British Columbia’s health minister says the province has done much to improve conditions in its long-term care homes, but is ready to do more if necessary to meet new national standards released Tuesday.
The new standards, drafted by the Health Standards Organization with the input of 20,000 long-term care residents, workers and community members, include the expectation that residents get at least four hours of direct care every day.
“These are the most comprehensive standards that have ever been created in Canada, and it’s a real opportunity to really elevate the care we are providing for every single resident at every care home in the country,” said Dr. Samir Sinha, the chair of the technical committee that developed the updated standards.
“We actually led the world with the highest percentage of deaths occurring in our long-term care homes (during the pandemic) basically because we were poorly staffing our homes across the country. We weren’t actually enforcing clear accountabilities towards standards, and it really made it clear we need to have better standards and we need to be better funding the care that actually occurs in homes.”
The standards also call for more single rooms — both for privacy and improved infection control — improved pay for workers, and new guidelines for the design of care homes and practices to prevent infection.
British Columbia’s current standards call for 3.36 hours of direct resident care per day, however about 80 per cent of care homes in the province are accredited, meaning one in five are not bound by those requirements.
“(B.C.) should follow the example of Quebec. Quebec has said this is the national standard, and they legislate their homes to all be accredited against the standard and to publicly report their findings as well,” Sinha said.
The pandemic exposed significant flaws in Canada’s long-term care system, which was the site of more than 80 per cent of COVID-19 fatalities, accounting for over 17,000 deaths.
British Columbia’s long-term care homes fared better than many provinces, but still experienced deadly outcomes. A 2021 report from the province’s seniors’ advocate found residents were 32.6 times more likely to die of COVID-19 than the general population.
B.C. has made significant changes to the system since 2020, including wage levelling for long-term care workers and improved training and retention.
It has also upgraded facilities to include better infection control, more single rooms and better ventilation.
Health Minister Adrian Dix said many of the standards outlined in Tuesday’s report dovetail with work B.C. is already doing, including implementing resident and family councils to inform care.
“Which is I think a big emphasis I think in this report, the need to ensure that the resident voice and the family voice be heard,” Dix said.
“B.C. has gone absolutely in the direction of these standards, and we’re of course prepared to review this and do more if that’s required.”
British Columbia’s seniors representative welcomed the new standards, adding she was pleased to see they centred around the rights of residents, the importance of family members, the focus on ensuring home-like environment and the discussion around autonomy and choice.
But she said she still has concerns about how they will be applied.
“How are care homes going to be monitored in their compliance with these standards, and what’s going to be the accountability if a care home does not meet the standards?” Isobel Mackenzie said.
“You can have the best standards in the world. And arguably these could be. But they are meaningless if they are not enforced.”
Terry Lake, CEO of the B.C. Care Providers Association, said the new standards showed the need for investment in two crucial areas: staff and infrastructure.
He said the province had made “tremendous” investments on the labour side, with regards to training and wage levelling.
But on the infrastructure, he said B.C. is lagging. While there are some new spaces in development in the province’s Interior, he said there has been little announced for the Lower Mainland or Vancouver Island.
Not only does the province need new spaces to accommodate an aging population, he added, but it needs to replace aging facilities that aren’t up to modern infection control standards.
“They don’t have air conditioning, they don’t have the ventilation systems that are needed, so there’s a lot of money that needs to be invested there,” he said.
“Unless the federal and provincial government, and largely the provincial government, invest more money in care it simply won’t occur. I mean you will get more private spaces built, but it will be at the higher end of cost.”