Sask. Health Authority slow to fix issues at Saskatoon special-care homes: provincial auditor

The Saskatchewan Health Authority (SHA) has “made little progress” fixing issues at contracted special-care homes in and around Saskatoon, according to the provincial auditor’s newest report.

The report, published Wednesday, found 13 of the 15 contracted special-care homes in Saskatoon — which provide 24-hour care to people who can’t care for themselves — had more than 27.5 per cent of residents using anti-psychotic drugs without a diagnosis of psychosis.

“This is often an indicator that special care home staff are chemically managing their residents,” auditor Tara Clemett said.

The report found the performance results at three of the special care homes in and around Saskatoon have worsened since a previous audit in 2019. Four of the six performance measures were unchanged compared with an earlier 2017 audit, it said.

Those elderly care homes aren’t the only ones found to have this issue, according to the Canadian Institute for Health Information.

About 34 per cent of residents on anti-psychotic medication in Saskatchewan care homes are undiagnosed, according to documented data from the institute. It’s the highest percentage among Canadian provinces, with the Canadian average at about 25 per cent.

The trend of potentially inappropriate use of anti-psychotic drugs in Long-Term Care homes as released by the Canadian Institute for Health Information in both Saskatchewan and Canada. Saskatchewan increased from 27.5 per cent in 2018-19 to 34.3 per cent in 2022-2023.
The trend of potentially inappropriate use of anti-psychotic drugs in Long-Term Care homes as released by the Canadian Institute for Health Information in both Saskatchewan and Canada. Saskatchewan increased from 27.5 per cent in 2018-19 to 34.3 per cent in 2022-2023. (Canadian Institute for Health Information)

The report said the health authority and private operators of the homes are developing a new contract expected to be complete by March. The auditor expects that will set the bar for quality and accountability, and clearly lay out roles. 

However, the health authority needs to work with the homes to improve its performance and quality of care, the report said.

“Failure to address non-compliance with expected quality of care performance targets can result in poor services provided to special-care home residents, which may negatively impact their quality of life,” it said.

Four of the recommendations laid out in the 2017 audit are still in the middle of being implemented, including laying out the contracts to set expectations, periodically inspecting special-care homes for compliance and the SHA acting when it finds homes don’t meet compliance.

Clemett said these issues have been around for six years.

“While I know COVID created challenges for special care homes, a number of the recommendations we made here existed before COVID, through COVID, and continue to exist after,” Clemett said.

Staffing affecting youth meeting with psychiatrists

The auditor’s report also found there were 249 children and youth waiting for psychiatric services in and around Prince Albert.

When the report examined waiting lists in July, it found a patient had been waiting for a psychiatrist more than four months while displaying severe symptoms. In another case, a patient with moderate symptoms had been waiting more than four years.

The report said the SHA found staffing was an issue. All three child psychiatric positions were vacant at the time the staffing was reviewed in July.

A 2022 audit report found the health authority is struggling to fill hard-to-recruit health-care positions.

The health authority recently received about $1.9 million in funding from the Ministry of Health to recruit more staff.

In an email Thursday, the Ministry of Health said it is offering a $200,000 incentive to psychiatrists recruited to regional centres, like Prince Albert. It also said a full-time child and adolescent psychiatrist began working in Prince Albert on Nov. 1.

LISTEN | Sask. provincial auditor Tara Clemett speaks with CBC about her newest report: 

The Afternoon Edition – Sask9:08Sask. auditor says SHA’s new payroll system could cost $240M

The Saskatchewan Health Authority’s yet-to-launch health care payroll system could reach a cost of $240 million, triple the initial projection. Provincial auditor Tara Clemett joins host Garth Materie to talk about a number of issues in the second part of her annual report.

The other half of its analysis of the Prince Albert area noted an increase in people using detox centres and a higher percentage of their users being homeless.

In a 2017 audit, the health authority recorded 802 detox unit stays for people in the area were homeless, nearly tripling to more than 2,300 in 2022. That doesn’t mean 2,300 different people have used the service, since some may stay multiple times.

About 70 per cent of the stays were from people who were homeless, the report said.

Clemett said housing options haven’t improved in the Prince Albert area and the health authority needs to do more work.

“While we found the Authority collaborated with the Ministry of Social Services on some issues, it has not made progress in enhancing housing options for mental health and addictions clients, especially for those with addictions,” the report said.

People in blankets lay outdoors near a sidewalk
This photo of people sleeping outside near a vent to stay warm, posted in October 2020, sparked discussion in Prince Albert about homelessness at the time. (Facebook/Bev Masuskapoe)

The overall number of people using the service also rose to 3,315 in 2022 from 2,672 in 2021.

Three of the auditor’s five recommendations for access to mental health and addictions services have been implemented.

The outstanding suggestions include developing a strategy to collect “key” mental health and addictions information, and collaborating with the Ministry of Social Services to enhance housing options for those clients.

On Wednesday, Saskatchewan Health Minister Everett Hindley said homelessness, mental health and addictions issues are intertwined, and that aiding people experiencing those issues will need to be a joint goal between ministries “to help them on a pathway to recovery and to bettering their lives.”

Hindley told reporters the provincial head of surgery is working to adopt some of the auditor’s recommendations.

The Ministry of Health also said in an email that the goal of its new 10-year mental health and addictions action plan is to increase capacity for treatment, improve the system, and move to a recovery-oriented system that focuses on treatment and recovery. It referenced $518 million in 2023-24 budget funding for mental health and addictions services. 

“By the end of the plan, there will be at least 500 new treatment spaces in Saskatchewan, which will more than double the number that exist today,” it said.

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