The Ministry of Labour, Training, and Skills Development (MLTSD) enforces the Occupational Health and Safety Act (OHSA). They do this by sending inspectors to visit workplaces to ensure the OHSA is being followed. An Inspector will complete a Field Visit Report for each site visit and list orders given to the workplace parties to ensure compliance. Although all field visit reports will contain a reason or purpose for the visit, they frequently do not have orders. Because the Ministry enforces the OHSA, they are sometimes referred to as the external responsibility system (ERS). They are the external authority a Joint Health & Safety Committee (JHSC) member will call to complain when the employer is contravening the OHSA and putting the safety of workers at risk.
Eatonville Care Centre
Eatonville was one of the hardest hit long-term care (LTC) homes in the first wave of the pandemic. It was one of the homes covered by the Justice Morgan decision. As ONA was escalating the health and safety issues, the SEIU was doing the same. The ongoing inspections of Eatonville were part of a settlement of an SEIU appeal for a failure to issue orders.
The management co-chair was chairing all the Joint Health and Safety Committee (JHSC) committee meetings. The order required that the workers select a co-chair of their own and that the chair of the meetings rotates between management and worker co-chairs.
There were multiple issues with occupational illness reports. There were 106 total reports, but the Ministry only received 104. The order required the missing reports be shared with the Ministry. The occupational illness reports were not being shared with the committee. The order required the occupational illness reports go to the JHSC. The inspector also ordered the Public Health Ontario Outbreak checklists, all Form 7s from WSIB for COVID-19, and the minutes from the COVID-19 committee.
In the first wave Ministry inspectors were only going to LTC homes if there was a work refusal. It was not surprising that as soon as an inspector set foot in a home that had a bad outbreak (106 occupational illness cases is an extremely bad outbreak), we saw meaningful orders.
The inspector using their powers to review documents like the Public Health Ontario checklist was important. ONA would have liked to see the Ministry extend this to requiring exposure reports go to the Joint Health and Safety Committee but unfortunately, we have had to fight the Ministry on this issue since very early on in the pandemic.
Arnprior Regional Health Centre
Denial of an N95 respirator following a point of care risk assessment.
The employer was ordered to provide the N95 respirator.
This was an early order requiring the employer comply with Directive 5.
Anson Place Long-Term Care
The LTC home had a COVID-19 outbreak which prompted an investigation by the Ministry. At the time of inspection, there were 34 workers and 44 residents who tested positive for COVID-19. There were several safety issues found during the inspection, including the employer’s failure to follow public health guidance regarding physical distancing and screening, not following measures and procedures regarding Aerosol Generating Medical Procedures, failing to have an established Joint Health and Safety Committee, and failing to instruct workers on how and where to properly store their PPE when they take their breaks.
This home had nine orders issued. The inspector was thorough in their investigation and compliance dates were quick to ensure that violations of the OHSA were corrected ASAP. The inspector issued orders that required the employer ensure for proper physical distancing and personal protective equipment during screening and to ensure all required questions were asked on the Ministry of Health’s screening tool. There was also an order for the Employer to provide the information and instruction to protect the health and safety of workers regarding COVID-19.
A number of orders were written regarding Personal Protective Equipment. One order was written for the instruction and training of workers regarding PPE because not all staff were aware of the need to wear an N95 respirator when caring for a patient on a CPAP machine and to keep the door of the residents’ room closed. An order was written to ensure workers are instructed in the care and use of the PPE so it can be properly stored when on break. The employer was also required to ensure that the PPE is stored in a clean and sanitary location when not in use. Employers are responsible to ensure that employees are properly trained on the care use and limitations of personal protective equipment (PPE).
The employer was also required to establish and provide training in consultation with the JHSC on measures relevant to the worker’s work; not all workers were aware of the process to get additional PPE during off shifts. The inspector asked for copies of the JHSC inspection reports, and it was noted that the last one was done in February 2020. This is a violation of OHSA and an order was written to require the Employer to ensure the JHSC is established and functioning according to the Act.
Due to the nature of the COVID-19 virus, it is important to ensure that health and safety measures are in place to protect the workers. Workers (i.e., screeners) were putting themselves and others at risk by not asking all of the required screening questions since they were not properly informed or trained by their employer. These orders ensure that workers are aware of the precautions that need to be implemented in order to ensure for safety; the orders also recognize that instruction and training are an important element to ensuring for worker safety.
It was evident that the JHSC was not functioning at this workplace in accordance with the OHSA. One of the core functions of the JHSC to help identify hazards in the workplace and make recommendations to resolve them. If inspections are not done, hazards can’t be identified, and workers are left at risk. The inspector identified gaps in knowledge and use of personal protective equipment, including how to access it, which puts workers at risk for their health and safety during a COVID-19 outbreak.
North Bay Regional Health (Hospital)
Workers providing direct care to COVID-19 suspected patients were being instructed to reuse procedural masks after breaks and lunches.
The employer was required to ensure that, once a mask is removed after treating a COVID-19 patient, it should not be reused.
It confirms that employers have a duty to provide a safe working environment and ensure that staff are not put at risk. This order stopped the reuse of masks which increased the risk of transmission to the worker of COVID-19 infection.
Baycrest Health Sciences
A nurse was denied N95s in a COVID Assessment Centre despite completing a point-of-care risk assessment (PCRA).
Inspector ordered employer to provide PPE as per a nurse’s PCRA.
Employer denied or did not provide PPE for protection against aerosol transmission contrary to Directives 3 & 5. The Ministry ordered compliance with the directives. The order was made under OHSA – Duties of employers, Sec 25(2)(h) to every reasonable precaution in the circumstances for the protection of workers.
