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ANALYSIS & SUBMISSION: Review of Staffing and Care Standards for Long-Term Care Homes

Posted: January 31, 2008

(January 31, 2008)

The Ontario Health Coalition has, in consultation with seniors’ groups, nurses’ organizations, physicians, community coalitions, unions, members of residents’ and families’ councils, come to a consensus set of key recommendations regarding quality of life and quality of care in long term care homes. Chief among our concerns is the lack of daily care for residents, and inadequate accountability for the levels of care provided by operators. Though many aspects of the physical structure of the homes are regulated, the daily care levels have been left without equivalent regulatory and compliance regimes. Yet inadequate nursing and personal support care levels have resulted in significant problems of access, creating a multi-tiered system based on wealth rather than need. Crushing workloads, stress, inadequate supports, lack of control, a punitive culture, rationing of supplies and inadequate resources have contributed to conditions that are creating harm to residents, stress and undue financial burden on families, and exacerbated staffing shortages across the sector.

Through successive years of significant funding increases to the LTC home sector, we have not found a commensurate increase in daily hands-on care provision. The vast majority of funding increases have gone towards an increase in the size of the sector rather than to improving the amount of daily care for existing residents and addressing the pressing quality of care issues.

There is a need to redirect funding and policy attention to quality of care issues. Care workers regularly report to us that they are unable to meet health and safety and professional standards at current staffing levels. Residents report unsafe or inadequate living conditions, lack of palliative care, and deeply disturbing concerns about quality of care, outcomes and quality of life. Families echo stories of a culture of fear, guilt, stress, and inadequate care.

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