Heather Court

An unlocked laptop displaying a resident's Medication Administration Record (MAR) was observed on top of a medication cart, exposing confidential information.

An enabler bar attached to a bed was not securely attached, allowing it to move and creating a gap with the mattress.

A resident was observed performing a sexual act over a roommate's bed.

Narcotic logbooks in the side slots of medication carts were observed unlocked and unattended.

A resident was observed shoving a walker into other residents' legs and hitting a resident on the head.

Two staff members had not completed the required annual fire safety education for the 2023 training year.

A staff member mistakenly administered one resident's medications to a different resident due to being distracted.

The home failed to report an incident to the Department's regional office regarding a resident's fall and subsequent rib fractures.

A resident was physically mistreated when another resident hit them in the side of the head during an altercation.

A required cognitive preadmission screening was not completed within 72 hours prior to a resident's admission to the secure dementia unit.

The home failed to follow prescriber orders by administering incorrect medications during noon administration.

A staff member was observed grabbing a resident by the arm and yelling, resulting in bruising to the resident's arm.

Laundry detergent was stored in clear Tupperware containers without the manufacturer's label.

Resident 3's RASP was not updated to reflect the use of an enabler bar on their bed.

Resident 3's RASP was not signed by the resident or the assessor.

A prescribed PRN medication for Resident 2 was not available at the time of inspection.

Enabler bars for Resident 1 and Resident 3 were not securely attached to the bed frames, posing a hazard.

No support plan had been completed for Resident 4 following their admission to the SDU.

A staff person was observed being physically and verbally abusive to a resident by forcefully pulling them by the arm and pushing them down on the toilet.

A staff person was observed using a manual restraint by holding a resident's hands down while the resident was combative during care.

A resident was subjected to physical abuse when resident #1 pushed resident #2, causing a fall and resulting in fractures.

The home failed to report an incident of resident-to-resident abuse, involving a fall and fractures, to the Area Agency on Aging as required.