of the dead from the COVID-19 in the walls, reveals a compilation done by our Office of investigation.
The Pavilion Marie-Victorin, an intermediary resource (IR) located in Longueuil, has almost had as many cases (31) that it has beds (37) since the beginning of the crisis, as well as 10 deaths. Thirteen employees have also been achieved. In Sainte-Adèle, Home Wilfrid Grignon, which has 75 seats, has recorded 68 cases and 13 deaths. Sixteen employees are also sick.
And this is just the tip of the iceberg since it is impossible to obtain statistics on the RI of less than 15 residents for privacy reasons, according to the ministry of Health.
Our Office of investigation had to address to each of the 22 CISSS and CIUSSS of Quebec to get their data, because the ministry has not revealed any precise statistics on the number of cases or deaths in RI, unlike NURSING homes or private residences for seniors.
More than 60% of the residents of Heritage, Plateau, Montreal, have caught the COVID-19.
We also discovered that no clear rule only governs the inspections in RI, and that no inspection report is not available. Each CISSS is free to do as it wants.
Result : the inspections are unequal to the scale of Québec, as well as the quality of services, recognizes the department.
According to the data compiled, of the RI are inspected thoroughly five times per year. But in other regions, there has never visit formal. We then count on the employees to report problematic cases.
The Council for the protection of patients (CPM) urges the government to establish standards. A former leader of an intermediate resource sounds as the alarm.
“There must be inspections, but there should also be follow-up recommendations. It is necessary to draw the ear of those who do not follow them, threaten them with loss of their licenses “, said the spokesman of CMP, Paul G. Brunet.
Almost all of the 37 residents were infected at the Pavillon Marie-Victorin, Longueuil. More than a quarter have died.
It is necessary to act
Currently, the department conducts visits to RI only to evaluate the work of the CISSS, in particular, to see how they apply to government programs.
Experts in the field of health believe that it is necessary to act to avoid that intermediate resources are the blind spot of the healthcare system.
“How can managers make informed decisions without having evidence ?” asks Pierre-Luc Fournier, a professor at the University of Sherbrooke and a specialist in operations management in the health sector.
“I’m not certain that it is the right thing [to do that] to rely on the employees to report situations,” says Roxane Borgès Da Silva, professor at the School of public health of the University of Montreal.
A director resigns
The coordinator of an intermediate resource in the Laurentians has slammed the door in full pandemic, blaming the Centre for integrated health and social services (CISSS) to have failed to intervene to stop the contagion within the residence.
For Marjorie Ouimet, it is clear that the CISSS of the Laurentians has failed in his duty to the House, Wilfrid Grignon, Sainte-Adèle.
This intermediate resource, which houses 75 residents, hit the headlines several times because of the speed of the outbreak of COVID-19.
In April, a dozen employees of the CISSS have been called in reinforcement and the union representing them has warned that the unsanitary conditions in places. The mayor of Sainte-Adèle, Nadine Briere, has also denounced the lack of information communicated by the CISSS.
Ms. Ouimet, a nurse auxiliary, was in charge of the House Wilfrid Grignon from mid-march to mid-April. She claims to have found several shortcomings in his arrival.
“There was not even a fire safety plan,” she said. Also, the residence should have never been inspected by the CISSS, Ms. Ouimet.
The straw that broke the camel’s back occurred on 9 April when a resident is suspected of suffering from the COVID-19 refused to be placed in isolation.
Too late for intervention
Marjorie Ouimet has contacted the CISSS, responsible for the medical component of the residence, to know what to do and ask for the intervention of a social worker.
The CISSS would have said to forget about the isolation for the moment and let the resident badass in his room until the next day, to the care of the orderlies.
“You can’t get rid of the case just because he’s made 19 h or 20 h, and that all the world is a party […] They didn’t want to move, or have to do an intervention,” said Ms. Ouimet.
Ms. Ouimet has handed in his resignation the next day.
“I didn’t want to go into combat against the CISSS. I’m never going to win against them. I preferred to remove it. ”
For its part, the CISSS Laurentides, indicated that it did not want to comment on ” the departure of an employee who had no employment relationship with the CISSS of the Laurentians “.
From one extreme to the other
The latitude given to health facilities for follow-up of RI ensures that some are inspected once every three years, and the other, three times per year. Here are a few examples :
- The CISSS of the Laurentians said to rely on its own staff working in intermediate resources (RI) to ” identify as the problems and the differences of quality in order to be able to adjust “.
- In contrast, the stakeholders in the CIUSSS of the Saguenay–Lac-Saint-Jean assess the quality of services of RI every 18 months.
- The CISSS de la Côte-Nord to proceed to the evaluation of the quality of the services every three years. The CIUSSS of the Mauricie and Centre-du-Québec, it is nine times more, or three times per year.
- There are four ways to make in Montreal. The CIUSSS of Centre-Ouest-de-l’île-de-Montréal, an inspection is performed twice a year, while in the CIUSSS du Centre-Sud-de-l’île-de-Montréal, one does not inspect, but we evaluate the quality of services continuously.
- Champion in all categories, the CISSS de la Gaspésie performs at least five inspection visits per year in each RI.
The provincial government admits that it is necessary to act
Quebec admit that the quality of services is variable in the intermediate resources of the province and would be better to frame them.
Commenting on the large differences in material inspection in the IRS, the department of Health and social Services has indicated that it is aware that the ministerial directives are applied ” unevenly “.
“This is the reason why a system of quality control has been developed by the MSSS, in collaboration with the University Laval, offering a structured process, valid and objective “, we had reported by e-mail.
A pilot project, with a duration of six months, was in progress in two health care facilities this winter and the aim was to define a model to implement in all the intermediate resources of the province.
The initiative, however, was suspended due to the pandemic of COVID-19.
The ABC of intermediate resources
What is it ?
A facility that hosts users who need less care than those in NURSING homes. The CISSS/CIUSSS oversees the medical aspect of the patients, while the RI takes care of the accommodation, food and basic care of the patient.
How much does a account there ?
We account 9628 to open a socket RI in Quebec that host different groups, such as older people (468), young people in difficulties (5653), persons with intellectual disabilities (2720), etc.
Are they affected by the COVID-19 ?
According to figures obtained last week, there would still be 37 walks of life, with at least one confirmed case among the residents.
The RI among the most affected
- Notre-Dame-de-la-Paix (110 beds) 51 cases, 15 deaths
- Place Lacordaire (153 seats) 24 cases, 14 deaths
- Legacy Tea (57 beds) of 35 cases, 13 deaths
- Lev-Tov (87 seats) 63 cases, 13 deaths
- The Pavilions LaSalle (183 residents) 38 cases, 12 deaths
- Sky blue (104 seats) 30 cases, 9 deaths
- Residence The Strings (93 seats) of 55 cases, 17 deaths
- Residence The Firefly (149 seats) 39 cases, 14 deaths
- Home Wilfrid Grignon (75 seats) 68 cases, 13 deaths
- Pavillon Marie-Victorin (37 seats) 31 cases, 10 deaths
- The Maison Dauphinelle (73 residents) 52 cases, 11 deaths
Methodology : We obtained the to-date figures on the number of cases and deaths in the intermediate resources of more than 15 people affected by the COVID-19 everywhere in Quebec. The statistics are the most recent, and dates mainly from the beginning of June.