REGINA—The process the Ministry of Health uses to inspect special-care homes was a focus in Provincial Auditor Tara Clemett’s latest report.
The investigation of special care homes zeroed in on the frequency of inspection and how the inspections were carried out, as well as the use of antipsychotic drugs.
According to the report, the Ministry of Health had begun inspecting special care homes in December of 2021 and had planned to inspect each home within three years, with homes notified in advance of inspections.
The provincial auditor took issue with how that transpired, finding that inspection frequency and announced notice did not align with good practice.
The report stated the Ministry needed to use what is described as a “risk-based inspection approach” that prioritizes homes with higher likelihoods of poor care outcomes. Those would include homes with high rates of chemical or physical restraint use, reported critical incidents, or public complaints.
When asked why advanced notice of inspections doesn't align with good practice, Clemett said that that what they found with other jurisdictions is that they undertake unannounced inspections, because “otherwise if you do give a special care home… notification that you're coming, we did find instances where all of a sudden the care plans are updated.”
“So they haven't been updated for perhaps two years or a year, and now you have the Ministry reaching out to a special care home and indicating ‘well, we are going to come on site, we are going to inspect you.’ They give them sort of four weeks notice. There are things that can be undertaken just to make sure that obviously they're in compliance when the Ministry is coming and checking. So doing unannounced inspections would be probably a better process to get a better sense and a true representation of what is the care that special care home is providing when the Ministry goes on site.”
Another issue Clemett identified is that there were many special care homes that had not been visited yet, almost four years in. As of July 2025, a total of 130 out of 161 special-care homes had been inspected since December 2021 with over 30 more still left to go.
“So the Ministry has only been doing inspections of special care homes since 2021.
They envisioned that they would inspect all special care homes within three years. It's now been closer to four, and as we've said there is 30 care homes that they still haven't got to,” Clemett said.
Clemett indicated this stems from not using a risk-based approach to inspections.
“So they should have been doing inspections that weren't necessarily about, you know, proximity or ‘let's go here and then cover other homes because we're in this area as well.’ They should be going to homes where they have more critical complaints… Right now they're allowing those special care homes to almost self-report and say we fixed everything that you've asked us to. We would expect the Ministry should go back and confirm that is the case.”
It was also noted in the provincial auditor’s report that some concerns got missed by the Ministry of Health inspections. They found five homes with critical incidents between April 2023 and June 2024, but not inspected until 2025.
The Provincial Auditor also found the Ministry did not inspect two homes with very high rates of residents potentially receiving antipsychotic drugs, or chemical restraints, inappropriately until over three years after the inspection program began. The homes saw percentages of 63.1 per cent and 58.6 per cent respectively for that antipsychotic use.
The Provincial Auditor also reported that since 2022, the Ministry conducted only one independent follow-up inspection, which in the end turned up critical non-compliance issues related to physical restraint use, they stated.
The Provincial Auditor's office also tested 16 of the Ministry's inspections, and reported it had taken up to 203 days in some instances to fix critical or high non-compliance issues, because of extensions granted to the special care homes. Clemett spoke some more about that issue to reporters.
“What was happening is special care homes are asking for extensions in terms of more time to actually address the critical and high risk issues,” Clemett said.
She did acknowledge there were some instances where major concerns are addressed right away, but “the Ministry should not necessarily be granting these extensions up to in the case of a critical or high risk non – compliance issue. They're sometimes giving the special care homes six months to rectify that, which seems like an extremely long time frame. So they need to figure out ‘what is our time frame by which we want some of the different issues that we find fixed, and then how quickly should we probably go back and actually follow up and confirm that again they have addressed the issues and the more significant ones in a very timely manner.’”
The other issue cited was the use of anti-psychotic drugs, with findings that Saskatchewan had the second highest rate in the country of residents in long-term care homes on antipsychotics without a diagnosis of psychosis, at 34.8 per cent. That was above Canada’s overall rate of 24.5 per cent.
“This would be information that we would envision that the Ministry should be considering when it's almost setting its risk-based inspection plan,” Clemett said. She called it “information that the Ministry would want to be more aware of” and, as a result, be visiting those homes where that is the case and then deciding if that is a non-compliance issue that should be addressed.
