The organization representing the majority of Ontario long-term care homes has some ideas for how the provincial government can improve accountability and transparency, which Long-Term Care Minister Rod Phillips has called one of the new "pillars" he plans to build the sector around.
Ahead of the Ford government's planned reform of the Long-Term Care Home Act, expected sometime this fall, the Ontario Long-Term Care Association (OLTCA) is calling for more detailed, public reporting on homes, a more "collaborative" inspections process, and revamped aid for struggling homes.
The proposals were shared with QP Briefing in advance of the OLTCA's official announcement on Thursday.
To improve accountability, the OLTCA says it wants the minister to be able to appoint supervisors, similar to those in hospitals, to govern struggling homes as they recover. Those supervisors should be required to have long-term care knowledge, the OLTCA said.
The government has instructed some struggling homes to be taken over by local health organizations during the pandemic.
The OLTCA also called for a "tiered" inspections process that rewards good homes while giving support to ones that are struggling but want to improve — so they can hit clear, public targets. Negligent homes should have "stepped, transparent penalties and enforcement processes where willful negligence may have occurred, leading up to license removal as necessary," it said.
The Ford government faced significant controversy after it cut comprehensive long-term care inspections, leading to far fewer infractions caught after it took office.
The OLTCA's plan does not say whether those should be reinstated.
But Ontario should do away with "pass/fail" quality checks, which hurt staff morale, the organization said, suggesting compliance instead be based on finding solutions and giving more support to struggling homes.
Homes should have more "flexibility" to cater to residents' care preferences, the plan adds — "for example, supporting resident choice that does not match legislative requirements, or innovating to meet the needs of their residents."
All long-term care homes should have to publicly report — in detail, and in plain language — on current conditions, as well as past incidents, the OLTCA said.
And the ministry should develop a critical incident reporting system, and should look into having the patient ombudsman manage complaints, the plan reads.
On Thursday, the OLTCA will also make public recommendations on how to stabilize planning and funding, attract and retain more staff, speed up the development of new homes, and create a more "comprehensive" care sector.
In Ontario, 3,822 long-term care residents have died with COVID-19, as well as 13 staff members. The province saw 9,804 overall deaths, meaning long-term care deaths make up 39 per cent of the total.
The tragedy in long-term care was avoidable and well-documented, with a commission detailing shortcomings in a report released in April. Poor infrastructure, long-running staffing issues and a slow government reaction have been found to have exacerbated the crisis. The government has vowed to be prepared next time.
Phillips has said far-reaching reforms will come to Ontario's long-term care homes sometime this fall.
He has stressed the need to make it easier to hold negligent operators accountable, saying the overhaul won't "just be window dressing."
OLTCA CEO Donna Duncan said accountability and transparency must be at the core of that overhaul.
“To build trust with residents and their families, and to recruit and retain thousands of new personal support workers, registered practical nurses, registered nurses and allied health professionals in the midst of a health human resources crisis, inspections must be about more than checklists and must focus on ensuring that we are achieving outcomes that speak to our residents’ quality of life as well as the quality of care in our homes,” she said in a news release.
The OLTCA represents 70 per cent of Ontario's long-term care homes.
Clarification: This article originally stated that the OLTCA would submit recommendations on stabilizing planning and funding, rather than making public those recommendations. The article was updated Thursday, October 14 at 9:30 a.m. to reflect the change.