The Ontario Nurses Association (ONA) has filed its official report to Ontario's Long-Term Care COVID-19 Commission along with several recommendations calling on the provincial government to take action to improve the safety and care of residents.
The ONA also wants legislated changes to protect the workers who look after the patients in those homes.
Ontario's Long-Term Care COVID-19 Commission has held public hearings and has gathered evidence of conditions in long-term care homes since the commission was formed last summer. The commission is now in the report-writing phase and is expected to table its first report on April 30, one month from today.
As expected, the ONA report is filled with examples of poorly run homes, of staff being overworked and of residents suffering and dying as a result.
The report is broken down into four sub-reports; ONA Survey Results; ONA Final Submissions and Recommendations, Voices of Ontario's Long-Term Care Nurses and Fatal Choices, COVID-19 Nursing and the tragedy of long-term care.
In the report on final recommendations, there are 105 recommendations to the commission that cover every topic from provincial funding, the physical structure of the homes where shared rooms and shared bathrooms were called into question, along with the need to have more qualified medical (nursing) people on staff at all times.
Staffing is a key concern for ONA, and one of the recommendations was not only to have enough mandated staffing to cover 4.1 hours of direct care per patient per day, but that it should include 20 per cent of Registered Nursing care, 25 per-cent of Registered Practical Nursing and 55 per cent of personal support workers.
Along with the several medical-oriented recommendations, the ONA also believes that Occupational Health and Safety needs to be taken into account. This includes having the Ministry of Labour must deploy inspectors into long-term care homes to ensure that the homes are prepared, from a health and safety perspective, to respond to an outbreak.
Another recommendation called on the labour ministry to carry out "a proactive inspection blitz in long term care homes, which would include unannounced inspections."
The homes would also be required to demonstrate they had sufficient supplies of PPE (personal protective equipment) and to ensure that all staff members are trained in properly using the PPE. Another recommendation is that if an employee requests PPE and is denied that equipment, the employee would have the right to refuse to work.
Better communication during pandemic conditions was also recommended and this included letting all staff members know immediately when any employee or patient tests positive for the virus. This would allow for better infection prevention and control measures. Patients who test positive would be required to wear a wristband so that if that patient wanders in the home, everyone would be aware.
The two final recommendations are directed at improving work conditions for employees.
One called for mental health supports to be provided for employees who work through a pandemic for up to two years. ONA recommends that WSIB should be mandated to provide support for any mental health issues or injuries and be classed as a workplace injury.
The final recommendation is that nurses who worked in a long-term care home that experienced an outbreak should be entitled to be compensated a set amount of damages for mental distress/post traumatic stress disorder.
The amount of damages would be higher for those who acquired COVID-19 in the workplace, and higher still for those who were hospitalized.
The ONA report was submitted to the LTC Commission on March 22 with a comment from ONA president that she hopes the province takes note of the nurses' concerns, unlike the follow up to the SARS epidemic when "the ONA's voice was ignored."