While the numbers may be striking to some, people who work or have loved ones in the long-term care sector say they’re not surprised, given the flaws they’ve observed in the system.

LOW STAFFING LEVELS

Candace Rennick is secretary-treasurer of Ontario’s Canadian Union of Public Employees (CUPE) chapter that represents PSWs and nurses across the province. Before this role, she worked in long-term care homes for years.

Candace Rennick - Candace Rennick photo

Rennick said many of the conditions contributing to the spread of COVID-19 in long-term care and nursing homes existed long before the virus emerged.

“People can be saddened by what’s happening here, but absolutely nobody who’s been paying attention can be surprised,” she said.

Rennick has fought for several years to reinstate a care standard that would see every resident receive a minimum of four hours of direct care from a nurse or PSW per day — which means many facilities would need to add staff.

“If we had adequate staffing levels to provide support, proper care and cleaning, proper hygiene and proper cohorting when these illnesses and infections are happening, we’d be in a much better position to control or slow the spread of the virus,” she said.

For example, staff shortages in some facilities mean employees are unable to serve meals to residents in their rooms, she said. Residents have continued to gather for meals in communal dining rooms — possibly contributing to COVID-19 transmission.

Rennick is also disturbed that residents with suspected or confirmed COVID-19 infections are being kept in long-term care centres, where she says staff — who are often not trained in infectious diseases — are instructed to keep them comfortable.

“The fact that nobody I know of has been transferred out of long-term care to receive care in hospitals, I think, is something for us to question,” she said.

In an email statement, Donna Duncan, CEO of the Ontario Long Term Care Association, said the staffing crisis in long-term care homes has been exacerbated by COVID-19, but the association has been working with the province on a number of the changes.

“Ontario’s long-term care homes are at the heart of their communities, and understand the needs of residents and staff best. We must empower them with the infection control prevention measures and resources they need to retain and attract staff to ensure they can keep residents safe — now and into the future,” she added.

A LACK OF INSPECTIONS

Lawyer Amani Oakley has represented hundreds of residents of long-term care facilities and is engaged in three class-action lawsuits against nursing home operators.

Amani Oakley - Rene Johnston/Toronto Star

She believes a lack of accountability among private long-term care homes and society’s disregard for people who live in these facilities have culminated in the situation Ontario’s long-term care sector is facing today.

“I feel like this is all about the chickens coming home to roost,” she said. “It’s a sad comment on the fact that we, as a society, have neglected the care of people in nursing homes, and this pandemic has boomeranged back onto us because of that negligence.”

As of 2016, the province no longer conducts annual inspections of most care homes. Oakley said officials generally visit only after the Ministry of Health and Long-Term Care receives a complaint. The ministry lists complaints about harm, neglect or danger to residents as meriting a quick response.

Oakley said facilities are also not required to call a coroner to examine someone who dies in a home, a policy she wants to see changed.

“The coroner’s office needs to get back to monitoring deaths in facilities, because that is an early warning sign in a scenario like a pandemic that could have easily identified this problem was taking root in homes,” she said.

POWERLESS PSWS

Miranda Ferrier, president of the Ontario Personal Support Worker Association (OPSWA), said empowering PSWs to self-regulate would address many of the issues advocates have flagged in the long-term care system.

Miranda Ferrier - Mohawk College photo

It would give PSWs a governing body that would ensure they are working in a safe, professional and ethical manner, she said.

“You would also have more PSWs who have more pride in their job. They would get the respect and recognition that they deserve. We knew years prior to this, we were siphoning PSWs out of the field faster than we can keep them and make them.”

She said a lack of full-time and permanent part-time positions and high resident-to-PSW ratios contribute to high turnover.

“Before the pandemic, we were seeing 10 to 15 residents per PSW, now we’re seeing 25 to 42 residents per PSW because there aren’t any PSWs on the ground,” she added. “Even in this pandemic we are still siphoning PSWs.”

Despite advocating for self-regulation for five years from the provincial government, Ferrier said no progress has been made.

She said last week, the OPWSA submitted a letter to the provincial government demanding change.

“Once this pandemic is over, we are going to need PSWs. That need is not going to go away,” she said. “We have to think long term here and how do you provide for a profession that has been ignored. (We have) been the invisible workers for decades.”