THE REPORT OF THE PRESIDENT AND EXECUTIVE DIRECTOR

TO THE CITY CENTRE CARE SOCIETY (CCCS) AGM

JUNE 17, 2008

 

 

City Centre Care Society (CCCS) and its predecessors have provided services for one hundred years to residents of the Downtown Eastside (DTE).  CCCS continues to evolve and renew itself in the way that it provides meaningful services to the residents of the Downtown Eastside.  CCCS evolved from the merger of two societies - Central City Mission Society and the Wilberforce Cooper Care Society.  This evolution continues within our existing programs as we explore other options for providing service. 

 In 1907 Central City Mission Society (the Mission) provided shelter and food for persons in Gastown.  The “Mission”, a six storey building at 233 Abbott Street, opened in 1910 providing meals, shelter and an alcohol and drug treatment centre.  Starting in 1953 and continuing for almost 20 years, the Society also operated up to five group homes for children.  During the 1960’s the “Mission” subsequently became a long term care facility.  The Society was involved in outreach programs and in 1967 helped establish the Dugout, a drop-in social centre that also provided coffee and soup. 

 In 1993 the Abbott Street location was closed and replaced by Central City Lodge, a new building at West Pender and Homer.  City Centre Care Society was incorporated in 1997 to amalgamate Central City Lodge and Cooper Place, an intermediate care facility operated since 1983 by the Wilberforce Cooper Care Society.  In 2003 Cooper Place re-opened, after being closed for a year, as the first assisted living program serving the Downtown Eastside and Chinatown.  In the meantime the programs in the Lodge evolved to care for residents requiring increasingly more complex levels of care.  In 2007 our Society was chosen to be the operator of supportive housing in the Park and Marble Arch Hotels.

 This reports reviews initiatives occurring during the past year, at both the program and society levels. Our organization continues to strive to meet its long term goals and renew itself.  A key goal of our organization is to build a resident-centred community that strives to provide meaning and hope in the lives of some of society’s most marginalized members.  One essential component of this goal is to continue to strive towards building a community where staff can live their values by providing care, with dignity and respect, for the residents and tenants.

 Complex Care and Special Care at Central City Lodge

 The complex care program continues to evolve as we care for 100 residents requiring increasingly more complex levels of care with a wide variety of needs.  The population that we serve continues to change.  Only in more recent years have we started caring for female residents and an increasing number of younger residents.  The knowledge of our staff continues to grow as does the workload that arises from caring for residents with more complex needs.  Staff from all departments interact with the residents and thereby play an important role in enhancing the residents’ quality of life.

  The largest initiatives have been: implementing the Resident Assessment Instrument, upgrading our technology, undertaking renovations, implementing the new medication system, and cultivating good working relationships with our many partners.

 The most extensive initiative in the Care Department was the Resident Assessment Instrument (RAI) which is serving as a catalyst for renewal within the organization.  RAI [also known as Minimum Data Set (MDS)] is an internationally used system that assists staff in conducting resident assessments and treatments.  Under the direction of the Care Managers, staff have made commendable progress in learning the system and completing many assessments.  We will have fully implemented this project by the Vancouver Coastal Health’s (VCH) mandated deadline of March 2009.

 We are also upgrading our technology so that staff can best use their time to serve the residents.  Staff made improvements in computerized scheduling and coordinating the replacement of a computer network server to meet the growing computer needs of more users and programs.  Our Society is exploring options for upgrading our telephone and nurse call systems.

 Central City Lodge opened in 1993 and, as is normal in building life cycles, requires more maintenance.  We are replacing some of the Building Automation System, fixing leaks, and planning improvements for the building security system. 

 We wish to thank Craig Williamson, who has recently resigned as the Manager of Social Work, Recreation and Addiction Recovery, for his three years of contributions to the Society.  In the past year Craig also was instrumental in the Society’s application and planning for Supportive Housing.

 The Addiction Recovery Program at Central City Lodge

 The Addiction Recovery Program experienced another successful year in terms of continued improvement in the services provided to 147 residents.  Our occupancy rate was 92.4% or 7,437 bed days in the year.  Sixty-four residents successfully completed the 90-day program.

 We increased our proficiency in group facilitation, centering on modules relating to relapse prevention, interpersonal skills, and emotions management.  The program continued to build its capacity in serving the needs of residents with concurrent disorders in three ways.  We worked with these clients by helping them comply with their medication regime, cope with crises, and self-manage their symptoms.  

 By strengthening our relationships with community mental health providers, health centres, transitional housing programs, and the Hepatitis C Clinic, we furthered the residents’ ability to make linkages with and develop effective resource and support systems for sustained recovery.

