Nine personal support worker (PSW) shifts are going unstaffed each day at county long-term care homes due to staffing shortages that are costing taxpayers $800,000 in overtime pay, according to a deputation and staff report presented to Simcoe County council this week.
The deputation and report drew attention to the severe staffing shortages of PSWs that exist county-wide, with a warning that the situation will only get worse as the population ages.
“About two years ago, we really started to experience this shortage, particularly in home and long-term care,” said Debbie Roberts, vice president of quality and performance of the North Simcoe Muskoka Local Health Integration Network (LHIN). “This shortage is being felt across the province, the country and even internationally.”
Roberts and Jill Tettmann, CEO of the North Simcoe Muskoka LHIN, came to Simcoe County council to discuss the serious shortage of PSWs in the county and brainstormed solutions to try to get more people into the field.
While Roberts indicated that the situation in Simcoe County isn’t so dire yet that they’ve been unable to admit patients solely due to staffing shortages, many local agencies are having to rely on overtime to fill the gaps.
According to the county staff report, during the first three quarters of 2018, the four county long-term care homes (Trillium Manor in Orillia, Sunset Manor in Collingwood, Georgian Manor in Penetanguishene and Simcoe Manor in Beeton) experienced 2,556 unfilled shifts with an average of nine open shifts per day, or the equivalent of nine unfilled full-time positions. The county realized $800,000 in overtime payments.
According to Advantage Ontario, as seniors are living longer with more complex needs coupled with an increasing prevalence of dementia, one of the most significant considerations is behavioural issues arising from these conditions including verbal or physical abuse, disruptive behaviour and hallucinations.
This trend can leading to safety risks and undesirable working conditions. With this trend, homes are seeing a surge in the rate of employee workplace incidents with 43 WSIB claims and 141 resident related incidents of violence in 2017.
In 2017, the county’s long-term care and social services department recruited over 243 employees. However, during the same time period, the department experienced a similar rate of employee exits with a turnover rate of 27 per cent, the highest among them being registered practical nurses at 63 per cent, followed by PSWs at 25 per cent, and registered nurses at 19 per cent.
As a result, the county’s long-term care homes are operating with significant staff vacancy rates.
The staff report also outlines consequences of relying on overtime as a permanent solution, including staff labour fatigue, a stressful work environment, and work-life imbalance.
“We need to improve recruitment and retention of personal support workers,” said Roberts. “The reason we are here today is, as much as we are working with health service providers and others locally to identify and implement strategies to improve the situation... we do need change at a provincial level and policy change.”
“Municipalities and upper-tier governments have the opportunity to influence, advocate and ensure that the government understands the concerns of your local residents,” she said.
Innisfil Mayor Lynn Dollin and Bradford Deputy Mayor James Leduc asked questions about the average wage of a PSW in the area and whether that can have an impact.
According the Tettmann, a PSW can make anywhere between $16.50 and $20 per hour, depending on where they work and the kind of work they’re doing.
“They need to get a better wage for the work they do,” said Leduc. “A house cleaner can make more money cleaning your house... and a house cleaner is cash, no tax. The education system has to be better. I think the PSW course is 15 weeks, and that doesn’t really indicate the scope of what a PSW does.”
“We definitely need to work on a better wage structure,” he said.
“The pay structure just doesn’t reflect the training that’s involved,” said Tiny Township Deputy Mayor Steffen Walma, adding that he was under the impression the training for PSWs was two years.
Jane Sinclair, the general manager of health and emergency services with the county, clarified that the County of Simcoe tends to run higher on the scale of pay for PSWs compared to private companies or other municipalities, with rates ranging from $20 to $25 per hour to start in long-term care.
“That being said, it’s very, very challenging for staff in this industry,” said Sinclair. “That’s why we’re looking for more support from the province.”
Orillia Coun. Pat Hehn made suggestions on how to get more people to enrol in PSW programs locally.
“I think education is a problem. I’ve known people who needed to work and couldn’t take time off to get the education to become a PSW, although they really wanted to,” she said. “If we could work with Georgian College or others to provide that education on part-time or in the evenings... that might help fill the gap.”
Tettmann pointed to strides the North Simcoe Muskoka LHIN has made in regards to making education easier to obtain, including exploring a possible PSW apprenticeship program.
“We believe that has great merit in regards to addressing the shortage,” she said.
Orillia Mayor Steve Clarke spoke up about retention, saying he has seen work environment issues even when visiting his father-in-law at a long-term care facility.
“The retention piece really needs to involve some sort of structural change, but I’m not sure what that looks like,” he said. “It’s that quality of job. We need to increase job satisfaction so (workers) become ambassadors for the job.”
“How closely is the education they are given aligned to what they will experience?” asked Clarke. “It seems to me there is a surprise element when they get there.”
Tettmann said that during focus groups, PSWs indicated that when students are doing their work placements, they are only responsible for one or two residents, which doesn’t prepare them adequately for the ratios they’ll be dealing with as a staff member.
Warden George Cornell read out a recommendation that he, along with general managers at the county level would be reaching out to local MPPs and the Ministry of Health and Long-Term Care for solutions to the shortage of PSW positions. That motion was carried.
“We all have different avenues that reach out to to find a solution to this and it’s going to take a community to get to the bottom of this and find some solutions and improve the situation,” said Cornell.
