Standards group calls for sweeping post-pandemic changes to how long-term care homes operate

A national standards association is calling for profound changes to the way Canada's long-term care facilities are run after the pandemic exposed serious weaknesses that contributed to thousands of deaths.

The package released today by the Canadian Standards Association runs to 338 draft recommendations for new long-term care standards.

Among other things, the CSA is calling for single rooms with private bathrooms for long-term care residents, dedicated hand-hygiene sinks and better contingency plans for staffing shortages when "catastrophic" events occur.

In the first few months of the pandemic, more than 80 per cent of Canada's known COVID-19 deaths happened in long-term care and retirement homes — the highest such rate among nations in the Organisation for Economic Co-operation and Development (OECD).

According to the National Institute on Ageing's latest numbers, more than 16,000 residents of long-term care homes in Canada have died because of COVID-19. Thousands of staff members in long-term care facilities have been infected as well, and more than two dozen of them have died as a result.

"We really took a different approach in the development of these standards," said Alex Mihailidis, chair of the CSA Group technical subcommittee that developed the draft standards. He said the advisory group that came up with the standards included long-term care residents and family members.

"The hope here is that they all now have skin in the game … The hope is that they will lead the charge to see change from within," he said.

The CSA draft standards released today are part of a larger package of standards requested by the federal government last spring. The first part of that package, released at the end of January by the Health Standards Organization (HSO), proposed standards for the quality of direct care that covered things like staffing and residents' rights.

The CSA draft standards are comprehensive and include detailed infection control measures covering such things as PPE supplies, laundry and waste management and rules for cleaning a room after an outbreak or death.

They also cover aspects of day-to-day functions — such as helping residents eat, bathe and go outside — and visitation policies. They include a section on staff training and education as well.

The CSA document proposes new standards for the design of long-term care facilities themselves. It calls for single-occupancy rooms with private bathrooms and improvements to ventilation and medical gas systems.

Mihailidis said CSA drafted the standards with the goal of keeping residents safe while giving them more control over their lives.

"We kept in mind throughout … even though it's quite technical in some places, that these are people's homes," he said.

"We are not developing a standard for a hospital or medical facility. These are most likely the last homes that many individuals would be living in."