 Licensed Assisted Living at Cooper Place

 The year was very eventful as we developed and carried out a plan for the year-long maternity leave relief of the Manager of Assisted Living, assessed the services we provide, undertook several major renovation projects, and developed a preliminary plan for using the vacant land next to Cooper Place.

 We implemented an interim organizational structure during the maternity leave of the Manager of Assisted Living.  Under this structure the Manager’s duties were allocated to several individuals.  Team leaders and staff at Cooper Place rose to the occasion and took on additional responsibilities to ensure that the tenants’ needs continued to be met. 

 Managers from our Society provided additional clinical, dietary, administrative and maintenance services to Cooper Place.  Care Managers participated in bi-weekly clinical meetings, a dietitian assessed several residents and maintenance hours were increased to deal with the many maintenance projects.  We would like to thank the managers for their extra efforts and for utilizing their expertise.  This enabled the continuation of improvements in several areas including risk management, incident reports and team building.

 The hiring of a Maintenance Manager in March 2007 has enabled us to undertake several renovation projects during the year.   The two most extensive projects were the replacement of the water piping throughout the building and repairing the roof.  In the upcoming year we have contracted for a major Heating, Ventilation and Air Conditioning (HVAC) project and will be enhancing the building security system. 

 We initiated a review of the services provided at Cooper Place.  Previously in 2002, Cooper Place closed as an intermediate care facility and was extensively renovated.  It re-opened in 2003 as a licensed 72 bed Assisted Living facility.  We now have had several years of operating experience.  While most assisted living facilities are not licensed, we have concluded that based on the needs of the tenants that we are serving, Cooper Place should continue to be a licensed care facility while operating under an Assisted Living philosophy. 

 Recently we added to the holistic nature of our programming by having the first Celebration of Life for two deceased tenants.  Rev. Fr. Mark Greenaway-Robbins, the Rector of St. James Anglican Church, led the service and many tenants participated in the very touching and meaningful service.

 One of our goals established last year was to explore external strategic opportunities that utilize our Society’s strengths, address unmet needs in the community, and serve as a source of renewal for the organization.  To this end we worked on developing the land next to Cooper Place.  We engaged the services of an architect to develop a very preliminary plan for building on the vacant lot next to Cooper Place.  Our Society has a long term lease for the site.  Our architect advises that the zoning on the lot could support a building containing 35 small units for seniors.  We could provide some supportive services out of Cooper Place.  Together with our sister organization Central City Foundation, we are exploring means of obtaining funding for the soft costs to develop this site. 

 Supportive Housing

 Our second external strategic initiative was to expand into Supportive Housing.  We confirmed that Vancouver Coastal Health (VCH), who funds all our existing programs, does not have any funding for expanding either our complex care program or our addiction recovery program.  Also, there is not a community need for more assisted living in the DTE.  The opportunity that arose was in supportive housing under the Provincial Government’s Homeless Initiative Program which is being administered by BC Housing.

In 2007 our Society, after submitting an Expression of Interest, was chosen to be the service operator to convert the Park and Marble Arch Hotels from Single Room Occupancy Hotels to alcohol and drug free supportive housing.  The Park Hotel is scheduled to start providing supportive housing for 50 residents in 2009.  The two target populations are persons who have completed an addiction recovery program and persons with concurrent disorders, i.e. persons with both an addiction and mental illness.  In this project we can utilize our experience in developing programs and our addiction and mental health expertise.  This is consistent with our mission, which includes being part of the solution to homelessness, especially for persons with addiction and mental health issues. 

This movement into supportive housing will be a catalyst for organizational change and is consistent with the direction of health care reform and provincial priorities.  The government is creating more options on the health and housing continuum.   Persons are being offered a setting that meets their needs.  Our Society was very innovative in offering the first non-profit assisted living project.  It is continuing its innovation in offering alcohol and drug free supportive housing.

Renovations on the Park Hotel, estimated to cost four million dollars, will begin in 2008 and be finished in 2009.  During this time we will be developing an operational plan and negotiating a budget with BC Housing.  Our greatest challenge will be trying to operate an Alcohol and Drug (A & D) Free program in a populated building that is not A & D free.  Initially, the Marble Arch Hotel will be used to house persons from Single Room Occupancy Hotels whose hotels are being renovated.

Expansion into supportive housing, in addition to contributing to the welfare of the residents of the Downtown Eastside (DTE), also has several advantages for our organization.  By utilizing our administrative resources in more programs we are able to provide economies of scale and more cost effective service.  Growth creates job opportunities, and hopefully a career path for our staff, which makes our Society a more attractive employer in times of labour shortages.  Operating additional programs provides increased funding which enables us to be both innovative and leaders in providing services for residents of the DTE.

