‘Troubling’ inspection alleges two incidents of sexual abuse at Shalom Village

Shalom Village will undergo an organizational review in response to a troubling" Ministry of Long-Term Care inspection that alleged sexual abuse that went undocumented, as well as a failure to do police checks on new hires.

In addition, a number of infection, prevention and control issues were found despite the Westdale home being in the midst of a COVID outbreak when the majority of the inspection took place.

We are deeply troubled by some of the inspection findings," stated a letter to residents and their families dated Wednesday and signed by CEO Ken Callaghan and board chair David Horwood. The board of directors of Shalom Village is undertaking a full review to investigate every single finding in the ministry's report and to explore and identify any other areas for improvement."

The report, which is available online, was dated Feb. 28 but the letter wasn't sent until after The Spectator started asking questions about the inspection.

We expect the findings to become public and we wish to share them with our community directly," stated the letter which was provided to The Spectator by Shalom Village. Interview requests were declined.

The inspection at the Macklin Street North long-term care home with approximately 127 beds was triggered by a complaint and took place over 20 days in January and one day in February.

It resulted in 22 written notifications, 16 voluntary plan of corrections and five compliance orders. In addition, the report noted a number of other compliance issues over the last three years.

I want to assure you that Shalom Village fully co-operated with the ministry inspection, and we have already taken action to address findings in the report," stated the letter.

The report found that the home failed to protect two residents from abuse by a personal support worker (PSW).

First, a registered practical nurse (RPN) observed the PSW inappropriately apply an intervention" to one resident.

The incident was not reported to management until four days after it had occurred, and there was no documentation of the incident or assessments conducted," found the report. It delayed further actions being taken."

The inspector put some of the blame on deficient training.

The lack of adequate training may have increased the risk for delays and lack of reaction to alleged abuse situations by staff," stated the report. As a result, residents were at significantly higher risk of not being protected from abuse by the home."

The delay allegedly had serious consequences: As a result, (the PSW) was able to return to work and another abuse incident occurred."

This time, a resident complained the PSW was inappropriate with them."

There was no evidence that the resident was assessed after the incident and there were no written statements or interview notes kept," stated the report.

The inspector expressed concern about whether either resident received the support or referrals they needed.

For two incidents of alleged sexual abuse, there was no documentation in the residents' charts about the incidents, whether the residents were assessed after the incidents, it was not reported to the director immediately, and the police were not contacted immediately," stated the report. After one of the incidents the physician was not notified."

In addition, the home was found to have failed to do a police check or require a declaration of past criminal offences when the PSW was hired in 2021. The same documents were missing for another PSW hired last year as well.

Shalom Village has no tolerance for abuse, and the PSW staff member involved was immediately removed from the home at the time," stated the letter.

The home's leaders say the inappropriate contact" in the first incident occurred during the application of a barrier cream. As for the second allegation, they say staff promptly notified police" and fully co-operated with their investigation." They also say the training issue has been addressed.

In addition, another incident raised questions of neglect when a resident was injured while two PSWs were in the room to provide care.

Both PSWs stated they were unsure how it occurred," stated the report. The resident's son alleged that this was neglect."

There were no written statements or documentation of witness accounts obtained from either PSW.

When interviews were not conducted with all witnesses as part of an alleged abuse investigation, the results of the investigation may have been inaccurate, which placed residents at risk for being abused in the future," stated the report.

The second part of the inspection dealt with alleged failings related to infection, prevention and control despite the home having a COVID outbreak and the inspection taking place almost two years into the pandemic.

A number of staff were seen not wearing or improperly wearing personal protective equipment (PPE) - particularly N95 respirators.

There were more than 80 staff members ... that were either not mask-fit tested, their mask-fit testing was expired since 2020, or were fitted to a mask that had not been available in the home for an extended period of time," stated the report.

The home's letter says the fit testing is underway and mostly completed.

Mask-fit testing was delayed due to the unavailability of accredited professionals," stated the letter. During the pandemic, it has become increasingly difficult to find, hire and schedule these fit tests. We have now resolved this."

In addition, Shalom Village was accused of failing to do active COVID screening of those entering the home, including when the inspectors were let in.

When individuals were not actively screened at the entrance, it posed a risk that someone carrying the virus could enter the facility, causing potential risk of harm to residents," stated the report.

The letter from the home's leaders stated: Other items such as documentation, background checks, PPE training and screening have all been addressed to the ministry's satisfaction."

Lastly, the home was accused of breaching the privacy of a resident by posting their specific medical condition on the door to their room.

The home was given a variety of dates ranging from May 2 to Aug. 1 to comply with the ministry's orders. The letter commits to providing public updates upon completion of the organizational review.

Shalom Village has an excellent reputation for providing exemplary care to seniors," stated the letter. We understand how deeply troubling these matters are, and we are committed to doing everything possible to ensure that all our residents, participants, family members, and staff, feel safe, and secure, in a warm, family care environment."

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com