The post-pandemic future: We will regulate long-term care to protect residents
Patty Coates is president of the Ontario Federation of Labour
In private long-term care, profit is king. To keep shareholders happy, many for-profit long-term care companies often offer part-time, temporary, low-wage positions without sick days or benefits. And yet workers in long-term care help residents with every aspect of their lives. You can’t have good resident care without providing good working conditions for their caregivers.
Their duties might include anything from feeding to toileting to turning on the television. Homes are regulated under the Long-Term Care Homes Act and the Design Manual, which mandate things like facility details, hygiene requirements and varied diets for residents. However, the Act gives long-term care homes one big pass: there is no minimum for staffing. Homes can save money by hiring fewer workers, but there is no reduction in the amount of work required in the home. For residents this means less care. It also means that long-term care workers—performing heavy, physical work at a crushing pace—have the highest rate of injury of any sector in the province. A high proportion of care sector workers are women, racialized and immigrant workers, so the government’s insufficient regulations put equity-seeking workers at disproportionate risk of injury and illness. And with fewer work hours available to them, workers must often take on two or even three jobs to support themselves and their families.
The pandemic has opened the public’s eyes to the reality that Ontario’s long-term care system is broken. More than 1,800 care home residents have died in the last four months as a result of Covid-19, too many in squalid conditions. The root causes of the horrors we’ve seen in long-term care lie in privatization, deregulation, understaffing and poor work laws. But recovery plans give the Ford government an opportunity to take off its blinders. Increasing staffing levels and improving worker protections will improve our long-term care system.
For the good of long-term care residents and public safety in our province, the government must implement annual unannounced inspections of care facilities, and they must regulate staffing standards to protect the workforce and the people they care for. Workers and families of long-term care residents have been calling for a regulated four hours of care per resident per day since long before Covid hit.
The government can also improve LTC by regulating training. Currently, personal support worker training has no standardized curriculum and can be delivered by a wide variety of institutions, some of which are mainly online. Workers who take this training might easily start work in long-term care without ever having set foot in a facility. To ensure worker and public health, the government must ensure standardized training that includes co-ops and training on infection control. All workers in the province must also have paid sick days so they can afford to stay home when they are ill without facing financial hardship, and they must have quick access to workers’ compensation when Covid-19 or other illness is contracted at work.
This isn’t rocket science. Other provinces are implementing some of these solutions. In response to the Covid crisis in Quebec, the province set out to train and hire 10,000 PSWs and increased wages. In B.C., the government increased wages and provided full-time work in long-term care. The evidence shows that improving working conditions and wages improves the system.
For greater public safety, Ontario must use public funds to improve staffing levels and stop private care homes from squeezing every penny out of housing our loved ones. Look at the numbers: deaths in private homes due to Covid were much higher than those in publicly run facilities. As the possible second wave approaches, we must act now and care for people with dignity.
More from our post-pandemic future package
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Patty Coates is president of the Ontario Federation of Labour
In private long-term care, profit is king. To keep shareholders happy, many for-profit long-term care companies often offer part-time, temporary, low-wage positions without sick days or benefits. And yet workers in long-term care help residents with every aspect of their lives. You can’t have good resident care without providing good working conditions for their caregivers.
Their duties might include anything from feeding to toileting to turning on the television. Homes are regulated under the Long-Term Care Homes Act and the Design Manual, which mandate things like facility details, hygiene requirements and varied diets for residents. However, the Act gives long-term care homes one big pass: there is no minimum for staffing. Homes can save money by hiring fewer workers, but there is no reduction in the amount of work required in the home. For residents this means less care. It also means that long-term care workers—performing heavy, physical work at a crushing pace—have the highest rate of injury of any sector in the province. A high proportion of care sector workers are women, racialized and immigrant workers, so the government’s insufficient regulations put equity-seeking workers at disproportionate risk of injury and illness. And with fewer work hours available to them, workers must often take on two or even three jobs to support themselves and their families.
The pandemic has opened the public’s eyes to the reality that Ontario’s long-term care system is broken. More than 1,800 care home residents have died in the last four months as a result of Covid-19, too many in squalid conditions. The root causes of the horrors we’ve seen in long-term care lie in privatization, deregulation, understaffing and poor work laws. But recovery plans give the Ford government an opportunity to take off its blinders. Increasing staffing levels and improving worker protections will improve our long-term care system.
For the good of long-term care residents and public safety in our province, the government must implement annual unannounced inspections of care facilities, and they must regulate staffing standards to protect the workforce and the people they care for. Workers and families of long-term care residents have been calling for a regulated four hours of care per resident per day since long before Covid hit.
The government can also improve LTC by regulating training. Currently, personal support worker training has no standardized curriculum and can be delivered by a wide variety of institutions, some of which are mainly online. Workers who take this training might easily start work in long-term care without ever having set foot in a facility. To ensure worker and public health, the government must ensure standardized training that includes co-ops and training on infection control. All workers in the province must also have paid sick days so they can afford to stay home when they are ill without facing financial hardship, and they must have quick access to workers’ compensation when Covid-19 or other illness is contracted at work.
This isn’t rocket science. Other provinces are implementing some of these solutions. In response to the Covid crisis in Quebec, the province set out to train and hire 10,000 PSWs and increased wages. In B.C., the government increased wages and provided full-time work in long-term care. The evidence shows that improving working conditions and wages improves the system.
For greater public safety, Ontario must use public funds to improve staffing levels and stop private care homes from squeezing every penny out of housing our loved ones. Look at the numbers: deaths in private homes due to Covid were much higher than those in publicly run facilities. As the possible second wave approaches, we must act now and care for people with dignity.
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