A Cape Breton special care home where an autistic man was confined to a room for two weeks last year is beset by a "climate of mistrust and suspicion" where staff and management have an adversarial relationship, concludes an independent review released Tuesday.
The review paints a grim picture of what it is like to live and work at Braemore Home Corp. in Sydney, a residence for people with disabilities that found itself under scrutiny after the Nova Scotia government launched an external investigation earlier this year of its operations.
The report by consulting firm Deloitte outlined a number of problems with Braemore's workplace culture and how that affects care for its residents.
"There is evidence of a command-and-control management style, as well as ineffective management practices at all levels," the 29-page report said.
"Adversarial relations between leadership and staff undermine client support.… There is a climate of mistrust and suspicion, and use of grievance processes instead of dialogue between union and management.
"There is a significant need for changes at all levels of the organization — staff, leadership, board of directors and the Department of Community Services."
The provincial government has suspended Braemore's licence and replaced its executive director. The Cape Breton District Health Authority's board of directors is now acting as the interim board for the home.
The review was ordered by the province's Department of Community Services in February after officials found that an autistic resident of Braemore was locked inside a constantly lit room for 15 days last fall.
Minister says she feels 'absolutely terrible'
At the time, Community Services Minister Denise Peterson-Rafuse said the review was needed after her department concluded the 20-year-old man, who was allowed out occasionally for exercise and meals, sometimes urinated in the room when he couldn't leave to use a bathroom. The home's executive director, Debra MacPherson, later apologized.
Peterson-Rafuse, who was in Sydney on Tuesday to meet with the interim board, said she was taken aback by the report's findings.
"I accept the responsibility as minister to say that we could have done better too," she said in an interview.
"I feel absolutely terrible that the things that happened to that young gentleman and other individuals had to take place."
Peterson-Rafuse said a new executive director has been appointed to replace Debra MacPherson and a clinical team has been put in place to address issues like long-term strategy and oversight, accountability, organizational culture and governance.
MacPherson could not be reached for comment.
Union welcomes findings
The Canadian Union of Public Employees, which represents about 160 unionized staff at Braemore, issued a statement Tuesday saying it welcomed the review's findings.
"It confirms many of the things our members have been saying for several years about the operation of Braemore Home," said union spokeswoman Kathy MacLeod.
"We now see the door opening to long overdue changes at this facility."
The report issued nine recommendations. They call on the government to develop standards for special care homes and enhance oversight, as well as urge Braemore to work with an organization that specializes in adult autism and residential services.
"The unfortunate and confusing aspect of this environment is that many people living at Braemore appear content and happy," the report said.
"For many, institutional life at Braemore is all they have known."
The Cape Breton District Health Authority's board of directors will oversee the home's operations until the report's recommendations are implemented.
Braemore provides housing and rehabilitation services for about 130 youths and adults with disabilities. It is privately run but receives public funding.