Debate on care standards

Saskatchewan NDP senior’s critic Danielle Chartier speaks during an online media briefing, May 31.

The provincial government and opposition are disagreeing about the need for legislated minimum care standards for long-term care homes in Saskatchewan.

The recent reports by the Canadian Armed Forces about conditions in Ontario and Quebec long-term care homes placed the spotlight on standards of care in these facilities across Canada.

Last week the Saskatchewan NDP made a call for minimum care standards for long-term care homes in the province and also asked for the release of the Saskatchewan Health Authority (SHA) 2019 CEO tour report of facilities.

NDP senior’s critic Danielle Chartier said families and advocates have raised concerns about conditions in long-term care homes and problems have also been identified in reports by the provincial auditor and the provincial ombudsman.

She noted the Saskatchewan Party government has twice defeated an NDP private member’s bill in recent years that called for the re-establishment of minimum care standards, which the government cut in 2011 and replaced in 2013 with a policy document, titled Program Guidelines for Special Care Homes.

“We've been arguing for years not only do we need to have those minimum care standards in place, but they needed to be legislated to strengthen them, and legislation is a lot stronger than a policy document,” she said. “And aside from just legislating them, the secondary piece is the funding piece. It's great to have legislation, but the organizations providing the care need to be properly supported to be able to make those minimum care standards happen.”

Premier Scott Moe disagreed with the NDP’s position during a media briefing on May 28, when he referred to a statement on the opening page of the policy document that indicates the standards in the document are considered to be minimum standards.

“So we most certainly do have program guidelines for special care homes, which are considered the minimum standards here in the province and we are very fortunate that these are working,” he said. “They're working because we have very competent and hardworking and dedicated staff in our long-term care homes across this province that are adhering to the guidelines and to the standards that we have and they are doing a very good job and that is showing in our numbers, in particular in our number of fatalities here in Saskatchewan due to COVID-19.”

The premier’s view about the status of this policy document as minimum standards prompted a response from NDP leader Ryan Meili on May 29, who emphasized that these are only guidelines and that there are no legislated, enforceable minimum standards of care in Saskatchewan.

“That absolutely has to happen and we need to use this moment to change our long-term care system, to bring in those minimum standards, to invest in protecting seniors, in protecting our elders, and looking at how we develop the kind of system that brings in home care and improves long-term care so that people really are always getting the care that they need and especially in a difficult moment like this,” he said.

He felt there is a need for a mechanism to ensure that inspections are happening regularly and that these standards are enforced. It is also necessary to provide adequate funding for staff to provide care in these facilities. He felt a national standard of care for long-term care homes will be appropriate.

“There is a reality that seniors care is happening everywhere and having a baseline to make sure that everybody is doing the same at least is a good place to start, and then in Saskatchewan we need to be working on the guidelines and making sure that we adapt the federal standards to make sure we meet the specific needs of our population,” he said.

Saskatchewan Health Minister Jim Reiter described the issue of minimum care standards as a matter of semantics during a media teleconference on June 1, and he repeated the point made previously by the premier that the standards in the policy document are minimum standards.

“You can call them whatever you want, but obviously there's guidelines or standards that need to be met and we need to be doing the best we possibly can to ensure that that's happening,” Reiter said.

He added that the guidelines in this document are applicable to both public and private care facilities in the province.

“When it's a private care facility, they're required under agreement to adhere to them,” he said. “When it's SHA facilities, obviously if something is not followed, we take corrective action.”

This guideline document was revised in May 2016 and he felt a review might be necessary in view of what has happened in other provinces and in light of the current COVID-19 pandemic.

“I think it's fair to say that periodically those sorts of things are reviewed and updated as required,” he said. “With COVID and experiences in other provinces, we'll likely in the near future be reviewing those.”

The provincial government released the CEO tour report on May 29. The 251-page document provides details about information gathered by SHA senior management during visits to long-term care facilities across the province.

These tours have been conducted annually since 2013 to find out what is working well and to identify areas for improvement. Reiter said the government sees value in these tours to identify areas for improvement and they will continue.

“It helps formulate that decision,” he mentioned. “I think it's important that we always try to do better. I think things have been improving, but we can always do better and it's important to hear from the people that are most directly affected.”

He acknowledged that financial support is necessary to provide long-term care facilities with adequate resources and staffing. He said the current Saskatchewan Party government has increased funding for long-term care by 45 per cent since 2007 and frontline staff in these facilities have increased by about 11 per cent during this same period.

“We're always striving to make sure that there's adequate staffing,” he said. “We've added a lot of staff. There's always going to be people that are concerned that there's short staffing. We're always evaluating where we're at.”

The NDP felt the 2019 CEO report revealed major problems in long-term care facilities with regard to rushed or inadequate care, insufficient staffing levels, and crumbling infrastructure.

“This report confirms everything we already know about long-term care that people have been telling us for years that staff work so hard to meet the residents' need, they want to be there and they love their job and leave at the end of every day feeling frustrated that they can't do what they want, what they need to do for residents in their care,” Chartier said during a media briefing on May 31.

Meili felt the patterns of rushed and inadequate care are directly related to understaffing of long-term care facilities.

“The people who are working there are working hard, doing everything they can, but they have nowhere near the human resources to meet the needs and they're working in facilities that are constantly presenting serious infrastructure concerns,” he said. “So once again we're calling on this Sask. Party government to be honest about the real problems in long-term care, to implement legislated minimum care standards so that we know that we're actually going to be shooting for what seniors need and lastly funding long-term care and home care adequately so that those standards can be met on behalf of seniors here in Saskatchewan.”

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