Compliance Gaps: LTCHA Recommendations

I think that as dietary aides we could completely change the atmosphere of the dining room to make it more comfortable, enjoyable and home-like for the residents. For example, we put plain place mats

RESIDENTIAL SUPPORT - Barry wants staff to prepare the meals that he likes. Hope said that Barry meals are pureed, blended, or strained to make them into a smooth form. Hope noted staff prepare his meal according to his likes. They have a list of his likes and dislikes for food. PROGRESS MADE ON OUTCOME because he gets to have what he

Bruce Hall used to be a great example of combining catered wing and self-catered wing, but they are in separate buildings, which at the same time, separates the communications between catered and self-catered residents. For SA5, both self-catered and catered are located on the same floor, which creates a chance for interactions. Also, self-catered are minorities in SA5, so they’re experience and requirement would be focused on in this report.

Each story has various departments located on it. On the first floor we have check-in, the waiting area, and various staff offices. The waiting room has a very comfortable feeling, decorated in a way that makes families feel welcome and comfortable. There are complimentary water bottles, juices, and fruit snacks for families, which is another way to make them feel more at ease while waiting on loved ones. The second floor is an intensive care unit for those patients that need more closer monitoring. This floor will have 5- 8 beds. The second floor will also have the diagnostic equipment. Our facility will include an X-Ray room, CT scanner, as well as an MRI machine. The third floor will have 10 beds and a physical therapy area. The third floor will also have the same idea of 10 beds but will also contain the speech pathology area. The fourth floor will focus on an area for the occupational therapists. The fifth and sixth floor will both have 10-12 beds along with offices and areas for the dietician and social workers. The basement of the building will also be

The list of questions was created with the intention to understand the standard, and the services provided by the facility from a family member point of view. For example: what is the style of food, will the menu be changed consistently, or do they provide extra services such as hairdresser/dental care regularly. For a complete list of planned questions, please refer to Appendix

During our DCC observation, we had the opportunity to engage with Curtis Thomas, Yolanda Wright, and Josephine Rose. Each of these employees taught us about the different operations in DCC. First, Curtis showed us how to run SmartSubs for the evening meal. He explained to us that he addresses the conflicts that arise from fluid-restricted patients. If the order says, “No replacement found,” Curtis went back into Computrition to manually put items back in using the “Fluid Restriction Guide.” Next, he printed the tally guide report for each line. Each line had 3 reports: hot food, cold food, and loader. Afterwards, we met with Yolanda to observe her printing the first set of tray tickets for the evening meal. She mentioned that whoever works the early morning shift in DCC is responsible for printing out the queue list, updates and late trays using Vista software. Once she printed the tray tickets, she cut each page into 3 and ordered the tickets based on each unit. Yolanda mentioned that each meal has a different color pen specifying the number of diet orders for each unit to avoid any confusion. If there were more than 20 orders for one unit, she would put the excess into the next set because the meal carts only hold a maximum of 20 trays. Ms. Rose told us that she is currently responsible for running the select menus for CLC, SCI, and 6D. DCC explained that diet changes are typically ordered by doctors and dietitians through CPRS

The amount of work expected from staff members is quite high. Assisting everyone due to the limited staff members is difficult. The care partners who work in the medication room oversee 64 elders. Even though there only three elders receiving personal care services at this time, the staff feels stress when they are pulled in different directions. Ideally, we would have more staffing available to help ease the workload of each person who is on the shift in the med room. Due to budgeting issues and concerns, St. Luke’s is not able to hire more staff members. Administrative staff wear different hats and help each other when needed to accomplish tasks. Because the Department of Housing regulates how many elders are excepted into the various financial tiers, there can only be 13 elders in the 30%, 39 elders in the 50%, 12 elders in the 60% pay

The lack of effort piles responsibility on other employees who already have too much on their hands. This can result in low quality of work for the seniors in the center. On the other hand, there are some challenges employees face with patients, and that is when they are very demanding in the quality of food they receive. Some patients are accustomed to having buffet style at their home, and this program only offers them one or two options.

Another experience I have been learning about is care planning. Care planning is about assessing the resident and listening to their concerns to develop a plan of care. Each department, such as nursing, activities, dietary, social services all develop a care plan for the resident. These care plans need to be updated every three months. There may or may not be changes to these care plans based on events in the resident’s life. All of this is documented in our charting system.

Patients should not be eating their snacks in the dayroom. We have bug infestations, and it’s not sanitary. Please have the patients in the dining room before handing out snacks.

In a residential care home, there are many people who look after patients. These people include a nurse, carer, manager, cleaner and chef.

Many cafeterias don’t have enough storage space that the eatable stuffs are handing around the food preparation and delivery counters and ultimately lead to insufficient cafeteria capacity

  There are three ways a customer can purchase food. They may sit down at one of the 68 seats in the dining room and get full service from a waitperson. A separate take-out counter services those who wish to pick up their food. Most take-out food is prepared to order with orders coming from the telephone. Delivery (an indirect form of take-out) is available at certain times and to a limited area.

* Table/Plate Service - The meals are placed on individual plates, and delivered to the customer;

Meal plan services are a necessary function if education and graduation rates are to rise. At first glance it may not seem like the two are connected, but they truly are; if students do not eat enough food