Personal Support Workers
Personal Support Workers
The report, obtained by the Star after an eight-month freedom of information process, revealed that the agency hired to administer the registry failed to conduct sufficient background checks
Report revealed major gaps in Ontario personal support worker registry
Agency hired to run online database failed to conduct sufficient background checks on PSWs before registry was shut down by the province in January, according to a report obtained by the Star.
Miranda Ferrier, who heads the Ontario Personal Support Worker Association, says her group would like another chance to host the province’s PSW registry, which was shuttered in January. (NAKITA KRUCKER / TORONTO STAR)
A registry designed to protect the growing number of patients relying on personal support workers was shut down in January after Health Minister Eric Hoskins received a report that exposed alarming shortfalls in its administration.
The report, obtained by the Star after an eight-month freedom of information process, revealed that the agency hired to administer the registry failed to conduct sufficient background checks, including vetting the criminal, education and employment records of more than 30,000 personal support workers whose names appeared in the online database. The report said the registry’s annual budget was just over $2.5 million in 2014-15. It launched in 2012.
Deborah Simon, chief executive officer of the not-for-profit Ontario Community Support Association, which ran the registry, told the Star her team “did the best we could realistically manage with the resources and timeline assigned to us.”
She said “certain parts of the report are inaccurate or lack context to the point of being misleading.”
The report highlighted a disconnect between what the provincial Health Ministry thought it was providing to the public and what Simon’s agency believed was its mandate.
When the ministry announced plans to launch the registry in 2011, then health minister Deb Matthews promised it would “promote greater accountability and transparency.” Clients and family caregivers were encouraged to use the registry to inform their hiring decisions.
But the registry disabled the site’s search function and publicly advised clients to conduct their own “research and rigorous screening process” when hiring a personal support worker.
“The registry did not provide assurance that registered PSWs were competent and safe to practise, therefore, clients and family caregivers could not rely on the registry to make informed choices,” stated the report, which was prepared for the Health Ministry by Britain’s Professional Standards Authority for Health and Social Care.
While the registry required applicants to provide information about their education and training, they did not have to provide certified copies of training certificates. Some supplied only copies of “honourable certification” — a document that attests to high grades but not graduation.
The report noted: “We saw registration files with the following: a black-and-white photocopied certificate, scanned copy in colour, a photo of a certificate and an image pasted onto a Microsoft Word document … All these could be easily fabricated.”
The report criticized the registry’s weak eligibility criteria. The registry did not specify how current education needed to be, and there was no requirement that registrants keep their training up to date.
Personal support workers were not required to be employed for any minimum period of time before registering.
“We found a case where the letter from the last employer confirmed that the registrant was employed as a PSW in the summer (of) 2014 and during the Christmas holiday in 2014,” the report stated. “The lack of a minimum number of practice hours to be eligible to apply for registration could be considered a gap in the eligibility criteria.”
In four years, the registry moved to suspend the registration of just one personal support worker — a person caught on camera mistreating an elderly patient. The worker was fired by the employer.
When the incident occurred in 2015, there was no policy or procedure to suspend registrants. The report noted the registry took two months to remove the name from its online database.
The registry said the delay was caused by a disagreement over the language in the letter it sent to the registrant, as it would set the standard for future cases. The policy for removing workers from the registry was still in the draft stage several months later, the report stated.
Simon said her group focused its energy on fulfilling what it understood was the government’s primary objective: ensuring as much of the PSW workforce as possible was captured in the database.
In a 2011 letter, Matthews asked the registry to enrol, within one year, 70 per cent of all personal support workers employed by publicly funded home-care employers.
It’s unclear whether the registry met this target because there are no records of how many of these workers exist. Still, the report deemed the “current number of registrants to be an achievement.”
Simon told the Star this is one area in which the ministry’s “very ambitious goals for the registry conflicted with one another.”
“For example, the extremely thorough vetting that would have been required for the registry to be a stand-alone solution to ensuring public safety could not be easily reconciled with the requirement that we register as many PSWs as possible, from across the province, at absolutely no cost to the PSW and very little inconvenience to registrants, on a very short timeline,” she said.
Miranda Ferrier isn’t swayed by Simon’s defence.
Ferrier leads the Ontario Personal Support Worker Association, which bills itself as “the official voice” for PSWs in the province.
Her association began registering personal support workers six years ago. She hired Sterling BackCheck to vet applicants’ criminal and educational backgrounds. Joining the association’s registry costs $120, half of which goes to BackCheck, Ferrier said.
“As an association, we’re trying to set a standard,” she said. “In health care, there is no room for being wrong.”
Another independent committee deals with public complaints and disciplinary issues and decides whether PSWs require additional training or suspension from the registry.
Ferrier’s group had applied to host the provincial registry in 2011. She would like another chance.
“Right now, with the majority of personal support workers, you don’t know who’s knocking at your door,” Ferrier said. “You’re just trusting they are who they say they are. Mandatory governance is necessary to fix that problem.
“As the association that represents tens of thousands of PSWs in Ontario — we provide standards of practice and accountability — we are more than prepared to work with the government to make that happen.”
The 100-page report recommends the ministry set up a body to host the voluntary registry or house it with the College of Nurses of Ontario.
Health Minister Eric Hoskins’ spokesperson said the government is working with its partners on a long-term strategy.
“That work is underway and we continue to look at a variety of options for how we can best serve PSWs, employers and the public,” Shae Greenfield wrote in an email, adding that “no final decisions have yet been made.”