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Deadly outbreak at Roberta Place illustrates widespread problems in long-term care: union

'There has been a staffing shortage in long-term care for many years, despite the constant efforts to change that,' says official

The union representing more than 100 staff at Roberta Place says the issues being seen at the Barrie long-term care home aren't new and are only now being highlighted because of the pandemic and the deadly outbreak at the south-end facility. 

Health Care and Service Workers Union Local 304, which is affiliated with the Christian Labour Association of Canada (CLAC), has 115 members, consisting of personal support workers (PSWs), registered practical nurses (RPNs), and other program staff. 

The union is publicly expressing its concern for the staff and residents of the Roberta Place long-term care home since a variant of the COVID-19 virus was discovered in the Barrie home last week. The variant has since been identified as the UK variant known as B.1.1.7.

Roberta Place is the first long-term care home in Canada known to have the variant, which local health officials have said has proven to be highly contagious and more easily transmitted.

As of Tuesday afternoon, 46 Roberta Place residents have died during the outbreak, which was declared Jan. 8 by the Simcoe Muskoka District Health Unit. An essential caregiver associated with the facility has also succumbed to the virus, bringing the overall death toll to 47 people linked to Roberta Place. 

The long-term care home has also seen 127 positive cases among residents — which is all but two people residing there.

Additionally, there have been 82 positive tests among staff/team members, three external partners and three essential caregivers.

CLAC Ontario director Ian DeWaard says he is worried for the health of all involved, but added this ongoing crisis was foreseen in the long-term care sector. 

“Of course we, like everyone else, are very concerned. There has been a staffing shortage in long-term care for many years, despite the constant efforts to change that,” said DeWaard.

“The issue has only come to the forefront because of COVID-19," he added. "It has been there far too long.”

Under-staffing in the industry has led to an average of approximately 2.75 hours of daily care per resident. That number is not nearly enough, according to DeWaard, and he believes wage suppression and caps have been a large part of the problem.

“Wages have actually declined due to the caps and the cost of living combined together,” DeWaard said. “Health-care workers do their job from a passion to help, but they need to be appropriately compensated. In that, I hold the government accountable and significant changes to the funding need to be implemented.

"Government needs to see what happened here and fix it," he added. 

DeWaard says 30,000 new workers are needed for Ontario’s long-term care industry, a number he points out was needed before the pandemic began last March. 

“We need to hire more staff for homes, that is clear. But we can’t attract more workers on the salary we have; it's just just not something people would be able to live off,” he said.

Starting rates for most long-term care staff is $18 to $19 an hour, and those rates progress to $20 or $21 an hour. Registered practical nurses, or RPNs, can earn more.

DeWaard says the province has temporarily increased wages for PSWs, the most populous classification, by $3 from October 2020 until March 2021, but not for any other class. 

“CLAC has asked that this wage adjustment be made permanent, and that there be corresponding adjustments to the other classifications, such as RPNs, aids and program staff, that work in long-term care,” he said.

When the pandemic began, the provincial government instituted a rule that no long-term care workers could work in other homes in an effort to contain any movement of the virus from one facility to another. 

The halting of crossover staff was the right thing to do, DeWaard said, but again shows how depleted homes are for staff.

“Absolutely, I understand that we can’t have staff going home to home. I think everyone gets that. But those staff would do that for the part-time work to help with pay and homes needed extra staff,” he said.

“It's right there in front of us. The need to hire more people can’t be any clearer.”

Since December 2014, Roberta Place staff have been represented by Health Care and Service Workers Union, CLAC Local 304.

DeWaard said there's never been a time like this and he hopes for the best for all involved.

“Roberta Place currently has 60 per cent of their staff at home sick,” he said. “I understand that the Red Cross has helped, and that is good news, but we’ve never seen anything like this before. It is certainly an unprecedented event.”

A Roberta Place worker who is now at home recovering after contracting the virus described their personal experience with the virus as being “like the flu on steroids.”

“At one point, my lower body was in immense pain," the worker, who requested anonymity, said. "I lost my sense of smell and taste and knew before my tests came back that I had it. I’m feeling a little better now, but it was really rough.”

The worker described the scene inside the home the last time they worked, which was just before the Red Cross came in to assist.

“We had managers and supervisors who were testing positive and so they were gone to isolate, but then some were working close to 24 hours and exhausted,” the worker said. “People were close to nervous breakdowns. It was absolutely chaotic in there, but everyone is doing what they can.”

The worker also commented on a ministry report that says Jarlette Health Services, which operates the facility, “has failed to ensure that the home was a safe and secure environment for its residents.”

The ministry inspection noted violations that could have led to further spread of the virus, such as residents leaving their rooms and wandering the halls, sometimes going into other rooms. Some staff were also providing care to both confirmed COVID-positive residents and residents not confirmed to have the virus.

“That is accurate, yes. We were all freaking out about it. It was impossible to stop,” the worker said. “We would have people all in their rooms like we’re supposed to, but you can’t watch them 24 hours a day and you are not allowed to lock their doors. You’re not even allowed to lock their wheels on their wheelchairs. It's a violation of their rights.”

While the worker understands not locking residents in their rooms can work at times, during the deadly outbreak there should have been some change in the rule.

“COVID-positive patients should have been locked in their rooms for their safety and the safety of others. The liberty has gone too far the other way,” they said. “People with dementia wander. It's what they do and we try to help, but we’re understaffed and in a crisis.”

The worker would've liked to have seen the military brought in to act as extra hands for wandering patients, but also says that just means more people could also become infected.

On Tuesday, Simcoe-Muskoka medical officer of health Dr. Charles Gardner said he understands the difficult situation Roberta Place staff are in. 

“It moved very fast and that speaks to the nature of the UK variant," the doctor said. "That made it difficult for the home to set up the cohorting that is required."

However, Gardner conceded it is "extraordinarily difficult" to put those measures in place. 

"Also, patients with dementia tend to wander a great deal and that can make it difficult to control even under the best of circumstances," he said. 

Cohorting is the grouping of residents based on their risk of infection or whether they have tested positive for COVID-19 during an outbreak. 

Jarlette Health Services president David Jarlette recently acknowledged staffing levels had been a concern, describing the Roberta Place situation as "tenuous." On Saturday, Jarlette further addressed the issue of cohorting, saying the virus came into the long-term care home so quickly they weren't able to achieve cohorting "in a quick and timely fashion."

As the number of fatalities linked to the Roberta Place outbreak has now reached 46 people, the worker said they had a personal connection and was there for two of the deaths. 

“I’ll never get that out of my head,” the worker said. “I spoke with her in the morning and she was fine. We had all been concerned for her, as she had some respiratory issues. I checked in a couple hours later and she was near choking, she couldn’t breathe."

The worker called for a nurse and they put a breathing mask on the woman and sat her up. They asked the resident if she wanted to go to the hospital and she said no. She had a do-not-resuscitate order.

"At this point, I just wanted to make her comfortable,” said the worker. “Her family was called, but she was turning blue. Her hands went purple. She was always such a lovely woman. I told we were here for her and she just whispered, ‘Thank you, dear.’

"Shortly after that, she was gone.”

The worker acknowledges Jarlette Health Services has been getting a bad rap from people outside the facility, but they say it's unwarranted. 

“Of all the places I have been, they treat their residents the best. Even families I speak to say the same thing,” the worker said. "Nobody was ready for this and, despite the chaos happening, we are doing all we can.”