UPDATE - Nov. 23, 2020: This article has been updated with new comments from a spokesperson from All Seniors Care.
Staff at an Alberta retirement home say they’re scared to work, demoralized and want to see change from their employer and the province after a recent COVID-19 outbreak that infected more than 10 staff members and 30 residents. And at least one expert says they’re not alone.
Alberta doesn’t publish individual case counts for outbreaks at facilities. Charlene Nero, who works at the union representing employees at the home, told HuffPost Canada it’s a “significant outbreak” and “was absolutely a preventable disaster.” According to the union, four residents have died, mainly in the home’s units for residents with dementia.
One staff member said their heart rate went up every time they entered the building in October, when the virus began spreading through the home like “wildfire.”
“You really just have to throw yourself out there, to wait for your turn to get COVID,” said the employee, whose identity HuffPost is not releasing because they are concerned about employer retaliation.
The outbreak has confined residents and has been devastating for them and their families, the staff member acknowledged. Residents have become sad, agitated, angry and moody, often experiencing a loss of appetite, they said. Staff are only supposed to spend 15 minutes in each resident’s room, but that’s an “impossible” amount of time to feed and provide compassionate care for someone, especially if they’re sick, the employee said.
“Residents are burned out. We are burned out. It’s been really stressful.”
Bruce Lillie, the regional marketing director of All Seniors Care Living Centres Inc., which operates the St. Albert home, said the company has followed all public health guidelines and has “done more than required” during the pandemic. He said many employees across the company’s sites attended social events without social distancing or wearing masks despite the employer asking them not to, and did not disclose when people from those events tested positive.
Staff concerned about PPE, screening
Rose Arndt, a recreation aide and union steward at St. Albert retirement residence, contracted COVID-19 in mid October. She told HuffPost she believes she contracted it from a resident on the unit where the facility’s first positive case was diagnosed.
“I’m concerned about our safety and our health in general, especially because I tested positive,” she said.
Before she tested positive and had to leave work, Arndt said she never saw an N95 mask. Alberta Health Services’ personal protective equipment (PPE) guidance states health-care workers are required to wear a surgical mask but an N95 should be worn when performing aerosol-generating medical procedures like intubation.
No residents at St. Albert are receiving aerosolizing generating procedures and N95 masks are not to be worn in place of medical masks, per an order from Alberta’s chief medical officer of health, Tom McMillan, assistant director of communications for Alberta Health, said in a statement to HuffPost.
N95 masks are on site if there is a situation where staff need one, Lillie said.
Arndt said she thinks the surgical masks they were given were too thin and often too loose to stay on securely. Two days before she left, she was given a face shield to wear over her surgical mask, but that was only after positive cases started appearing at the home. Now that she is back at work after isolating, she said staff are given better quality masks they change frequently during their shifts, as well as other PPE like gowns and gloves.
There’s nothing wrong with staff wearing a surgical mask if it’s changed regularly and worn with goggles, but at a home experiencing an outbreak, staff should be wearing N95 masks routinely, Donna Wilson, a nursing professor at the University of Alberta, told HuffPost.
A petition started by one staff member and shared with HuffPost outlines several other concerns, including having to do their own temperature check and screening in the morning, “extreme” short staffing at times and concerns about inconsistent cleaning at the home.
“I have never in my life been so scared to go back to work, as I am now.”
Lillie said staff are screened when leaving and entering the building and have their temperature taken, and they are provided with appropriate PPE, including masks to change throughout their shift. Staff are required to wear a mask and shield or goggles under public health guidelines. The surgical masks are provided by Alberta Health Services and are the same ones worn in hospitals, he said.
Before returning to work, Arndt said she was also concerned about the home’s staffing levels. She said, at one point, a health-care aide was alone caring for 18 residents on one floor.
“The morale of the staff is really low. I mean, it’s really sad. And like I said, I’m a very strong person. I have never in my life been so scared to go back to work, as I am now.”
Lillie said staff morale is “naturally” lower than normal because of the stress of the pandemic. He said the home has complied with the Alberta Health Services requirement to be staffed to the level of two staff members per 35 residents. All Seniors Care has also hired about 25 new staff members to work daily during the pandemic, he said. It has also brought staff from other locations to work at the St. Albert home.
In the past few weeks, Alberta Health Services has sent assistance to St. Albert including nurse practitioners, leadership support and a social worker to help with family communication. Most of the staff who tested COVID-19 positive have now recovered and returned to work, spokesperson Kerry Williamson said.
McMillan said the province is giving more than $260 million to operators on a monthly basis to support the safety of residents in long-term care and designated supportive living facilities, which St. Albert offers. The funding, which goes toward enhanced staffing, cleaning supplies, covering revenue loss and supporting facilities experiencing outbreaks, is retroactive from mid-March and will continue “until a vaccine is discovered,” he said.
Company, govt pandemic pay not given to all employees
The “most important thing is that we don’t get compensated,” staff wrote in the petition. “There’s no increase in our salary, in spite of the extreme exhaustion [we’re] handling day by day.”
