Job Specification

Purpose of Position :

The LTC Homes Inspector - Nursing, as a member of a highly trained inter-disciplinary inspection team, is responsible:
- to promote the health, safety, comfort and rights of LTC home residents through the assessment and determination of non-compliance with the applicable legislation, regulations and standards, and
- determine the appropriate action/sanction and time frames to achieve compliance once non-compliance is identified;
- to follow up on non-compliance to ensure compliance is achieved within the time frames identified;
- to collect and present, as required, the evidence of non-compliance which has led to the application of an action or sanction;
- to promote and strengthen the quality of LTC homes' inspections; and
- to focus, develop and maintain risk profiles on LTC homes as required.

Duties / Responsibilities :

The PIC Branch is responsible for reviewing and following up on deficiencies, infractions or violations identified through the Health System Accountability and Performance Division's accountability process. Working under the general supervision o of the Manager, Service Area Office, Compliance and inspection, Performance improvement and Compliance Branch, the incumbent:

75% - Inspections a member of a multi-disciplinary team, ensures that efficient and effective annual inspections, complaints, critical incidents, follow-up and other inspections (e.g. pre-sale, occupancy, licensing, etc.) are conducted with respect to nursing care and services in LTC homes by:
- Conduct inspections under the applicable Acts and regulations that govern LTC Homes as they relate to resident care issues; coordinating, where appropriate, the inspection process with other inspection from the disciplines of running, environmental health, dietary as well as other resources including financial, legal counsel, medical and other.
- Identify, collect and document evidence gathered to determine non-compliance, ensure that is collected in accordance with policies, procedures and direction to support reporting of non-compliance, appeals processes and other requirements for evidence collection;
- Interview licensees, staff, residents within the LTC home and other parties, taking statements, obtaining and discussing information relating to the inspection and other related requirements;
- Maintain effective communications with LTC home licensees, staff, residents, families and other related parties, (often under very stressful conditions);
- Analyze the data and evidence gathered to ensure there is evidence to support the actions/sanctions invoked;
- Determine based on the analysis of the data and evidence the appropriate action/sanction to take;
- Review the management, operations, resident care programs, services, employee and general records in accordance with the requirements of the LTC Homes Act, 2007, and accompanying regulations, policies and directives;
- Utilize nursing skills to evaluate and assess the provision of clinical care to residents including the organization structure for care and services, policies & procedures required by the LTCHA, 2007 and other relevant health care legislation, quality programs outcomes, required staffing hours, staff qualifications and training, standards of nursing practice, management philosophy and objectives and other requirements under LTCHA;
- Verify all non-compliance with applicable legislation, regulations, policies and directives through observation, sampling and other testing methodologies to support the non-compliance;
- Issues orders;
- Review and evaluate submitted plans for compliance;
- Conduct financial audits on resident trust accounts; accommodation charges and other approved service charges in accordance with legislation and policies;
- Act as an agent of the Minister of Health and Long-Term Care where the Ministry must take over the operations of a home;
- Provide information as required to support the review of reports of non-compliance;
- Obtain clarification regarding interpretation of legislation and regulations and provides that information to others as required;
- Evaluate and assess the immediate risk of harm to resident health, safety and welfare, refer as required so appropriate action can be taken;
- Communicates with complainants, residents, families, LTC Home staff and operators, CCACs, LHN representatives, Ministry or other OPS staff, and other stakeholders to obtain details related to complaints, issues, provide clarification of Ministry legislation or regulations, inspection report findings, evidence gathered and actions taken or any other matter related to LTC home operations or care provisions. Advisor to the Manager and Director, Long-Term Care Homes

20% - Provide expert technical knowledge in nursing and resident care, with a particular focus on the risk and threat to the quality of care of the residents in Long Term Care facility (LTCF) settings;
- Identify non-compliance and issuing the appropriate action/sanction to LTC homes, as appropriate;
- Conduct special investigations as required by the Director in relation to service delivery in LATCF settings. For example, major nursing related and other complaints lodged with the Branch by LTCF residents/their relatives, and/or by agencies, advocacy groups or members of the general public, responding to issues raised about specific homes;
- Work in collaboration with an interdisciplinary health team, i.e. dietary, environmental health, financial, legal and Services Area Offices and others;
- Participate in the decision-making process re: license revocation/renewal and other actions;
- Provide written inspection reports on investigations conducted, making recommendations to the Director to apply sanctions, where applicable;
- Prepare documents and presenting evidence, testifying as an expert witness in appeals and court proceedings or other hearings or coroner's inquests;
- Compile data, analysis and evaluates and prepares reports summarizing the findings of the analysis (e.g. Risk Indicator reports, Early Warnings, etc.);
- Draft correspondence and reports as requested including inspection reports for operations and the public;
- Oversees the work of the Ministry appointed agent to ensure the day-to-day care of the LTC home residents in cases where the Ministry has taken over the operation of a LTC home;
- Contribute to briefing notes and other issues management functions, including providing details to SAO manager of potentially contentious issues. Performs other related duties as assigned

5% - Attend staff meetings;
- Attend Provincial training and education sessions.

