The federal government plans to improve the quality of care in nursing homes across Canada by introducing legislation that would complement new, voluntary national standards.
The Health Standards Organization (HSO) released standards on Tuesday aimed at addressing gaps in care exposed by the coronavirus pandemic and the failure of many homes to protect vulnerable residents. Homes should protect residents from abuse, respect their lifestyle choices and protect their privacy, the standards say.
Ottawa is also committed to doing more to support seniors across the country, Health Minister Jean-Yves Duclos and Seniors Minister Kamal Khera said in a joint statement on Tuesday. In the coming months, they said, the government will move forward with consulting Canadians on federal legislation governing nursing homes, known as the Safe LTC Act. They did not say what the legislation would entail.
Prime Minister Justin Trudeau told reporters he recognizes that long-term care falls under the jurisdiction of the provinces and territories. “But I think all Canadians, regardless of the order of the government, want seniors to have the best quality of care possible and that’s what we’re going to continue to work on,” he said.
Ottawa asked the HSO, a non-profit group, to develop the new standards in 2021 to better protect people living and working in nursing homes. The Liberals promised during the federal election campaign that same year to enforce the standards through legislation. However, the government no longer plans to make the standards mandatory.
The 2021 federal budget earmarked $3-billion over five years to help the provinces and territories improve elder care. “Now, we are looking forward to [signing] agreements with provinces and territories to see how they can use those dollars to further meet these new standards,” Mr. Duclos told reporters.
Asked whether the new standards will be on the agenda when Mr. Trudeau meets with provincial and territorial leaders next Tuesday to hammer out a new health care funding agreement, Mr. Duclos said they are “complementary” to but “separate” from those talks.
Health care advocates said the new standards are useful only if they are mandatory.
The new long-term care standards amount to, “about 70 pages of nice concepts, but nothing enforceable,” said Linda Silas, president of the Canadian Federation of Nurses Unions.
Ms. Silas said her organization and SEIU Healthcare, a union that represents frontline health staff, including the personal support workers who provide much of the care inside nursing homes, have urged Ottawa to create national standards with teeth. “We need that backbone from governments to be able to put them into action,” she said.
Without legislation, Canada will continue to have a patchwork of practices. Quebec, for example, makes accreditation mandatory, requiring homes to adhere to the standards. In Ontario, accreditation is voluntary; 16 per cent of homes choose not to undergo the process.
Ontario Long-Term Care Minister Paul Calandra declined to say whether the government plans to make accreditation mandatory for the province’s nursing homes. The province already has some of the most stringent laws governing long-term care in Canada, he told reporters.
“I have no interest in watering down Ontario’s very high standards,” he said.
Ontario introduced legislation in 2021, requiring nursing homes to provide residents with four hours of daily care by March, 2025. The requirement, based on an average of four hours across the entire sector, is aimed at addressing staffing shortages during the pandemic, when COVID-19 cut a deadly swath through the province’s nursing homes.
Doris Grinspun, chief executive officer of the Registered Nurses’ Association of Ontario, said the four-hour standard is one aspect where Ontario is “way ahead” of the HSO standards, which fall short of addressing inadequate staffing. The national standards say only that a home needs to have “the appropriate staffing ratios and the appropriate staffing mix,” but do not stipulate how much daily, hands-on care a resident should receive.
Ms. Grinspun said she would welcome mandatory national accreditation for all homes. But she said some of the HSO’s standards don’t go far enough.
The recommendation on staffing homes is “really wishy-washy at a time when we must be bold and precise,” she said.
With reports from Kelly Grant and Ian Bailey