Ontario long-term care homes need stricter enforcement, more inspections
Ontario’s long-term care homes have been significantly impacted by the COVID-19 pandemic and need continued care amid the second wave.
The province’s commission on the facilities was released on Friday, highlighting various recommendations to improve the quality of care provided.
In this second interim report, the three-person commission noted that the province must resume annual Resident Quality Inspections (RQI) of the 626 facilities.
In 2018, 329 long-term care homes received an RQI. However, that number dropped to 27 homes in 2019.
“This reduction in RQIs which are intended to provide a holistic review of operations in the homes left the Ministry with an incomplete picture of the state of Infection Prevention and Control (IPAC) and emergency preparedness.”
The commission also said each inspection should check the home’s level of infection prevention and control readiness.
The commission further recommends that there be enhanced enforcement.
“In addition to the discontinuance of RQIs, we are concerned about the apparent lack of enforcement and follow-up verification of compliance with Orders issued by the ministry.”
In 2019, the two most common enforcement actions were Written Notification and Voluntary Plan of Correction.
The commission notes that neither require mandatory follow-up or verification from the long-term care home to ensure there has been compliance with the requirement under the Long-Term Care Homes Act (LTCHA).
“Also, it appears that fines or prosecution penalties for failure to comply with orders under the LTCHA are rarely applied as a form of corrective action, which may feed into the lack of urgency illustrated by LTC operators to come into compliance.”
In order to ensure there is more enforcement, the commission also called for more inspectors to patrol the homes. The commission also called for more accountability and transparency for leadership in the sector.
The Ontario Health Coalition supported the commission’s report adding “clearly the measures that have been undertaken to contain the spread of COVID-19 in long-term care homes are not adequate.”
“The measures recommended by the Commission, including clear assignment of an infection control lead and on-site comprehensive inspections expressly including staffing levels and infection control, are critical to containing the spread of COVID-19,” said Dr. Amit Arya, palliative care physician and Board member of the Ontario Health Coalition, in a statement.
“We are worried about the spin that we are already seeing from Ministry spokespeople. The bottom line is clearly validated by the Commission is that the comprehensive inspections are vital, and they have not been happening. These recommendations must be implemented now.”
The province first launched the commission in May after reports were made by the Canadian Armed Forces on the state of facilities, citing “serious concerns” around staffing, infection prevention and control, resident safety, food preparation, and janitorial services.
As of Friday, there are 680 confirmed active cases among residents with 2,265 reported deaths. There have been 3,737 total deaths in the province from the virus.
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