No interest in 'watering down' LTC standards to meet national ones: Ontario minister

Ontario will take a look at new national standards for long-term care, the minister responsible for the sector said Tuesday, but wouldn't want to "water down" what the province is already doing to improve care.

The Health Standards Organization released updated standards Tuesday, including that residents should get at least four hours of direct care every day and that staff receive adequate, and competitive compensation.

Ontario Long-Term Care Minister Paul Calandra noted that the province has already legislated a goal of an average of four hours of direct care per resident per day by 2025.

"I'm going to take a look at the federal standards," he said after making an announcement aimed at speeding up diagnostic testing for long-term care residents.

"I suspect Ontario will still have the highest standards in Canada...I'm uninterested in any guideline that would water down the very high standards that Ontario has put in place with the fixing Long Term Care Act."

The law was introduced and passed in 2021. A military report published in 2020 after Canadian Armed Forces teams were deployed to seven long-term care homes in Ontario included accounts of aggressive feeding that caused choking, bleeding infections and residents crying for help for hours.

Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, was on the committee that developed the national standards and said they won't "water down" what Ontario is already doing, rather they will be complementary.

"Ontario certainly has the most standards across the country," she said in an interview. "We have legislation that is certainly the most robust in Canada with respect to long-term care. The problem is the enforcement of those rules."

Along with strengthening compliance, Meadus said the province should take particular note of the section on workforce and recommendations to pay long-term care staff more. Ontario introduced a pay bump for personal support workers during the pandemic and made it permanent last year.

But Meadus said nurses are critical to care in those facilities and are paid less than their counterparts at hospitals.

"If you don't have properly trained staff, staff that want to be there, staff that are going to stay for long periods of time and get to know the residents, you can't have quality care," Meadus said.

"You can have the best legislation in the world, but...that's going to affect the quality, if you just don't have enough staff."

The standards recommend boosting staff retention by providing opportunities for full-time employment, provide continuous training and learning opportunities, involve staff in scheduling and overtime decisions, promote work-life balance and recognize staff contributions, both formally and informally.

The standards also talk about ensuring residents are treated with courtesy and respect, are properly cared for, are free from abuse and protected from infection. As well, the standards recommend flexible nutrition options, access to outdoor activities and evaluating each resident's physical, social and mental health needs.

Ontario has come under fire from advocates for a law that allows hospital patients awaiting a spot in long-term care to be sent to a home not of their choosing up to 150 kilometres away. But Calandra said that law doesn't conflict with the principles in the national standards.

"It's the right care at the right place at the right time," he said.

"There is not one person that I've spoken to - I've visited homes across this province - who has said that they want to go back to a hospital after being in a long-term care home."

Lisa Levin, CEO of AdvantAge Ontario, which represents Ontario's not-for-profit and municipal LTC homes, said in a statement that the standards are good, but more funding is urgently needed.

"Homes need earmarked funding for front-line staff, for infection prevention and control, and for better built environments for seniors to live in," she wrote.

"Without significant new investments in seniors care and long-term care in Ontario, and across Canada, the standards cannot be realized."

Ontario's budget is set to be delivered by March 31.

Calandra and Health Minister Sylvia Jones were at Toronto's Humber River Hospital to announce pilot projects at that hospital and Royal Victoria Regional Health Centre in Barrie, Ont., aimed at helping long-term care residents get faster access to diagnostic tests.

The pilot projects are set to include transportation to appointments and increased access to a nurse navigator who can help co-ordinate services for long-term care residents.

This report by The Canadian Press was first published Jan. 31, 2023.