HUMAN RESOURCES AND VOLUNTEERS

The Society’s second goal was to continue developing and utilizing staff talents to identify unmet resident and tenant needs in the physical, social, emotional and spiritual realms.  We continue to strive to find innovative ways to meet these needs by setting challenging yet achievable goals in the areas of leadership, clinical skills, teamwork, collaborative decision making and interpersonal skills.

For service organizations a major key to success is that staff are highly committed to meeting the needs of the residents.  We appreciate that our staff are very capable of handling many difficult situations and that the demands on staff have increased over time.  Managers strive to assist staff to meet the increasingly difficult demands of the workplace.  These demands arise from increasingly complex resident conditions due to health care reform and from rising expectations from our funders, regulators and the general public.

Recognizing the challenges that our staff face in caring for residents with very complex needs, we continue to develop strategies to assist staff in carrying out their responsibilities.  One strategy we utilize is to sponsor increased training in clinical matters, teamwork, conflict resolution and computers.  During the year staff attended courses on clinical topics that included Non Violent Crisis Intervention, Personality Disorders, Obsessive Compulsive Disorders, Bathing Strategies, First Aid, Geriatric Recreation Programming and Dual Diagnosis. 

Three managers had notable achievements in upgrading their skills and credentials.   They are Wendy Harvey, our Director of Human Resources and Administrative Services who has completed the Executive Coaching Graduate Certificate Program in the Faculty of Management from Royal Roads University; Michelle Moloney, Team Leader Addiction Recovery Program, obtained her designation as a Registered Clinical Counsellor; and James Lee – Maintenance Manager has almost completed his Facility Management program.  Senior leaders attended conferences with themes of “health care leadership”, “Spirituality in the Workplace”, and the Resident Assessment Instrument as well as management courses sponsored by the Health Employers’ Association of BC.  Our two clinical coordinators from the Complex Care program and the clinical team leader for Assisted Living will be attending Vancouver Coastal Health’s “Frontline Leadership Certificate” program in the fall of 2008. 

Another strategy is to devote resources to employee wellness, graduated return to work and retention programs.  Health and wellness information is provided to employees and a wellness clinic will begin in the fall of 2008.  We continue to work with our partners to develop successful return to work programs which have resulted in a very high percentage of our staff in these programs returning to meaningful employment within our Society.

In addition to offering staff education, our retention efforts include accommodating employees to work at both sites enabling them to work more hours.  Our Society encourages staff to take courses to upgrade their skills.  One employee upgraded her skills twice, serving residents as a Housekeeping Aide, a Care Aide and is now a Licensed Practical Nurse.  Currently several Care Aides are studying to become Licensed Practical Nurses.  We are hoping that employees will obtain the necessary training to take advantage of opportunities arising from our Society’s expansion into Supportive Housing.   

With the end to mandatory retirement we appreciate the contributions of Bill Legge and Bonnie Lockley, two employees who continue to work beyond their 65^th birthday. 

Several employees reached major service milestones between April 1, 2007 – March 31, 2008.  The four employees celebrating twenty-fifth anniversaries are Cecily Eng, Chamberlin Febre, Jim Friesen, and Alan Luo.  The five employees celebrating twentieth anniversaries are Ken Liao, William Low, Anna Sem, Rebecca Sharp, and Odette Span.

Employee recognition is the corner stone of our retention strategy.  We celebrate our employees by recognizing their contributions and years of service.  The average length of service is 12 years and 48% of our staff have over fifteen years of service.  Throughout the year we hold a variety of employee recognition events and encourage staff to regularly acknowledge the efforts of other staff.  Over the years the Society has consciously made the decision not to contract out staff positions because we believe that our staff, rather than agency staff, can provide better care for our residents and tenants.

BUILDING RELATIONSHIPS WITH OUR EXTERNAL COMMUNITY

We would also like to thank our many volunteers who help in so many ways to enhance the quality of life of the residents.  Their efforts range from serving on the Board of Directors to providing hands on activities such as bringing in their pets to interact with the residents and tenants.  We are fortunate to have volunteers from UBC’s Trek Program, the Tzu Foundation, and St. James Anglican Church.  Residents enjoy an intergenerational program with Seymour Elementary School. 

Our Board Members for the past year are:

Gordon Crozier: Board President

Linda Ruiz: Vice-President

Anne Murdock: Treasurer

Marie Whelan: Secretary

John Hood: Director

Michael Sorochan: Director

Deborah Kitson: Director

Harley Harris: Director