(June 3, 2020)<\/p>\n
By: Shane MacDonald, Orilla Matters<\/p>\n
The COVID-19 pandemic has ravaged Ontario\u2019s long-term-care homes, but experts and industry members say the conditions that let it happen have been an issue for decades.<\/p>\n
A Canadian Armed Forces (CAF) report detailing findings in five\u00a0Ontario long-term-care homes released May 26 found that residents were living in deplorable conditions, that there was poor infection control protocols, and staffing levels made it impossible to provide appropriate care.<\/p>\n
\u201cThe description of what happened is criminal,\u201d said Natalie Mehra, \u00a0executive director of the Ontario Health Coalition (OHC), an advocacy group that seeks to improve the public health system. \u201cIt\u2019s so completely wrong, but these systemic issues of inadequate care,\u00a0inadequate staffing \u2026 this has gone on for decades.\u201d<\/p>\n
As recently as December, the OHC was advocating for steps to alleviate what it calls a crisis in personal support worker staffing in long-term-care homes.<\/p>\n
\u201cThere was a severe, severe staffing shortage before COVID-19,\u201d Mehra said.<\/p>\n
In April, workers in long-term-care homes were ordered to work in only one home to help slow the spread of COVID-19. While the move may have helped from an infection-control perspective, Mehra said it exacerbated other issues.<\/p>\n
Mehra said it can take years for a personal support worker to find a full-time job, so many were working part-time in multiple homes to make\u00a0ends meet.<\/p>\n
\u201cOnce the workers had to choose one home to work in as of April 22, some homes are just decimated,\u201d she said. \u201cThey just lost tons of \u00a0staff.\u201d<\/p>\n
Mehra said the conditions of care in these facilities is directly related to the conditions of work.<\/p>\n
\u201cI cannot see a way out of this without getting a stable trained workforce in place in the homes,\u201d said Mehra. \u201cIn order to stabilize the workforce, they need to improve the wages and working conditions. They need to insist that the homes provide full-time work.\u201d<\/p>\n
The private sector\u2019s involvement in long-term care should also be looked at, she said.<\/p>\n
\u201cThe consequences of trying to make care ever cheaper and cheaper is that people suffer,\u201d she said. \u201cFinally it\u2019s been laid bare for everyone to see. In a horrible way, I\u2019m happy because I hope it means that we \u00a0can never go back.\u201d<\/p>\n
In the long-term-care homes operated by the County of Simcoe, there is a bright spot, as there have been no cases of COVID-19 identified.<\/p>\n
“It\u2019s not business as usual,\u201d said Jane Sinclair, general manager of health and emergency services for the county. \u201cThere are huge precautions in place.\u201d<\/p>\n
Speaking about the CAF report, Sinclair said they are the exception, not the rule, and cautioned against painting all long-term-care homes with the same brush.<\/p>\n
\u201cThere are many, many amazing long-term-care homes across the province,\u201d she said.<\/p>\n
While much has been said about the inspection regime for long-term-care homes and whether it is thorough enough, Sinclair said she doesn\u2019t think that is the main issue.<\/p>\n
\u201cIt\u2019s much deeper than that,\u201d she said. \u201cIf long-term care isn\u2019t \u00a0funded properly and there isn\u2019t enough staff, then it\u2019s going to be\u00a0really hard for the homes to make sure everything is done the way it\u00a0should be.\u201d<\/p>\n
Before the government directive that long-term-care workers only work in one home, the county offered its part-time staff full-time hours to\u00a0secure its workforce.<\/p>\n
Sinclair said 206 part-time employees took them up on the offer.<\/p>\n
“Even with that, we still struggle with staffing to a certain amount,\u201d she said, acknowledging staffing was a challenge even before COVID-19 started.<\/p>\n
\u201cNow we have people that are off for 14 days because they might not even have COVID symptoms, but they came into a risk situation.\u201d<\/p>\n
Recognizing these challenges, the county supplements the amount of money it receives from the province to operate its long-term-care homes.<\/p>\n
\u201cCounty council made that decision because they recognize that, with the funding that we have, it doesn\u2019t provide the appropriate level of care,\u201d Sinclair said.<\/p>\n
According to the county, the province funds 59 per cent of the cost to operate the county\u2019s long-term-care homes, 29 per cent comes from resident occupancy fees and 12 per cent comes from municipal contributions.<\/p>\n
Sinclair added she feels personal support workers, the pillars of long-term-care homes, are not recognized for the hard work they do.<\/p>\n
\u201cThere is an issue with compensation and just valuing them \u2014 that\u2019s got to be a big part of why we can\u2019t get enough people in this industry,\u201d she said. \u201cThere needs to be better funding, better staffing \u00a0levels and better recognition for our care providers.\u201d<\/p>\n
While the county long-term-care homes have done relatively well in\u00a0battling COVID-19, those inspection reports show they are not immune to some of the issues drawing negative attention to the sector.<\/p>\n
In a Jan. 20, 2020, critical-incident report for Sunset Manor for Senior Citizens in Collingwood, an inspector details how the licensee the county) failed to respect a resident\u2019s dignity when staff withheld\u00a0the application of an incontinence product.<\/p>\n
Sinclair said they take these instances extremely seriously.<\/p>\n
\u201cAny variance from standards and expectations, we do an entire investigation,\u201d she said, adding dignity is critical when caring for seniors.<\/p>\n
\u201cIf we find our staff are wilfully not showing dignity and all the respect, then we take action,\u201d she said. “In response to that specific \u00a0incident, we did take action.\u201d<\/p>\n
She could not elaborate due to the fact that it is a personnel matter.<\/p>\n
\u201cThis doesn\u2019t happen everywhere, but, having said that, there are some really serious underlying support issues for long-term homes that\u00a0need be addressed,\u201d she said.<\/p>\n