Coalition urges HSO to improve working conditions in its new standards

In March 2021, the Health Standards Organization (HSO), a non-governmental agency, announced it is collaborating with the Standards Council of Canada (SCC) and the Canadian Standards Association (CSA Group) to develop new National Standards for Long-Term Care.

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Responses to Health Standards Organization (HSO) survey, “Developing National Long-Term Care Standards: Your Opinion Matters!”

https://www.surveymonkey.ca/r/HSOLTCNSC

Submitted by the Canadian Health Coalition. July 29, 2021.

Survey Questions

1. Are you aware that existing long-term care standards are currently being used by long-term care homes in Canada?

x Yes

2. In your opinion are long-term care homes in Canada providing safe, reliable and high quality care?

x Disagree

HSO’s National Long-Term Care Services standard is a revision of its existing Long-Term Care Services standard (2020). The new standard will focus on:

• Resident-and-family-centred care practices that value the importance of respect, dignity, trust and quality of life,
• Safe, reliable and high quality care based on evidence-informed practices,
• A healthy and competent workforce to ensure sustainable, team-based, compassionate care, and
• An organizational culture that is outcome focused and strives towards the safety and well-being of residents, families, and the long-term care workforce.

3. What is most important to you when it comes to providing “resident-and family-centred care practices that value the importance of respect, dignity, trust and quality of life” in long-term care homes?

Listening to the voices of frontline health care workers, residents and their families is essential to redress the terrible shortcomings of the LTC system that were exposed by the pandemic.

Canadian Health Coalition members, including the Canadian Labour Congress (CLC), Canadian Federation of Nurses Unions (CFNU), Unifor, UFCW, United Steelworkers (USW), the Council of Canadians and others will ensure the views of frontline health care workers are included in the standards-making process.

As long-term care expert and Canadian Health Coalition Board member Dr. Pat Armstrong reminds us, “Conditions of work are conditions of care.”

The Coalition urges the HSO to improve working conditions in its new standards, including adequate staffing levels and ratios within long-term care facilities, to reach a minimum of 4.1 direct hours of care per resident per day. This will require the HSO to take proactive steps to engage marginalized and racialized groups of people among LTC workers, residents, and families.

4. What is most important to you when it comes to providing “safe, reliable, and high quality care” in long-term care homes?

The Canadian Health Coalition, comprising community organizations and unions representing frontline health care workers, is renewing its urgent call for the Government of Canada to enact legislated enforceable national standards for long-term care (LTC), and to provide significant additional funding for provinces and territories that is conditional on these improved standards being met.

5. What is most important to you when it comes to maintaining a “health and competent workforce” in long-term care homes?

The Canadian Health Coalition supports the recommendations put forward by the Canadian Labour Congress. A healthy and competent workforce to ensure sustainable, team-based, compassionate care requires:

• good permanent full-time jobs and benefits with wages that are commensurate with the skilled care work performed;
• standards that ensures workers have access to adequate proper-fitting personal protective equipment;
• standards that address the high levels of violence and harassment experienced by long-term care staff;
• standards that set out a continuous learning framework, providing long-term care workers with employer-paid training and education on paid time; and
• standards to address racism and discrimination that workers face in long-term care homes.

The federal government should develop a Canadian health care workforce strategy.

6. What is most important to you when it comes to considering the environment, operations and maintenance of long-term care homes to improve the quality of life of residents and families?

The Canadian Health Coalition member-group Inter Pares stated the following in its report, The Impact of COVID-19 in Canada’s Long-Term Care Homes and Recommendations for Change (2021):

Ontario’s Long-Term Care COVID-19 Commission released its final report on April 30, 2021.

The Commission’s report is comprehensive looking at the history, delivery models and problems that have plagued residential long-term care for generations. And its recommendations are far-reaching. If adopted they would turn the delivery of residential long-term care on its head. Of course, there are several recommendations on pandemic preparedness and infection control, but the Commission goes much farther. It recommends a substantial increase in funding and in the number of beds to meet coming demand, changes in facility design, resident-centered care, greater government oversight and increased accountability as well as greater integration with the broader health care system. Perhaps most significantly, the Commission makes a number of recommendations that would mean drastic changes in residential care; more nursing staff, better training for care workers and significantly a requirement that at least 70 percent of the staff in each facility be employed on a full-time basis.

7. In your opinion, do you think long-term care homes should be required to meet standards in long-term care?

x Yes

8. Are there any other issues that the national long-term care standards should address?

x Yes

Removing for-profit investors from the long-term care system is also a shared priority of Canadian Health Coalition members. The long-term care sector has been dominated by corporate investors who put profits first, and care second. The companies failed Canadians miserably, and now it’s time to put residents, families and workers ahead of investor dividends.

9. Reflecting on your responses to the survey, what is the most important issue the national long-term care services standards ought to address?

There is no short-term fix for long-term care. We need federal funding for long-term care to be tied to provincial compliance with national standards, and to transitioning for-profit providers out of the system.

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We thank you for your time and sharing your opinions in our survey.