Complaint Investigation
Inspection Information
Facility Type
Residential Care - 400
Received Date
09-May-2023
Subject
["Neglect","Emotional Abuse","Physical Abuse"]
Contraventions: A summary of the new contraventions found during the inspections are listed below.
Code
Category/Description
A licensee must ensure that each care plan is reviewed and, if necessary, modified if there is a substantial change in the circumstances of the person in care
Observation: Through the investigation process, Licensing determined that the care plan for a person in care had not been reviewed or modified when a substantial change in the circumstances of the person in care occurred.
Corrective action: Ensure that each care plan is reviewed and if necessary, modified if there is a substantial change in the circumstances of the person in care. Action/s Required by Licensee: Licensee to submit a corrective action plan to Licensing specific to the contravention. Action/s Required by Licensing: On August 24, 2023, Licensee submitted a corrective action plan to Licensing. The corrective action plan included that all care plans were completed and reviewed by staff by September 15, 2023. The corrective action plan was reviewed and accepted by Licensing. On January 21, 2024, Licensee confirmed in writing that all care plans were reviewed by September 30, 2023. Licensing to review and monitor this corrective action plan.
Subject to subsection (3), if a person in care is involved in a reportable incident, the licensee must immediately notify a medical health officer, in the form and in the manner required by the medical health officer
Observation: Through the investigation process, Licensing determined that the Licensee did not notify a medical health officer immediately in the form and manner required by the medical health officer when a person in care was involved in a reportable incident.
Corrective action: Ensure to notify a medical health officer immediately in the form and manner required by the medical health officer, if a person in care is involved in a reportable incident. Action/s Required by Licensee: Licensee to submit a corrective action plan to Licensing specific to the contravention. Action/s Required by Licensing: On August 24, 2023, Licensee submitted a corrective action plan to Licensing. The corrective action plan included a procedure for reporting critical incidents that was provided to all staff and staff were to review policies, including the critical incident policy. The corrective action plan was reviewed and accepted by Licensing. On January 21, 2024, Licensee confirmed in writing that Critical Incident Reporting Policy was reviewed with staff at Twin Oaks on September 15, 2023. Licensing to review and monitor this corrective action plan.