Michael Garron Hospital
ICU Nurses were denied N95s.
Inspector ordered employer to provide PPE as per nurses’ PCRA.
Employers denied or did not provide PPE for aerosol transmission contrary to Directives 3 & 5. The Ministry ordered compliance with the directives.
Region of York
Public Health – Measures & Procedures – employer was not controlling access to workplace to reduce risk of COVID-19
Employer to develop measures and procedures for the entrance of the work area. Employer should document all workers/visitors to the workplace.
The employer did not have active screening before entry to the workplace. The Ministry ordered compliance with public health measures to reduce the transmission of COVID-19 by implementing screening before entry to the workplace. Although no order was written, the employer was reminded that a worker co-chair must be selected in accordance with the Act (Sec. 9(8)).
Fletcher Assessment Centre – William Osler
This inspection was the result of a complaint to the MOLTSD over the lack of precautions in place at a relatively newly opened assessment centre run by William Osler.
There were several H&S issues that were addressed by the inspector.
The orders addressed both physical and occ illness hazards as well as the establishment of a JHSC for the centre.
The inspector ordered active screening of patients to be implemented.
The inspector ordered that protective eyewear be required within 2 meters of a patient.
The inspector required physical distancing to be maintained in the lunchroom while unmasked.
The inspector required the employer provide lighting be installed in the walk-in tent where patients were being assessed after dark.
The employer required tripping hazards (chords) be removed.
The inspector required tables that were not in use to be stored safely.
Finally, and most importantly the inspector required the establishment of a JHSC.
This set of orders is quite long. The inspector did a good job of inspecting the assessment centre as a whole. This in person assessment allowed the inspector to write orders.
As COVID-19 is transmitted by aerosols we do not agree that distancing is enough in and off itself in a lunchroom, but the orders made it clear that the employer had to comply with the public health Ontario guidance that was in place.
The main thing that was important about these orders was requiring a new JHSC so that Hazards could be addressed. We were very happy to see a JHSC ordered as the lack of a JHSC in these instances can hamper the quick resolution of things such as the physical hazards identified by the inspector.
Grand River Hospital
The MLTSD was called because the workers were concerned about the masks provided to workers. They were arriving in different, unnamed boxes and some workers were having reactions. The Employer was failing to provide the product information, including test results. After a number of calls to MLTSD on this issue due to the Employer’s continued failure to provide the information to the JHSC, orders were issued.
The employer was to afford assistance and co-operation to the JHSC specifically providing information regarding potential hazards of face masks currently being used.
In consultation with the JHSC, the employer will develop, establish and put into effect health and safety measures and procedures respecting reporting of defective face masks and evaluation of replacement masks.
The employer was not appropriately involving the JHSC and lacked appropriate measures and procedures to protect workers. The MLTSD did a follow up visit to ensure compliance.
Hamilton Health Sciences
The MLTSD received an anonymous complaint alleging workplace violence and harassment from family members of ICU/CICU patients.
The worker will be informed of the results of the investigation and any corrective actions taken, or that will be taken.
The employer shall reassess the risks of workplace violence as often as is necessary.
At the time of the MLTSD field visit, there were many gaps in the employer program. There had been inadequate training for workers, security and supervisors. The orders issued addressed immediate gaps and also ensured for ongoing compliance.
Southlake Regional Health Centre
Southlake Regional Health Centre submitted an investigation report related to an incident of workplace violence that occurred in the Inpatient Cancer area on December 30th 2020. The Ministry of Labour (MoL) investigated and specifically referenced two current and ongoing investigations of workplace violence.
The inspector identified and was critical of supervisor competency, lack of maintenance or diligence regarding functional personal safety devices, and gaps in the flagging policy. His closing paragraph is worthy of repeating:
“In closing, the writer is fully cognizant of the gravity of the orders issued in this report. However, given the extended attempts that this Ministry has made over the years at SRHC including through the courts to succeed in having this employer proactively address and resolve the long ongoing and outstanding issues regarding protecting workers from the inordinate amount of violent/assaultive incidents at this workplace, the writer sees no other option than to issue more prescriptive direction to protect the workers at Southlake Regional Health Centre.”
The inspector wrote the following orders pursuant to OHSA Sec. 25(2)(h) – Every reasonable precaution:
“The employer shall ensure that ALL assessments for SRHC patients regarding a history of or currently presenting with violent behaviours are documented by means of a permanent record that is effectively communicated and readily accessible to workers tasked with providing care/comfort to those patients.
The employer shall ensure that conspicuous visual indicators required based on the permanent record of SRHC patient assessments that indicate a history of or currently presenting with violent behaviours are in place and visible to workers at the point of patient location at all times.
The employer shall ensure that the Personal Safety Response System devices (Versus Pendants) provided to workers by the employer are maintained in good operating condition by establishing and maintaining documented verification that the devices provided are in good operating condition…”
The inspector concluded with this order: OHSA 32.0.3 (1) – Assess risks of Workplace Violence:
“The employer shall assess the risks of workplace violence that may arise from the nature of the workplace, the type of work or the conditions of work. The employer shall conduct a violence risk assessment for the Inpatient Cancer area of the workplace.”
The orders require the employer to implement stronger flagging procedures, enhanced oversight of their personal safety devices (pendants), and a risk assessment for violence. These orders should encourage
Southlake to proactively consult with the JHSC and union to reduce workplace violence and create a safer workplace for all staff.