Over the weekend the Ontario Long-term Care COVID19 Commission chaired by Associate Chief Justice Frank N. Marrocco released an interim report to Long-term Care Minister Merrillee Fullasrton. The Commission’s full report is not due until next April, but the but the interim report was issued “because the second wave is upon us and, given the continuing urgency of the situation and high risks in long-term care homes, our Commission is making some early recommendations that focus on staffing, collaborative relationships, and infection prevention and control.”
The report pointed out that “residents of LTC homes in 2020 are a much frailer group than residents were ten or twenty years ago; 81% of residents have some type of cognitive impairment, and often residents have advanced and ongoing medical conditions. For that reason, the quality of care and quality of life for long-term care residents depend on an adequate supply and mix of skilled and qualified staff available to meet their clinical, recreational, social and daily living needs.”
The report identified the main problem in the long-term care sector is staffing, Not enough staff, and low wages and poor working conditions that deter people from entering the field. The report reads, “improving the employment environment for workers can enhance the ability to attract people willing to work in the LTC sector and ultimately improve the quality of resident care. We recognize the ministry is providing funding to increase staffing as part of the fall COVID-19 Long-Term Care Preparedness Plan, including a temporary wage enhancement for personal support workers (PSW) to March 2021. In addition, we recommend the following:
1. In addition to increasing the supply of PSWs, ensure that LTC staff recruitment efforts address the requirement for an appropriate staff mix to meet the increasing acuity and complex care needs of residents.
2. While all witnesses agreed on the need for staffing flexibility given the 24/7 nature of homes’ operations, more full-time positions must be created to ensure staffing stability and retention, and resident continuity of care.
3. Beyond these initial steps, identify the permanent investments required to develop and implement a comprehensive human resources strategy that addresses the full range of staffing issues in the sector. The ministry’s Long-Term Care Staffing Study, released in July 2020, identifies the best path forward. Further “study” of the Study is not necessary. What is required is the Study’s timely implementation.
4. Consistent with that study, the Commission recommends a minimum daily average of four hours of direct care per resident. The government needs to increase permanent funding for more nurses and support staff, to enable homes to increase their staff to resident ratio, and provide more hours of care, based on residents’ needs.
5. Given the essential role of families and caregivers in supporting not just physical care needs but the psycho-social well-being of residents, we reinforce the calls from residents, families and caregivers to ensure that families and caregivers have ongoing, safe and managed access to long-term care residents.”