Staffing levels and long-term care beds were top of mind for councillors as they received an outline of a two-year strategic vision for H.J. McFarland Memorial Home last week.
The 2018–2020 strategic plan was presented to councillors by McFarland Home administrator Kim Mauro during last Thursday’s committee-of-the-whole meeting.
The plan is meant to guide management staff for the next two years and focuses on improving service delivery and enhancing the physical operations of the facility. The plan is divided into specific operational areas within the home, dealing with items like nursing, Willow Wing initiatives, dietary services, and volunteers.
Within each operational area, the plan outlines concerns and issues and specific corrective actions that administration and staff will work toward over the next two years. The plan also notes measurable goals and accountability for achieving the objectives.
However, much of the discussion revolved around staffing levels and long-term care beds at the facility.
Councillor Steve Ferguson questioned how much staff turnover there is at the home.
Mauro said there isn’t currently a lot of staff turnover, noting there was about seven to eight per cent turnover in 2017. She said a lot of that turnover can be attributed to part-time staff leaving to take advantage of full-time opportunities elsewhere.
Councillor Gord Fox questioned whether the home’s administration was hiring several part-time employees to fill the role of one full-time employee in an effort to save on wages and benefits.
“In my opinion, if you hire people on a full-time basis, then they have a sense of security and you’re going to get more loyal employees,” he said.
Mauro said she didn’t disagree. She said the home doesn’t recruit externally for full-time employees and instead all full-time positions are posted internally. In terms of staffing levels, she said McFarland Home is in line with the provincial median with 21 full-time staff for 84 residents.
“I understand what you’re saying, I do agree that that gives people a sense of security when they have a full-time position, but there are a number of variables that do contribute to the fact that we continue to work short-staffed,” she said.
She said many of those variables deal with full-time staff. When those full-time employees call in sick or take time off for short-term disability, the home is forced to pull in part-time staff to fill the gap. That creates new gaps as the pool of part-time employees available shrinks.
“We also follow an agreement that only allows us to schedule part-time (personal service workers) two out of three weekends,” said Mauro. “Weekends are one of our biggest problems in terms of staffing, so there are a number of variables involved.”
Councillor Treat Hull said the plan was comprehensive, informative, and very sobering.
“I was struck in particular by the fact that there is certainly a provincewide shortage of professional staff compared to the needs,” he said. “The sheer volume of externally-mandated programs and requirements looks like it’s ever-escalating and I’m not aware of any funding to go along with it or any meaningful funding.”
He said the increased and likely growing proportion of dementia cases and the approaching need for redevelopment of the home all lead to an important question: Is the home financially sustainable at 84 beds?
“I’m flabbergasted, actually, with the number of programs and improvements and monitoring and measuring which are all not about direct care and yet the requirements for direct care are increasing in demand and difficulty — is it, over the medium term, viable to pursue a facility like this with 84 clients?” said Hull.
Chief administrative officer James Hepburn said the Ministry of Health and Long Term Care recently announced plans to add another 5,000 long-term care beds. He said staff have been working on the appropriate number of beds for McFarland Home.
“We don’t think 84 beds is necessarily the sweet spot in terms of economies of scale and it’s going to be difficult long term,” he said. “One of the things we’re wrestling with is just what the real size of H.J. McFarland Home should be.”
Based on design criteria, Hepburn said, the province wants to build facilities in multiples of 32 beds. That would mean the County should shoot for a 96, 128, or 160-bed McFarland Home.
“The last go around we had we were applying for the Picton Manor beds, the sweet spot is probably somewhere — for an independent home like this — somewhere between 128 and 160,” he said. “We’re going to be doing some more analysis of that and making a decision moving forward.”
Hepburn said the deadline to apply for the beds is March 2 and staff are currently working on a response. Council is expected to receive an update.
Mauro said the discussion will see an added wrinkle if the province moves forward with the proposed Bill 33 Time to Care Act, which would mandate four hours of direct nursing and personal care per day for each long-term care resident. Mauro said that would mean an increase in PSW staff.
“If you think we have challenges now, that’s going to create an even bigger challenge,” she said.
She said many administrators around the province believe there’s a need for more PSW schools and programs as, if the act is implemented, all homes will feel the impact.