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- Falls Prevention And ManagementFalls
The home did not follow its own falls prevention policy for a resident who experienced multiple unwitnessed falls. Although staff completed head injury observations, they did not do so within the timeframe specified in the home's policy, and one observation was started more than seven hours after a fall occurred.
- Dealing With ComplaintsReporting & complaints
Inspectors found that after investigating a resident's verbal complaint, the home did not provide the resident with a response about the investigation results or what steps would be taken to prevent the issue from happening again.
- Resident RecordsPrograms & admin
Inspectors found that the home did not keep resident records up to date. A resident's complaint and the investigation into it were not documented in the home's electronic record system. Additionally, when staff initiated observational charting for a resident based on a verbal referral, the home did not document why the charting was started or record the referral itself.