CUPE is concerned the Health Standard Organization’s draft long-term care (LTC) standard is missing key elements, including set hours of care, full-time jobs, and paid sick leave needed to strengthen working and caring conditions. In its submission, CUPE called for these issues to be addressed, as well as the poor quality of care in for-profit long-term care in terms of governance and transparency.
CUPE was pleased to see that the draft LTC standard acknowledged that the conditions of work are the conditions of care. When the bulk of LTC staff work on a part-time or casual basis, workers need multiple jobs to make ends meet and residents encounter workers who don’t know their needs, preferences or stories. When workers lack paid sick leave, they face the choice of putting residents at risk or not being able to support themselves or their families. Better working conditions with full-time jobs and paid sick leave is a pre-requisite for safer, better resident care.
Standards are meaningless without concrete measures that can be assessed. The draft standard refers to “evidence-informed staffing levels”, but does not attach a specific target or measurable baseline. We encourage the HSO to be specific in the standard with a set minimum of 4.1 to 4.9 hours of care per resident day that has been shown in research to provide a baseline of care. Furthermore, the standard should require LTC homes to disclose information such as hours of hands-on care per resident day, percentage of hours worked by full-time employees, and financial statements to promote greater transparency and accountability to residents, workers and the public.
A second standard being developed by the Canadian Standards Association will provide guidance on safe operating practices and infection prevention and control in LTC homes. This standard is open for review and public comment until April 11, 2022. CUPE will also be making a submission on this standard arguing that IPAC measures need to be developed in consultation with front-line staff.
Ultimately, governments cannot outsource LTC quality to outside organizations and accreditation agencies. The COVID-19 pandemic has shown us that strong government action is needed to improve long-term care, including better legislation and regulations, inspection processes, and enforcement measures.
Ultimately, we believe the federal government needs to incorporate long-term care into our public health care system. This must be accompanied by a significant increase in funding conditional on respecting the Canada Health Act, quality and accountability metrics, and a commitment to not-for-profit and public LTC.