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An Analysis of Long-Term Care Home Inspection Reports and Responsive Behaviours
Lorna de Witt1, Stephanie Jonsson2, Roger Reka3
1Faculty of Nursing, University of Windsor, 401 Sunset Avenue, Windsor, ON Canada.
Ageing International
|June 26, 2023
Summary
Long-term care regulation struggles to address resident-to-resident aggression. Current inspection reports inadequately document responsive behaviors, leading to insufficient enforcement actions and impacting resident safety.
Area of Science:
- Gerontology
- Health Services Research
- Public Policy
Background:
- Residential long-term care quality and safety are international concerns, often highlighted by media reports on resident aggression.
- Existing long-term care regulations and inspection standards are questioned in light of these incidents.
Purpose of the Study:
- To analyze documented incidents of responsive behaviors in Ontario long-term care homes using public inspection reports.
- To identify differences in documentation and enforcement between for-profit and not-for-profit facilities regarding responsive behaviors.
Main Methods:
- Participatory action research and document analysis of 535 Ontario long-term care home inspection reports (2016-2018).
- Development of a data collection and analysis tool for seven long-term care service areas.
- Descriptive statistical analysis of documented incidents and enforcement actions.
Main Results:
- Significant differences were found between for-profit and not-for-profit homes in documentation of responsive behaviors, complaint/incident proportions, and enforcement actions.
- Incidents related to responsive behaviors were often categorized under different legislative sections, obscuring direct regulatory oversight.
- The majority of enforcement actions lacked inspector follow-up, with only four penalties issued over three years for responsive behavior-related issues.
Conclusions:
- Current long-term care inspection and regulatory frameworks in Ontario do not adequately address or track responsive behaviors.
- Revising the inspection report judgment matrix to specifically address responsive behaviors is recommended.
- Improved regulatory connection to responsive behavior care management is crucial for enhancing resident safety and quality of care.
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