Job Specification

Position Title:
LTC Homes Inspector
Job Code:
50122 - Nurse 2, Public Health
Job ID:

Purpose of Position :

To promote the health, safety, comfort and rights of long-term care (LTC) home residents as part of an interdisciplinary, provincial inspection team, through the assessment and determination of compliance by LTC Home Licensees, staff and others with applicable legislation, regulations, policies & standards; determining the
appropriate action/sanction & time frames to achieve compliance once non-compliance is identified

To conduct inspections and inquiries in accordance with the methodology and principles of the Long-Term Care Homes Quality Inspection Program (LQIP), prepare inspection reports, collect and present evidence of noncompliance and follow up on non-compliance to ensure compliance achieved within identified time frames.

To promote and strengthen the quality of LTC homes inspections and support the full inspection process for all LQIP inspection types, including acting as Primary Inspector as required

Duties / Responsibilities :

Inspections and Inquiries - Responsible, as member of a inter-disciplinary, provincial team, for inspecting and determining legislative, regulatory and policy/procedural compliance in accordance with the policies/procedures and methodology of the Inspections Branch; following up on any non-compliance identified. Works under the
general supervision of the Inspections Manager, Service Area Office, LTCIB

Conducting inspections and inquiries under the applicable legislation, regulations and policy/procedures governing LTC Homes as they relate to resident care and other operational issues; coordinating and leading, where appropriate, the inspection process with other inter-disciplinary inspectors as well as other resources including financial, legal counsel, medical and other;

Identifying, collecting and documenting evidence gathered to determine non-compliance, ensure that it is collected in accordance with LTCIB policies, procedures and direction to support reporting of non-compliance, appeals processes and other requirements for evidence collection;

Interviewing licensees, staff, residents of the LTC home and other parties, take statements to obtain and discuss information relating to the inspection and other related requirements

Maintaining effective communications with LTC home licensees, staff, residents, families and other related parties, (often under very stressful conditions)

Analyzing data and evidence gathered and reviewing the management, operations, resident care programs, services, employee and general records to identify if any non-compliance, determine appropriate action/sanction to take and ensure there is evidence to support the actions/sanctions invoked

Utilizing registered health professional clinical skills to evaluate and assess provision of clinical care to residents including organization structure for care and services, policies & procedures, quality of programs outcomes, staffing hours, staff qualifications and training, standards of practice, management philosophy and objectives and other requirements under LTCHA;

Verifying all non-compliance with applicable legislation, regulations, policies and directives through observation, interviews, record reviews, evidence collection, sampling and other testing methodologies to support the noncompliance;

Issuing orders or other actions/sanctions, provide written inspection reports on inspections conducted, making recommendations to the Director to apply sanctions, where applicable; reviewing and evaluating submitted plans for compliance

Conducting inspections on resident trust accounts, MDS data accuracy, accommodation charges and other approved service charges to ensure compliance with legislation and policies;

Acting as an agent of the Minister of Long-Term Care where the Ministry must take over the operations of a home;

Obtaining clarification regarding interpretation of legislation and regulations and to provide that information to others

Evaluating and assessing the immediate risk of harm to resident health, safety and welfare to determine if immediate actions required, taking appropriate action including referral of matter to others

Communicating with complainants, residents, families, LTC Home staff and operators, Placement Coordinators, LHIN Ontario Health representatives, Ministry or other OPS staff, and other stakeholders such as police services
and regulatory colleges 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.

2. Advisor to the Manager and Director, Long-Term Care Homes (Responsible for providing expert technical knowledge regarding resident care, with a particular focus on the risk and threats to the quality of care of the residents in Long-Term Care Home (LTCH) settings:

Conducting special inspections as required by the Director in relation to service delivery in LTCH or other settings or potential offence provisions, e.g. complaints lodged with the Branch by LTCH residents/their relatives, and/or by agencies, advocacy groups or members of the general public, responding to issues raised about specific homes.

