Just weeks after the Ontario government announced it is adopting British Columbia's model for a caregiver registry to protect seniors from abuse, B.C.'s Health Minister is promising to review the system in response to troubling reports of gaps in the safety net.
In one case, an investigation conducted by the B.C. Care Aide Registry confirmed that a caregiver had abused a frail senior, 98-year-old Violet Siddall, but the worker is still allowed to work in publicly funded care homes.
The investigator found that Mrs. Siddall had been subjected to emotional abuse. But the nature of the abuse was on the low end of the spectrum, the report concluded, and it ordered that the caregiver be put back on the registry – over the objections of her former employer.
The decision has infuriated Mrs. Siddall's daughter, Gay Standell. "This is my mother's home. No one should have to be afraid in their own home and she was afraid," she said in an interview.
The case is just one example that prompted the B.C. Care Providers Association to demand an independent review of the registry. The association says it has been sounding the alarm about safety gaps over the past year without a response from the B.C. government.
But Health Minister Mike de Jong, contacted Wednesday by The Globe and Mail about Mrs. Siddall's experience, said the registry's credibility is in trouble.
"While I and the government remain proud of the fact that we set up the registry which has led the way nationally, I have heard enough anecdotal reports to have a concern," he said in an interview.
Mr. de Jong said a detailed review will be carried out by the fall, and promised to make "any changes necessary to ensure that residents, patients, their families and the care homes themselves have the confidence to know the registry is operating as it was intended to."
To work in a publicly funded care home, workers must be listed on the registry. There is no legal framework and the registry offers little transparency because the public – even families at the centre of a case – have no access to the registry or its decisions.
Since it was established in 2010, there have been roughly 100 complaints of abuse. The registry has conducted 34 investigations and seven workers have been permanently removed from the list. "To be honest, we think it is working better than expected," said John Mabbott, executive director of Health Match B.C., which administers the Care Aide Registry. "The number of cases of abuse is quite small."
Mike Old, a spokesman for the Hospital Employees Union, which represents the largest number of care-aide workers, said the government should focus on establishing standards of care for seniors in care homes. "The benchmark these investigators use is quite high, we are confident there was due diligence and the worker involved should be allowed to continue to work in the system," he said.
Dave Hurford, a spokesman for the care homes, welcomed the promise for a review. "We think the registry can be a positive thing to prevent elder abuse, but is not operating as effectively as it should," he said. "Too often, it appears a negotiation to keep the worker on the registry."
Ms. Standell agreed. Her mother has been a long-time resident at the Beckley Farm Lodge in Victoria. Ms. Standell calls her mother every evening to wish her good night. Two years ago, she noticed her mom was agitated, worried about who would be in charge of her care.
At Ms. Standell's urging, the operators of the small, non-profit facility asked the Vancouver Island Health Authority to investigate. Allegations of physical abuse were not substantiated, but that investigation found the staff member had yelled at Mrs. Siddall. The care aide was dismissed from Beckley Farm Lodge.
The care home then asked the care-aide registry to remove the worker's name. What happened next was more like a mediation process than an investigation, said Theresa Vogel, president of the Beckley Lodge Farm Society. The operators had to defend the dismissal and were asked to offer the abusive care aide a cash settlement.
"We have vowed she will not ever come into this building again," said Ms. Vogel. "If it was your mother lying in that bed, what would your reaction be?"