West Park Long Term Care Centre (82 Buttonwood Avenue, Toronto) is a nursing home that is operated by Extendicare. There are approximately 200 beds in shared and private rooms.
Extendicare manages day-to-day operations, overseeing resident care quality, clinical support services (such as pharmacy, laboratory, and diagnostics), as well as other support functions like environmental services, nutrition, and laundry.
Governance and accountability, however, lie with West Park Healthcare Centre, the hospital. West Park Healthcare Centre offers specialized rehabilitative and complex care following life-altering illnesses or injuries, such as lung disease, amputation, stroke, and traumatic musculoskeletal injuries.
Inspection Reports for West Park Long Term Care Centre
Our research team at Caring Magazine carefully reviewed and summarized inspection reports for West Park Long Term Care Centre. You can read the original copies of the reports in the Government of Ontario website.
🔍 December 2023: Inspection
During the course of this inspection, the inspector(s) made relevant observations, reviewed records and conducted interviews, as applicable. There were no findings of non-compliance.
🔍 August 2023: Inspection
The inspection at West Park Long Term Care Centre, by inspectors Michael Chan and Henry Chong, included both a Critical Incident System (CIS) Inspection and a Follow-Up Inspection.
The licensee failed to ensure that safe transferring techniques were used when assisting a resident. This non-compliance was identified when a resident was sent to the hospital after sustaining an injury. The staff did not follow the Physiotherapist’s assessment and the resident’s care plan regarding transfers, increasing the risk for falls and further injury.
A re-inspection fee of $500 was applied, as this was at least the second follow-up inspection to determine compliance with the aforementioned Compliance Order. The fee must be paid from funds outside the resident-care funding envelope provided by the Ministry.
🔍 June 2023: Inspection
The inspection report for West Park Long Term Care Centre, by inspectors JulieAnn Hing and Lisa Salonen Mackay, focused on follow-up and critical incident system inspections.
- Plan of Care: The licensee failed to reassess and revise a resident’s plan of care when their care needs changed. This was particularly critical after a resident experienced a fall that resulted in an injury. The resident’s care plan was not immediately updated with the Physiotherapist’s recommendations, leading to another fall and injury.
- Duty to Protect: The facility failed to comply with the compliance plan regarding the maintenance and inspection of hair dryers. This failure put residents at risk of harm.
The facility was found not to be in compliance with a previously issued compliance order, which highlighted concerns about their duty to protect.
A penalty of $1,100 was issued due to the failure to comply with the compliance order. The licensee is required to pay this penalty from funds outside the resident-care funding envelope provided by the Ministry.
🔍 May 2023: Inspection
The inspection report for West Park Long Term Care Centre, by inspectors Oraldeen Brown and Maya Kuzmin, was a Proactive Compliance Inspection.
- Plan of Care: The licensee failed to provide a resident with a nutritional supplement as outlined in their care plan. This failure was confirmed by the Food Service Worker (FSS) and the Food Service Manager (FSM), putting the resident at risk of not meeting their assessed nutritional needs.
- Directives by Minister: A Personal Support Worker (PSW) was observed not wearing their surgical mask properly while providing assistance to a resident. This non-compliance increased the risk of infection transmission.
- Communication and Response System: A visual indicator of the resident-staff communication response system was observed to be malfunctioning, potentially preventing timely assistance to the resident. The issue was fixed the next day after being reported.
- Additional Training for Direct Care Staff: An RPN and a PSW failed to complete all required training modules for falls prevention and management for the year 2022, increasing the risk to residents due to incomplete staff training.
🔍 March 2023: Inspection
The inspection report for West Park Long Term Care Centre, by inspectors JulieAnn Hing, Reji Sivamangalam, and Yannis Wong, was a Critical Incident System inspection.
- Infection Prevention and Control Program: The facility failed to ensure hand hygiene program compliance, specifically with expired hand sanitizer products found on wall-mounted units and testing areas. This non-compliance increased the risk of infection transmission.
- Plan of Care: The licensee did not collaborate in a resident’s assessment following a physician’s referral to Behavioral Support Ontario (BSO), leading to a missed BSO assessment related to the resident’s fall.
- Administration of Drugs: Medication was not administered as prescribed by the physician, leading to a resident’s pain not being effectively managed.