Working collaboratively with an inter-disciplinary health team, i.e., nursing, dietary, physiotherapy, environmental health, financial, legal, Service Area Offices and others to ensure effective coordination of inspections, information and evidence sharing and soundness of inspection outcomes.

Providing input to decision-making process re; license revocation/renewal and other actions, as requested; providing written inspection reports on inspections conducted, making recommendations to the Director to apply sanctions beyond the inspector's scope, where applicable;

Preparing documents and presenting evidence, testifying as an expert witness in appeals and court proceedings or other hearings or coroner's inquests;

Compiling data, analyses and evaluating and preparing reports, summarizing the findings of analysis. (e.g. risk indicator reports, performance reports, etc.); drafting correspondence and reports as requested including inspection reports for operators and the public.

Overseeing the work of the Ministry appointed agent to ensure the day-to-day care of LTC home residents in cases where the Ministry has taken over the operation of a LTC home.

Contributing to briefing notes and other issues management functions, including providing details to SAO manager of potentially contentious issues.

3. Carrying out training activities as assigned under the Inspector Certification training program and other training activities of LTCIB (10%); mentoring trainees; monitoring progress of trainees throughout training activities and providing written assessment to the Inspection Manager for final evaluation..
- Performs other related duties as assigned
Attending Staff meetings
Attend Provincial training and education sessions

Staffing and Licensing :

Current registration as a Registered Health Professional as a Registered Nurse, Registered Dietitian or Physiotherapist with a certificate of competence from the applicable College regulating the profession (e.g., College of Nurses of Ontario, College of Dietitians of Ontario, College of Physiotherapists of Ontario; in good
standing with no restrictions on practice.

Valid Ontario driver's licence, willingness to travel extensively in the Province and to work irregular hours including weekends and after-hours.

Ability to complete and successfully pass the Inspector Certification process within established timeframe.

Knowledge :

Extensive in-depth knowledge and experience of LTC or health care operations;
Knowledge of the various Acts and regulations governing LTC homes; including the Long-Term Care Homes Act, 2007, Ontario Regulation 79/10, Personal Health Information Protection Act, the Provincial Offences Act and relevant Ministry/Division and program policies and procedures related to conducting inspections, inquiries and investigations, determine compliance, identify non-compliance, issue reports and orders, apply and explain the intent of legislation.;

Knowledge of inspection and investigation practices, procedures, theories and methodologies

Expertise Compliance/Enforcement

Expands and uses compliance and enforcement knowledge to distribute/relay compliance and enforcement related knowledge to others through answering questions, providing extra knowledge, and demonstrating depth of
knowledge with the goal of achieving regulatory compliance and mandatory performance outcomes.

Ability to communicate effectively with LTC home operators, staff, physicians, other professionals and the general public.

Thorough knowledge of current applicable Regulated Health Professional theories and practices ' based on the applicable regulated health professional status of the employee;

Analytical and assessment skills to observe and evaluate resident care; resourcefulness and ability to perform with minimum supervision, exercising initiative and independent judgment in potentially highly stressful, politically sensitive situations.

Skills and abilities in dealing with clients requiring long-term care, including knowledge and expertise in gerontology generally acquired through a degree in Health Sciences.

Thorough knowledge of and consistent application of LQIP policies and procedures related to all inspections types as demonstrated by completing the required training and the prescribed Inspector Certification process

Skills :

' Concern for Quality and Standards

Monitors own work quality and processes against LTCIB policy and standards in order to reduce uncertainty and ensure principles and standards of information gathering/collection, inquiries, inspections, enforcement, and investigations are maintained.

Communicating Effectively Uses effective interviewing skills including active listening to respond appropriately and professionally, in a regulatory compliance role, when interacting with others, including in high stress, and contentious situations. Understands and uses both verbal and non-verbal behavior in communications. Listens, understands and responds professionally and effectively when interacting with others considering cross cultural sensitivity.

Written skills to prepare correspondence, briefing notes, comprehensive, accurate enforcement and status reports; prepare documentation for court procedures and appeals, with attention to detail;

' Leadership, flexibility, resourcefulness and assertiveness to work effectively with stakeholders and coworkers.

