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HALIFAX, N.S. - In one case a mentally disabled resident at a Nova Scotia residential centre is described in government reports as being dragged by a worker down a hall by her leg. In another, a worker is reported to have sprayed water on a female resident's head "to the point where she was gasping for air."
The descriptions of mistreatment are contained in reports stemming from 49 cases of abuse at Nova Scotia residences that were reported between October 2007 and July of this year.
John Cox, the Nova Scotia spokesman for People First, an advocacy group for the mentally disabled, said he found the descriptions unsettling.
"Some of this is vindictive, basically payback. ... It could definitely be avoided," he said after reading the descriptions, which were obtained by The Canadian Press under freedom of information legislation.
The provincial government says since the reports were filed under the Protection of Persons in Care Act, staff have been fired or disciplined, additional training is in place and an auditor appointed in the Department of Community Services is reviewing each case that's received.
Denise Peterson-Rafuse, the minister of community and social services, said in an interview she plans to overhaul the legislation that governs the facilities to give her direct supervisory power, rather than making recommendations to the independent boards of directors of the non-profit facilities.
Peterson-Rafuse said she was "disappointed and shocked" by the cases.
The government reports say 21 of the abuse cases happened at the aging Riverview adult residential centre in Riverton, near New Glasgow, where there are about 100 residents with a variety of mental illnesses and disabilities. Thirteen were cases of residents abusing other residents, while eight were of staff abusing residents.
The records provide brief descriptions of the cases.
They say that in April 2008 a resident had "water sprayed directly on her head by a residential worker to the point where she was gasping for air. The resident was then left sitting in a whirlpool tub chair with a small towel on her and without being dried off. ... The student who was present at the time felt that the resident was cold as the worker walked out of the room, and the student put a towel around the residents' shoulders."
They say that in the same month, "when a resident refused to drink water after taking pills, the worker pulled down the top of the resident's pants and poured water on him." The worker then held the resident's arms across his chest with one hand and put a knee on his lap, then put the cup to his lips "where the water ran down the front of his shirt."
Nancy Clarke, chief executive of Riverview, said one staff member involved in three incidents no longer works at the facility. Clarke added that three of the five staff involved in other abuse incidents "are no longer affiliated with Riverview."
The documents also say that in February 2008, a blind resident who couldn't talk was left on a commode chair with a suppository by a worker finishing their shift. The worker didn't report to others that the resident had been left on the chair. He was found 90 minutes later, asleep on the portable toilet.
Community Services recommended the residence ensure it had a better policy in place to check where residents were during shift changes.
However, six months later another incident was reported at Riverview after a "female resident was left on a toilet unattended in the washroom for three hours" during a shift change.
In July of this year, more than a year after the first case of staff physical abuse of a resident was reported at Riverview, another staff member "became frustrated by a resident's behaviour" and "the worker held the resident's arm while in a ... chair and placed a bar of soap in her mouth."
The worker was given a 14-day unpaid suspension and transferred to a position that doesn't involve direct care of residents, officials say. The worker was also sent for counselling.
Cox said he simply can't understand why anyone would do such a thing.
"It's only common sense that you don't put bars of soap in the mouth. Why would you want to put a bar of soap in my mouth for my behaviour?"
Peterson-Rafuse said she wants to create an atmosphere of "zero tolerance."
After visiting Riverview and meeting with the board of directors, the minister said she believes appropriate actions have been taken, including more training of staff on how to avoid abuse. Her office has also appointed an official directly responsible from its licensing division to oversee any reports of abuse, and Peterson-Rafuse has asked to see monthly reports.
However, she also said legislation needs to change to give her office the power to directly intervene with boards of directors of the municipally operated adult residential centres.
"I discovered the present legislation does not allow Community Services whatsoever to go in and make changes. We have no control or say to the board of directors, we have no control or say to the chief executive. We can make recommendations and that's what we have been doing," she said.
"It puts us in a difficult situation. We provide the funding ... but we don't have the control to go in and make those changes."
Peterson-Rafuse said she's planning to make the changes to the Homes for Special Care Act in the spring legislative session.
In addition, she said a multimillion-dollar renovation of the Riverview facility will create separate rooms for all 100 residents who want their own space. It will also provide three separate homes on the grounds and create what Peterson-Rafuse described as a "more home-like" atmosphere.
"We have to look at what is creating the stress. We know the facility and the conditions have to be creating stress," said Peterson-Rafuse, adding that she has gone through the facility and met the residents.
During an interview at Riverview, Clarke said she and her board view the eight incidents of staff abuse of residents as "very serious" and they reacted with serious disciplinary measures.
If other cases are reported, Clarke said they will be dealt with quickly and in all cases, it was her staff who reported the incidents.
"What it indicates is that our staff are very aware that they need to report," she said. "As an organization we are reporting because that is our responsibility."
Clarke said the facility has tightened its policies to avoid incidents where residents are left unattended. "We now have a different process of reporting a change of shift ... those two cases were neglect and the root cause was people not adhering to policy.
"We have educated and re-educated our staff to follow policy."
The government reports also say there were two serious incidents reported at the Sunset adult residential centre in Pugwash, a centre with 110 residents including people with mental disabilities and long-term mental illnesses. The 100-year-old adult residential facility - which was extensively renovated in the 1990s - has 150 staff.
The reports say that in October 2008, "A residential rehabilitation worker grabbed a (female) resident by the leg above her ankle and pulled her down the hallway to another unit. ... Another ... worker, present at the time, did not stop the first residential rehabilitation worker."
The worker who pulled the woman was suspended and fired, while the worker who didn't intervene was suspended for three days.
Sunset also had a case last year that was classified as institutional neglect, where it took days for staff to identify that a "non-verbal, total care" resident had a fractured femur.
"During an investigation into the cause of the bruising and swelling, it was discovered that on at least two occasions the week prior to the discovery of the fracture, he had fallen out of bed. This was not reported and he was not examined by nursing staff," says the report.
Since the incident, the resident has been given a bed that lowers to the floor, all of the workers involved were given training in lifting procedures and a policy on restraints, such as side rails on the beds, was reviewed and updated.
Mary Ellen Pittoello, director of the Sunset centre, said in an interview that proper followup actions were taken and the "staff and management are committed to providing a high quality of care and support that protects our clients safety, dignity and self esteem."
She said she would welcome the minister's greater oversight role, and supports the plan to extend the abuse legislation to cover unlicensed, smaller facilities in the province.
Still, the incidents anger Cox.
He repeated calls for an independent review of the abuse, saying an internal study of Riverview by the department is not sufficient.
"Why is this happening to people with intellectual disabilities? We're less than human."