Early in the pandemic, the retirement home’s operator promised temporary financial incentives, but they weren’t for all staff at the home.
Nero, who is the legal director of Labourers’ International Union of North America (LIUNA) Local 3000, said at the beginning of the pandemic, All Seniors Care implemented a $2-per-hour bonus for employees who were willing to sign a contract only to work at St. Albert. This was before the provincial government instituted a single site staffing order in April, which required staff to choose one facility to work in to prevent spreading the virus between homes.
In addition to offering a temporary bonus to employees who chose to solely work at St. Albert, the union also alleged the company offered to pay an additional premium to employees willing to move into the home during the pandemic.
“The intent behind the premiums was to mitigate chances of bringing COVID-19 into the residence,” Lillie, from All Seniors Care, said. He said about 85 per cent of the home’s employees agreed to sign onto working solely with Nutra 2000, the agency that provides staffing and operations for All Seniors Care.
“Because of this we saved lives,” he added. He also said an order from Alberta’s Ministry of Health instructed employers not to pay premiums beyond a certain date because the government wanted to “level the playing field” between operators.
Lillie also said staff wages at St. Albert were negotiated by the union and are competitive with the area. The company is lobbying to get government funding for all front-line workers, he said.
“So what are we, chopped liver?”
The union was concerned because the company’s arrangement meant some staff — who worked at multiple facilities and chose to stay at St. Albert during the pandemic — would receive the bonus, while others who had only ever worked at St. Albert wouldn’t be eligible for the premium. Despite their concerns, All Seniors Care walked away from negotiations and implemented the premium, Nero said.
Lillie said everyone who agreed to work at St. Albert exclusively was paid the premium. He said the company did not walk away from negotiations, but asked the union for consent and then went ahead with paying the additional funds to employees who agreed to only work at St. Albert.
LIUNA filed an unfair labour practice complaint with the Alberta Labour Relations Board claiming All Seniors Care and Nutra 2000 violated the union’s representational rights by communicating directly with its employees about this.
That legal action is ongoing, Nero said, and costing the company money that she suggested could be used to improve staff wages and working conditions, as well as resident-living conditions. All Seniors Care stopped its pandemic pay program mid-August and notified staff about it at the end of the month, according to the union.
“They didn’t even tell us that they were taking it off,” Arndt said. As a recreation aide, she isn’t eligible for the province’s $2-per-hour pandemic pay, which is for health-care aides in long-term care and designated supported living facilities.
“So what are we, chopped liver?” she asked. “We still [take] care of the residents in a different capacity.”
Wilson, the nursing professor, said a $2-per-hour benefit could help retain staff and acknowledge the extra work they’re doing during the pandemic.
“But the issue then is that, if that benefit is taken away or if it’s not applied evenly across everybody, then it’s a real disincentive,” she said. “And so people say, ‘Well, I’m going to find a better job.’”
Nero said All Seniors Care has made “several missteps” during the pandemic.
“From the beginning of the pandemic, All Seniors Care — not just this particular home, but the whole chain, with which we have a number of bargaining units — has not taken a cooperative, participatory approach with the union,” she said.
“They spent a lot of energy protecting their bottom line, when they should have been protecting their residents and our members.”
Lillie said retirement home operations are monitored by their licensing body to ensure proper accommodation for residents. Alberta Health Services also monitors the staffing and care provided, he said.
“Rather than not cooperating, this extra money the company offered its workers came right out of its bottom line,” he said.
Alleged lack of provincial actions
McMillan, from Alberta Health, said the province is “concerned with the growing number of outbreaks” in continuing and long-term care facilities. He said the government has put in place “strong measures” to protect residents, including updated operational and outbreak standards.
Those include “screenings of workers, balanced visitor restrictions, aggressive testing for any outbreaks, enhanced infection prevention and control practices and mandatory continuous masking at all times when staff are providing direct resident care or working in resident care areas,” according to McMillan.
“We are looking closely at our continuing care facilities and where the spread is occurring, including whether additional measures are needed to help slow transmission,” he said.
But both Nero and Wilson said Alberta hasn’t taken many province-wide steps to help retirement and long-term care homes during the pandemic.
“In many ways, so far, the government has stayed out of the nursing home industry, the nursing home business, other than general public health rules,” Wilson said.
Most retirement and long-term care homes in Alberta and other provinces are experiencing similar issues, she said. The government’s public health orders apply to nursing homes, and some relate directly to nursing homes, like the pandemic pay. But she said handling the pandemic has mostly fallen to individual operators, meaning there’s a variance in how homes have fared depending on factors like screening, masks, cleanliness, isolation protocols and the facility’s design.
Nero said there haven’t been any specific incentives to support retirement home workers in the province, which “speaks to and underscores the provincial government’s willingness to abandon vulnerable seniors and seniors communities.”
It’s “shameless” that the government has essentially allowed a privatized health-care system for retirement residences while not offering support to the companies operating the homes, she said.
CORRECTION: In a previous version of this story Lillie said All Seniors Care staffed St. Albert Retirement Residence to a ratio of one staff member per 35 residents. He now says the ratio is actually two staff members per 35 residents.