Leadership skills

Relationship Building Develops and maintains harmonious relationships while keeping to the code of conduct/professionalism with others. Actively seeks opportunities to contribute to progressive compliance, resulting in agreed upon solutions and voluntary regulatory compliance where appropriate. Determines the state of the relationship in spite of difficult interactions then builds the relationship, standing firm where required, in order to maintain regulatory compliance. Follows through on commitments, respecting confidentiality.

Conflict Recognition and Management Uses conflict management skills to identify potential conflicts and proactively brings disagreements into the open to help diffuse and address the conflict. Encourages open and constructive discussion as well as negotiates or facilitates win-win solutions where possible in conflict situations.
Proactively helps diffuse and address the conflict but negotiates and attempts to mediate to bring areas of disagreement to agreement. Knows when to remove oneself and regroup, and when to engage and disengage from a conflict, keeping personal security as a priority. These skills can be used with the public, LTC
administrators, licensees and other stakeholders.

Sound judgment to perform as an expert witness in court proceedings;

Problem Solving Recognizes and understands the issues that arise during ,inquiries, inspections and enforcement or investigation situations; breaks these situations down into their component parts to identify key issues. Systematically organizes and compares various aspects of the issue, problem or situation to determine cause-and effect relationships and resolve these problems in a sound and decisive manner. Recognizes the potential risks and impacts of the problem on a wider scale and the broader impact of actions. Identifies the regulatory requirement linked to the problem and takes appropriate actions to meet regulatory requirements and then
systematically determines next steps and actions to resolve the problem in a sound and decisive manner.

Knowledge of program evaluation methodologies, theories and approaches and clinical skills to observe and evaluate resident care and home operations, and determine non- compliance and appropriate actions/sanctions/orders is required

communication and presentation skills to present Ministry's requirements and direction;

Well-developed analytical skills to apply benchmarks, assess Critical Incident System reports and data relating to compliance issues, recommend required follow-up including sanctions;

Knowledge of and ability to use word processing, database and spreadsheet applications, inspection related software, e-mail, websites and electronic calendars;

Ability to work effectively within an inter-disciplinary health team;

Ability to operate and deliver in a highly stressful, high volume, politically sensitive, fluid environment with a 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

Freedom of Action :

'Compliance and Risk Understands compliance objectives and outcomes then identifies, assesses, understands, documents and communicates the level of risk. Informs clients of compliance action needed and takes compliance action when required to prevent harm and promote health, safety, comfort and rights of residents in LTC homes in investigation, inspection, and enforcement activities.

' Conducts inquiries and inspections and investigations both in a team environment and individually.

' Records observations, conducts inspections and investigations as necessary, for clinical, care related, legal and/or financial matters. Makes recommendations to SAO management, as needed where non-compliance has been identified. Makes recommendations to Branch management on key Ministry policies and
legislative/regulatory changes.

' Work is performed with a high degree of independence under the general direction of the Inspection Manager, and within the broad framework of the Ministry's strategic direction in the area of long-term health care, and within the requirements of MLTC and its legislation/regulations and policies.
Integrity takes actions that are consistent with OPS values and policy direction and are in accordance with the code of conduct/professionalism, e.g.the Regulator's Code of Practice. Communicates intentions openly and directly and welcomes openness and honesty, in interactions with internal and external clients.

Impact and Influence Influences and persuades others to adopt a specific course of action that corresponds with policy and direction to ensure regulatory compliance and public safety.

Situation Judgment/Discretion Identifies and takes necessary, appropriate and timely action in response to issues arising in investigations, inspections, and enforcement situations by using current knowledge and insights as well as the use of analytical and conceptual thinking. Does not overreact or underestimate the situation, taking
appropriate actions to immediately address the situation.

' Ineffective monitoring of LTC home operations could impact negatively on the health, safety, comfort and rights of residents, visitors and employees as well as public confidence and perception of government oversight.
Inappropriate use of enforcement powers could negatively impact on Ministry in legal proceedings.

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