Ombudsman preparing to investigate conditions in Ontario's nursing homes

Ombudsman Andre Marin said his office has been doing a "pre-investigation" for the last three months to determine whether a full-blown probe is needed and he expects to make an announcement in the coming days.

"There is no doubt with an aging population and some of the horror stories and allegations you hear, the public needs to have confidence that these places are working properly and that the checks and balances that are there are actually doing their job," Marin said in an interview. "These are allegations that need to be assessed."

His decision comes in the wake of an investigation by The Canadian Press which found three-quarters of the province's nursing homes had been cited for failing to meet some of the government's 400 standards - a proportion that hasn't changed significantly since 2004 when then-health minister George Smitherman promised a "revolution" in the province's long-term care.

Inspection reports from April 2007 to March this year show some long-term care homes were cited repeatedly for failing to provide a minimum of two baths a week while inspectors found other residents didn't own a toothbrush.

At other homes, inspectors found residents with greasy, unkempt hair wallowing in soiled, "foul-smelling" diapers.

More than 60 per cent of the homes in Ontario were cited for violating the specific set of standards that ensure residents are well-fed, clean and free of pain, as well as dictating how homes care for incontinent residents and when they use restraints.

These figures just add "grist to the mill," Marin said.

"These are very serious allegations and they resonate with the kind of complaints that we've been hearing from people," said Marin, adding his office gets hundreds of complaints relating to hospitals and long-term care facilities each year.

"We've heard allegations that these people are condemned to live a life of neglect and humiliation . . . As shocking as they are, they're unfortunately not all that rare."

Unlike his counterparts in Alberta, Quebec, Newfoundland and Labrador, Nova Scotia and the Yukon, Marin doesn't have the power to directly investigate Ontario's publicly funded long-term care homes.

Although Marin and others have been pushing unsuccessfully for the Liberals to extend his jurisdiction to include long-term care homes, Marin said in the meantime he can look at whether the Liberal government is holding the homes to account.

"The public is really wondering," he said. "People have expectations and it's an area that has to have full public confidence in order to operate properly."

Alan Findlay, spokesman for new Health Minister David Caplan, said Caplan had no comment Thursday on the prospect of an investigation by the ombudsman and had nothing to add to his earlier commitment to transparency.

Caplan has said the ministry focuses on the most egregious infractions that effect resident care and ensures those are corrected quickly. And while the proportion of homes still having difficulty meeting the standards hasn't changed, Caplan said the number of violations across Ontario has been steadily dropping thanks to increased investigations.

"I'm still learning about the specifics of the files and all of the actions that have been taken," Caplan said in an interview Wednesday. "First and foremost, the focus of the Ministry of Health is on the circumstances that effect direct patient care."

Janet Lambert, executive director of the Ontario Long-Term Care Association, said it doesn't make much financial sense for the ombudsman's office to investigate nursing homes when he receives so few complaints about resident care.

"I don't think public confidence is enhanced with an ombudsman," she said. "I think public confidence is enhanced with folks who see what they see and know what they know in a long-term care home."

But critics say an ombudsman's investigation is just what's needed to kickstart the Liberal government into improving the conditions in long-term care homes.

Progressive Conservative Leader John Tory said it's "insane" that three-quarters of Ontario's homes failed to meet some of the province's standards of care long after the Liberals promised a "revolution."

"There is certainly no question that Che Guevara and Fidel Castro don't have to worry about their place in history as revolutionaries alongside George Smitherman," Progressive Conservative Leader John Tory said in an interview.

"The revolution never happened . . . This is insane. We're spending billions of dollars on this and we say there are people out there in large numbers who don't have a toothbrush? All this stuff was the same stuff that was being written about in 2003."

New Democrat France Gelinas said she's thrilled Marin is looking at launching an investigation even though the Liberals have ruled out giving him full jurisdiction over the health-care sector. Marin's investigation would "shine a light on a sector of the health care system that has been kept in the dark for way too long."

There is no point in having some 400 standards to protect nursing home residents if they aren't being met, she added.

"There is a reason why the government put those standards in place - it's to protect the most vulnerable," said Gelinas, adding Caplan's lack of action is unacceptable. "He should be part of the people who are outraged that our most vulnerable are not getting the quality care that is set out in regulation."

Long-term care homes are expected to satisfy 400 rules relating to everything from what temperature food must be served at to ensuring a clean, safe and respectful environment for residents. Many of the province's standards relate to documentation and paperwork and more than one-third of Ontario's homes have been cited for administrative infractions.