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Staff gather outside the Orchard Villa retirement home to watch people lay flowers at an event to honour victims of COVID-19, on June 1, 2020.

Melissa Tait/The Globe and Mail

Premier Doug Ford’s government is facing calls to immediately hire more nursing home employees after an expert report detailed a staffing crisis that needs to be urgently addressed with more funding, better working conditions and full-time hours.

The long-term care staffing study was launched in February in response to a recommendation from a public inquiry into a former nurse who killed eight nursing home patients. The study found many recurring issues in the long-term care sector were exacerbated by COVID-19 – with numerous homes reporting “critical staffing shortages” at the height of the pandemic. In one case, a home reported as many as 60 vacant shifts for personal support workers a day.

The report echoes calls for four hours of direct care per day for residents, but doesn’t specify the amount of funding needed. Advocates and health care unions have estimated the costs of increasing staffing in the billions.

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“Addressing staffing shortages in long-term care cannot happen without additional funding,” the report said.

The staffing study was led by a 10-person expert panel chaired by Arthur Sweetman, an economics professor at McMaster University who holds the Ontario Research Chair in Health Human Resources. The study was among the recommendations made by Justice Eileen Gillese in her inquiry into former nurse and serial killer Elizabeth Wettlaufer. That inquiry took two years to complete and a final report was released last July.

The staffing study makes five key recommendations: more funding to address the staffing crisis; changing the culture in long-term care, which often doesn’t recognize the “critical role” of personal support workers (PSWs); improving workload and working conditions; better leadership and access to specialized expertise; and providing opportunities for growth.

Doris Grinspun, chief executive officer of the Registered Nurses’ Association of Ontario, said the problems in long-term care staffing are well-known. She said Mr. Ford needs to take action immediately, before the next wave of COVID-19 is expected this fall.

“When is the hiring starting to happen? That’s my critical question,” she said. “Residents need better care next week ... and even more importantly in the fall, when COVID-19 and influenza will be there.”

The Green Party said the government needs to invest $1.6-billion in elder care, and the NDP also called for more full-time positions. “Today’s report includes no commitments, no timelines and not a single dollar in funding to fix it,” said NDP MPP Teresa Armstrong.

Long-term care employs 100,000 people in 626 homes across the province, a mix of non-profit, for-profit and municipal homes. The report says 58 per cent of employees in long-term care are PSWs, but about half leave after five years, with most departing “due to burnout of working short staffed.”

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“Increasing the proportion of full-time, permanent positions would improve working conditions for staff and reduce the likelihood of spreading viruses, such as COVID-19, between homes,” said the report.

The report details how staffing shortages have a negative impact on resident care, including missed baths, missed personal care and a lack of access to toilets.

“It was reported that PSWs are often rushed and therefore cut corners to optimize the time they have available. As a result, residents may experience increased falls, levels of depression, infections, errors, complaints, anxiety, and conflict,” it said.

The Ministry of Long-Term Care said the study will inform a “comprehensive staffing strategy” to be implemented by the end of the year. On Wednesday, the government launched its independent commission into COVID-19′s spread in long-term care, which is set to release a report by the end of April.

More than 1,800 residents and eight health care workers died in Ontario’s nursing homes during the pandemic, which makes up more than 63 per cent of all deaths in the province, the report said.

The ministry said it has completed or undertaken 80 per cent of Justice Gillese’s 91 recommendations, although some have been delayed as a result of COVID-19.

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The government on Thursday announced $10-million toward an “annual training fund” to help front-line care staff acquire new skills.

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