Staffing and Licencing :

Current registration with and certificate of competence from the College of Nurses of Ontario as a Registered Nurse. Valid Ontario driver's license, willingness to travel extensively and to work irregular hours.

Knowledge :

- Extensive in-depth knowledge of and experience in LTC or health care home operations;
- Knowledge of the various Acts governing LTC homes; including the Long-Term Care Homes Act 2007, the Provincial Offences Act, Nursing Homes Act, the Homes for the Aged and Rest Homes Act, the Charitable Institutions Act and the Long-Term Care Act and relevant Ministry/Division and program policies and procedures related to conducting inspections and investigations, determine compliance, identify non-compliance, issue reports and orders, apply and explain the intent of the legislation;
- Knowledge and or experience in inspections and investigations;
- Ability to communicate effectively with LTC home operators, staff, physicians, other professionals and the general public;
- Through knowledge of current nursing theories and practices;
- Demonstrated ability to observe and evaluate care; well developed analytical skills, resourcefulness, assertiveness; exceptional ability to perform with minimum supervision and to exercise initiative and independent judgement, and the ability to perform in highly stressful, politically sensitive situations;
- Experience in senior management positions within a long-term care home;
- Extensive experience in dealing with clients requiring long-term care;
- Expertise in gerontology;
- Expertise gained thorough Bachelor's Degree in Health Services (nursing performed). Preparation at a Masters level also an asset.

Skills :

- Strong leadership, communication, written and interview skills;
- Ability to resolve contentious and highly sensitive issues;
- Maturity, tact, flexibility, resourcefulness, assertiveness to effectively communicate with stakeholders, the public and LTC administrators;
- Sound judgement in the evaluation of evidence, making recommendations to invoke orders/sanctions, as an expert witness in court proceedings;
- Sound program evaluation skills to observe and evaluate nursing care and home operations, and to determine non compliance and appropriate actions/sanctions/orders is required;
- Excellent problem solving and conflict resolution skills to resolve issues between the public and stakeholders;
- Advanced negotiation, communication and presentation skills are required to present Ministry's requirements and direction;
- Well developed analytical skills to apply benchmarks, analyze CIS reports and data relating to compliance issues;
- Excellent oral and written communication skills, including: correspondence, briefing notes, comprehensive, accurate enforcement and status reports, and preparing documentation for court procedures and appeals, with attention to detail;
- Ability to work with computers utilizing word processing, database and spreadsheet applications, e-mail, websites and electronic calendars;
- Ability to work effectively within an interdisciplinary health team;
- Exceptional ability to perform in a highly stressful, high volume, politically sensitive, fluid environment with minimum of supervision and to exercise initiative and independent judgement;
- Ability to identify opportunities for the development of corporate supports, policies and programs, such as education programs to support the enforcement process;
- Ability to work collaboratively with staff in the Service Area Offices in the inspection of homes.

Freedom of Action :

- Record observations, conduct investigations as necessary, for medical, legal and/or financial matters. Make recommendations to SAO management regarding the continued operation of a LTCF where violations and its regulations have been identified;
- The position is responsible for promoting the health, safety, comfort and rights of residents by ensuring that LTC homes are operated in compliance with the various Acts and regulations governing LTC homes. Job requires independent decision-making to ensure that legislation and regulations are consistently applied across the LTC home sector;
- Ineffective monitoring of LTC home operations could impact negatively on the health, safety, comfort and rights of residents, visitors and employees. Inappropriate use of enforcement powers could negatively impact on Ministry in legal proceedings;
- Work is performed with a high degree of independence under the general direction of the Manager, Compliance Inspection and within the broad framework of the Ministry's strategic direction in the area of long-term health care, and within the requirements of MOHLTC and its legislation/regulations and policies. Significant judgement is exercised in responding to client complaints and in the preparation of ministerial responses to client health care issues;
- The position makes recommendations on key Ministry policies.