Inspection reports offer a glimpse into the care a prospective resident can expect to receive in a given community. Sometimes, violations are easily fixed and don’t necessarily indicate a dearth of caregiving. Other times, a particularly disturbing picture is painted by the reports, reinforcing the need for thorough research before moving into a facility. Here are some of the incidents we discovered from one of the yearly inspections at Sunrise Home Care Services in Florida.
Dining room tables are set with paper and plastic products instead of china and silverware; this is the case for every meal. Residents are not given forks and knives at all, and were observed pulling chicken off the bone with plastic spoons or their fingers. Residents were not offered a choice of meals or drinks; everyone was served the same thing and was not offered other options even though some stated that they did not like or want the meal. Fruits and vegetables are always canned; it is very rare to have fresh produce offered. At snack time staff was observed passing out two foods – a pop tart or bread with peanut butter – and no one was asked their preference. Residents were handed one of the two items without the opportunity to choose. The supervisor stated there are other options for meals (canned ravioli, peanut butter and jelly sandwiches, or canned soup), but residents interviewed were not aware they could get something different. The menu is posted in a location inaccessible to residents.
There is not always enough food prepared to satisfy residents. Those asking for seconds were not always able to get more food, especially of the main dish prepared. Butter or margarine is not provided; residents eat bread dry. The supervisor claimed this is for the health of residents. Salt and pepper is also not provided. Residents complained of getting hungry before the next meal and some were noted as losing weight, though they were not on a documented weight loss plan.
- Facility administrator failed to provide regular meals which meet the needs of residents.
- Facility failed to meet recommended dietary allowances by failing to allow for a variety of foods adapted to the food habits, preferences, and physical abilities of residents.
Residents clear their own tables by bringing dirty dishes to the same counter where food is distributed. Second helpings are also provided at this counter when available, and staff was observed both handling dirty dishes and serving food without changing gloves. In the kitchen dishes are washed with a bleach solution, but the water temperature and the amount of bleach in the water are not measured for sanitation.
- Facility administrator failed to be responsible for total food services and the day to day supervision of food service staff.
- Facility administrator failed to ensure staff performed duties in a safe and sanitary manner.
Residents are often called “baby” and “honey” instead of by name. In one observed instance, a staff member was heard encouraging a resident to go use the potty and to have her diaper changed. This was done in the dining area in hearing range of every other resident at supper.
- Facility failed to ensure residents are treated with respect and with due recognition of personal dignity and individuality.
Several residents are owed money from an incident in their previous facility. The facility administrator says he has had their checks “maybe a couple of months;” the residents have not received their money. The administrator also processes residents’ social security checks, giving residents a portion of their money each month. The administrator was not able to produce documentation of payments or receipts from residents who had received their money.
Some residents do not have residency agreements in place.
- Residents have the right to manage their financial affairs unless otherwise authorized.
- Facility failed to maintain written business records using generally accepted accounting principles which accurately reflect income from residents.
- Facility failed to ensure that prior to or at the time of admission each resident executed a contract with the facility.
Many incidences of unsanitary and unsafe conditions are noted in the report. Furniture is indicated as worn, torn, and dirty. Bathrooms are not well supplied with towels and soap. A toilet seat is noted with a “dark substance” around the rim, and another toilet was left with feces in the bowl. One room smelled of urine and the supervisor stated that the resident is incontinent and it is hard to get the smell out of the bed. A musty/moldy smell was noted in the facility.
Floor tiles are observed to be in disrepair. Residents share adjoining bathrooms and apartment spaces; it is noted that residents of the opposite sex are able to unlock doors in their rooms and bathrooms to access each other’s rooms. Lighting does not work in all areas and exposed wires hang from the ceiling. One exit door was found to be jammed shut.
The inspector found many areas of the facility to be in general disorder, disrepair, and unpleasant condition.
- Facility failed to ensure every resident had a safe and decent living environment.
- Facility failed to provide a safe, clean, and hazard free environment for residents.
These egregious violations seriously bring into question the safety and well-being of residents. Reports like these reinforce the need for prospective residents to check inspection records and make a few surprise visits at a facility before choosing an assisted living community to call home.