Findings and recommendations concerning the health and social services network
Québec City, September 17, 2015 – In 2014-2015, the number of complaints and reports the Québec Ombudsman received concerning health and social services increased by 10.6%. The percentage of substantiated complaints and reports was 40.3%, up slightly (1.8 percentage points) from last year’s figures.
The six main grounds for these complaints and reports were, in decreasing order, failings regarding service quality, failure to respect rights, long delays, inadequate staff competence and behaviour, difficulty accessing services and deficient living environments and conditions.
The Annual Report also lays out the Québec Ombudsman’s findings and recommendations from the past year in the areas of mental health, physical health, disabilities, support for elderly autonomy, home support and service support.
Ten years after the 2005-2010 mental health action plan, its targets have yet to be reached even though needs are glaring and on the rise. Furthermore, the plan has not been updated since 2010.
The Québec Ombudsman is asking the Department to make good on its 2011 commitment to define policy regarding application of the Act respecting the protection of persons whose mental state presents a danger to themselves or to others.
This year again the Québec Ombudsman intervened to have certain institutions properly and promptly manage users at risk of suicide.
Noting that user consent, which is required by law, was not obtained before means of control (including isolation and physical restraints) were used, or before transfer to another institution occurred, it made recommendations so that from now on, the institutions concerned plan ahead for these situations and comply with the Act. For more information
Complaints concerning some hospital emergency rooms bring into focus the fact that waiting room patients are not reassessed by nursing staff despite clear standards to that effect. Even though the institutions concerned argue that high demand for services and a shortage of resources are to blame, the Québec Ombudsman has seen that other institutions grappling with the same constraints have been determined to comply with prescribed standards.
This year the Québec Ombudsman had to intervene regarding centralized waiting lists for those who do not have a family physician, more particularly, problems with prioritizing applications and with the registration process, which can be complex for vulnerable people. Generally speaking, the local institutions (health and social services centres, or CSSSs) concerned accepted its recommendations. For more information
This year the Québec Ombudsman published a special report on the services for young people with intellectual disabilities or autism spectrum disorders. The main difficulties encountered by these youth and their families are the lack of access to services and the absence of continuity and dovetailing among them.
In this regard, it recommended an enhanced role for system navigators, more systematic use of individualized service plans, better management of waiting lists and the creation of a template for an integrated service network. The Department approved its recommendations. For more information
Support for elderly autonomy
Private residences designed for autonomous or semi-autonomous client populations admit people with needs that exceed the residences’ ability to meet them. It also happens that these needs increase over time and that the residences can no longer offer residents services that are adequate and adapted to their health condition.
In another vein, residents in residential and long-term care centres (CHSLDs) are not given baths because certain institutions do not have the specialized equipment or the space to provide this service safely. The Québec Ombudsman recommended in particular that the Department draw up a list of the CHSLDs that do not have the required equipment and that it take the necessary measures so that CHSLDs can provide baths or showers without jeopardizing users’ safety.
The Department was open to the recommendations and committed to start work on implementing them in the coming months. For more information
At a time when emergency rooms must be unclogged and places in CHSLDs are in short supply, the importance of offering home support services that are accessible, in sufficient quantity and adapted to users’ needs is self-evident.
Despite this, the Québec Ombudsman has seen that development and strengthening of the slate of home support services is lagging and that regional disparities remain. The complaints received in the past year confirm that users are still contending with reduced services, long wait times and natural caregiver burnout.
In a context in which the health and social services network is being reconfigured, true access to adapted home support is a crucial issue. For more information
The investigations in the wake of service support complaints revealed that users have had to pay for care normally provided free of charge, especially for intraocular lenses and the use of high-tech surgical equipment.
Given that budgets are being squeezed and institutions are scrambling for additional funding, great care must be taken to avoid the slippery slope towards abusive billing.
There must be strict guidelines for the fees that can legally be charged to users and the Québec Ombudsman made specific recommendations to the Department on this subject. The Department agreed to act on them. For more information
See the 2014-2015 Annual Report of the Québec Ombudsman.
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Carole-Anne Huot, 418-646-7143/418-925-7994