- Medication Management System: Staff did not comply with policies for receiving and administering medications, such as failing to sign shipping reports for receipt of medication and pre-pouring medications in advance. These practices put residents at risk for medication errors.
The facility was ordered to implement a plan to ensure compliance, focusing on protecting residents from injury and abuse, particularly during visits to the hairdresser and in preventing resident-to-resident physical abuse.
🔍 December 2022: Inspection
The inspection report for West Park Long Term Care Centre, by inspectors Matthew Chiu, Parimah Oormazdi, and Ramesh Purushothaman, was a combined Complaint and Critical Incident System inspection.
- Plan of Care: The facility failed to reassess and revise care plans for residents when their needs changed, particularly for residents requiring assistance with mobility and safety interventions, leading to an increased risk of falls and injury.
- Infection Prevention and Control Program: The facility did not comply with IPAC standards, including improper use of N95 masks and not providing appropriate hand hygiene support to residents before meals. This increased the risk of infection transmission.
- Reporting Requirements: The licensee failed to report a suspected abuse incident to the Director as required.
- Residents’ Bill of Rights: A resident’s right to privacy during treatment was violated when a nurse provided care in a common area.
🔍 March 2022: Complaints Inspection
During the course of this inspection, Non-Compliances were not issued.
🔍 December 2021: Follow-Up Inspection
The follow-up inspection at West Park Long Term Care Centre, by Inspector Praveena Sittampalam, focused on a previous compliance order and overall safety and infection control practices.
- Safety and Secure Environment: The facility failed to maintain a safe and secure environment for residents. Specifically, there was an incident where a resident was interacting with a cart of dirty cups and cutlery without staff supervision, posing a risk of infection and safety due to wandering residents around the cart.
- Infection Prevention and Control Program: The facility failed to ensure all staff participated in the implementation of the infection prevention and control (IPAC) program. Issues observed included improper mask-wearing by staff, inadequate hand hygiene practices, and failure to follow hand hygiene protocols as per the home’s policy.
The facility was requested to prepare written plans of correction to address the non-compliance issues identified, focusing on ensuring a safe and secure environment for residents and full staff participation in the IPAC program.
🔍 August 2021: Complaints Inspection
The complaint inspection at West Park Long Term Care Centre, by Inspector Iana Mologuina, was focused on several key areas including management of hot weather, COVID-19, changes in resident conditions, and general compliance.
- Food and Fluid Intake Monitoring: The facility failed to comply with its own policy for monitoring food and fluid intake. This was evident in the case of a resident who did not meet their fluid goals for 10 days, and staff did not implement required interventions or refer to a dietitian for assessment.
- Falls Risk Assessment: The facility did not complete falls risk assessments for residents who were at risk of falls or had experienced falls, as required by the home’s falls policy.
- Nutrition Care and Hydration Programs: There was a failure to ensure the weight monitoring system for measuring and recording each resident’s weight monthly was implemented. This was particularly concerning in the case of a resident who experienced a significant decline in intake prior to their death.
- Registered Dietitian On-Site Requirements: The facility did not meet the requirement of having a registered dietitian on-site for a minimum of 30 minutes per resident per month to carry out clinical and nutritional care duties, especially during two months in 2020 when the regular dietitian was not working.
🔍 August 2021: Critical Incident Inspection
The Critical Incident System inspection at West Park Long Term Care Centre, conducted by Inspector Iana Mologuina, focused on various incidents related to falls and the facility’s compliance with the Long-Term Care Homes Act.
- Safe and Secure Environment: The facility did not ensure a safe and secure environment for residents. An incident was reported where a resident fell while trying to self-transfer, resulting in significant injury. Observations and staff interviews indicated that the resident was left at risk with a tripping hazard in front of their assistive device.
- Plan of Care: There were failures in ensuring that the written plan of care for residents set out clear directions for direct care, particularly regarding the use of falls interventions. This included a resident whose plan of care did not include a fall intervention, leading to unclear care directives.
- Provision of Specified Care: The care specified in the plan of care for a resident was not provided as outlined. A resident who required an assistive device for locomotion often forgot to use it, and on the day of their fall, staff were busy and did not ensure the assistive device was accessible, leading to a significant injury.