Tall Pines Long Term Care Centre (1001 Peter Robertson Boulevard, Brampton) is owned and operated by Peel Region. There are approximately 160 beds.
Inspection Reports for Tall Pines Long Term Care Centre
Our research team carefully reviewed and summarized inspection reports for Tall Pines Long Term Care Centre. You can read the original copies of the reports in the Government of Ontario website.
November 2023
Lead Inspector Yami Salam, along with additional inspectors Diane Schilling and Kristen Owen, oversaw this critical incident inspection from October 25 to November 1, 2023.
The inspection’s primary focus was on two intakes related to falls of residents resulting in injuries and included protocols for Infection Prevention and Control as well as Falls Prevention and Management.
- Care Plan: The inspection discovered that a resident did not have access to a specified communication device as outlined in their plan of care. This issue was promptly addressed by the staff, providing the resident with the necessary device, thus aligning with the care plan stipulations.
- Skin and Wound Care: Another significant finding was the failure to conduct a skin assessment for a resident who returned from hospitalization and was at risk of altered skin integrity. The omission of this assessment could potentially lead to unaddressed and untreated skin integrity issues for the resident.
During the inspection, non-compliance was identified but was subsequently remedied by the licensee before the end of the inspection.
September 2023
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.
June 2023
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.
May 2023
This comprehensive inspection, led by Katherine Adamski, took place between April 18-26, 2023, and focused on a range of critical areas including skin and wound care, medication management, and fall prevention.
- Medication Administration: The licensee did not comply with prescribed medication administration. A nurse administered a drug in an incorrect dosage, which could have led to adverse effects for the resident. Immediate monitoring ensured the resident’s stability.
- Compliance Order for Skin and Wound Care: This compliance order was issued due to a failure in addressing a resident’s skin integrity concerns. Despite observations by Personal Support Workers, the necessary skin assessments by registered staff were delayed, leading to the deterioration of the resident’s skin condition and subsequent hospitalization. The order mandates educational measures for staff and regular audits to ensure adherence to skin and wound care protocols.
February 2022
During the course of this inspection, Non-Compliances were not issued.
May 2021
The inspection at Tall Pines Long Term Care Centre was conducted by inspectors April Racpan and Valerie Goldrup on May 3 – 7, 2021.
This critical incident system inspection addressed issues related to the prevention of abuse, neglect, and falls management.
- Non-Compliance with Zero Tolerance Policy: The licensee failed to adhere to the home’s policy promoting zero tolerance of abuse for resident #001. Despite a resident’s report of verbal and physical abuse by a Personal Support Worker (PSW), immediate assessment was not conducted, and the PSW continued to provide care. This non-compliance potentially exposed resident #001 to harm. A Voluntary Plan of Correction (VPC) was requested to ensure adherence to the zero-tolerance policy.
- Failure to Report Abuse: The licensee did not ensure timely reporting of suspected abuse of resident #001 to the Director. The abuse allegations made by the resident to a registered nurse were not reported until two days after, posing a risk of harm to the resident.
February 2021
The inspection was conducted by inspectors Kim Byberg and Amanda Coulter.
This inspection, which included a review of falls prevention, infection prevention and control, and overall resident care, led to the issuance of a written notification for non-compliance.
The licensee failed to ensure staff adherence to the home’s infection prevention and control program. This specifically related to the appropriate use of personal protective equipment (PPE) and the disinfection of equipment. Two critical observations were made:
- A staff member was seen providing hand and nail care to a resident requiring contact precautions without wearing the necessary gown or gloves.
- Another staff member entered an isolated resident’s room, used a computer tablet there, and then continued to use the same tablet in another resident’s room without disinfecting it.
These lapses in following routine practices and additional precautions significantly increased the risk of exposure and transmission of harmful bacteria and viruses within the care home. To address this, a Voluntary Plan of Correction (VPC) was requested to ensure all staff participate in the implementation of the infection prevention and control program.