Health and Safety in Continuing Care Residential Communities:
Social Workers, Long Term Care Advocates
Must
Research Safety Issues In CCRCS For Seniors
By Lillian L. Hyatt, M.S.W. and a Resident of a CCRC
Excerpted from the Spring 2005 The CANHR Advocate newsletter
Illness and safety prevention programs protecting CCRC residents should be a given. However, this cannot be taken for granted by either residents or applicants to a CCRC. Most CCRCS have illness and injury prevention programs in place for employees, but what policies are in place to protect residents from illness by contact with sick employees?
CCRC providers may not have any policy in place to protect residents from infection from employees who report to work ill. For instance, a multi–facility provider in California had a severe outbreak of E. Coli in one facility, and of a nonovirus infection in another facility within one year. After these outbreaks, a resident in a third facility requested information about a policy that protects a resident from infection by an employee coming into work sick. The CCRC Administration assured the resident there was a "company policy" in place. Not satisfied, the resident persisted, insisting upon seeing a written copy of that policy after having been visited by a housekeeper who was obviously ill and was later sent home. The Administrator, after carefully searching for the policy that was supposedly designed to protect residents, gave the CCRC resident the following information: "I must admit that after reading the Illness and Injury Prevention Program Policy again, and looking for something in writing regarding employees not coming to work when ill or being sent home if ill, is not spelled out."
The problem is the fact that the policy in place refers only to employees. There is no provision for the protection of residents from having to come into contact with sick employees when a supervisor ignores the so–called "company policy" and insists that a sick employee report in for work. On the other hand, CCRC residents are instructed by staff not to leave their apartments when ill with flu or a cold to avoid spreading the infection to other residents, and they are expected to comply. Social workers should be sure their clients carefully explore these safety questions with CCRC administration before signing any contract.
Another vexing safety concern is the danger of fire or other emergency in a CCRC building. A resident or an applicant to a CCRC should ask the following questions: Does the CCRC provider have a Safety Committee? Are residents represented on the committee? Is it a "paper committee" or does the committee actually meet and attempt to review, develop and enforce the written policies? Are the minutes of this committee accessible to residents to review, or are the minutes considered confidential? What is the facility’s emergency evacuation plan? Is there sufficient CCRC staff available at night and on weekends to help all residents in the event of an emergency?
One multi–facility provider in California had very few fire drills over a five–year period and instructions given to residents when they were held were unclear and confusing. During an extensive renovation, subcontractors were permitted to work late at night. One night the fire alarm sounded for a half hour but no instructions were given to residents over the public address system. Fifty residents called security guards and were told that the fire alarm had malfunctioned. The fire alarm had not malfunctioned, but had been set off by an electrical subcontractor working adjacent to a kitchen area without first turning off the gas. A resident requested a Fire Department report of the incident from administration and was told it was not available. No report from the CCRC administration was ever given to residents concerning the events of that night.
Long Term Care Advocates and Social Workers should make their clients aware that the handling of safety issues in a CCRC affects a resident’s peace of mind. It may also be a crucial factor in a resident’s survival.
