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Ontario Government
Progress on
Long-term Care Facility Sector Reforms
September 2004- In spring of 2004,
Minister of Health and Long-term Care George Smitherman released the
report Commitment to Care: A Plan for Long-Term Care in Ontario.
This report contained many recommendations that Concerned Friends supported
and for which we had advocated over the years. Here is our update on
the Ministry's progress to date.
Improving
Quality of Life
The Ministry has followed through on its promise to provide funding
to the Family Councils Project to help develop, maintain and support
family councils in facilities across the province. He also reconfirmed
his intention to mandate Family Councils in all long term care facilities.
We hope this mandate will ensure that facility operators accommodate
autonomous family councils in each home, as recommended in the report.
Concerned Friends is not as yet aware of improvements to the training
and qualifications of facility administrators. The administrator plays
a critical role in setting an exemplary philosophy and standard of care
in the facility and we urge the Ministry to move forward in this area.
The Comfort Allowance has been increased by 3% to $115 a month. A more
substantial increase is necessary so that residents receiving the Old
Age Security pension can afford such basic comforts as telephone and
cable TV, haircuts, dental care, outings, etc.
Public Accountability
The Ministry is making progress in this area. In particular, work is
underway on a public website, which will provide valuable information
to the public about long-term care facilities. This information should
also be made available through Community Care Access Centres. Strong
new or revised policies on Abuse and Restraints are being developed.
Unannounced inspections are standard procedure now and the toll-free
Action line has been in place for some time. Concerned Friends would
like to see a report on the number and types of calls received and an
analysis of trends and actions taken.
Standards
and Compliance
Concerned Friends is pleased that the MOHLTC has begun the important
work of clarifying and strengthening some of the key Standards and Policies
that relate to the quality of resident care in long-term care facilities.
Along with other stakeholders, we were involved in the process of reviewing
and revising the 3 standards and criteria on Continence Care, Nutrition
and Hydration, and Skin Care and Wound Management, and the 3 policies
on Abuse, Restraints, and Critical Incidents. The revised standards
are clear, specific, and measurable. We believe that both residents
and staff of facilities will benefit from having program standards that
are clearly understood and consistently followed. To that end it is
critical that the Ministry compliance staff and facility administration
and staff receive ongoing education and training about these revised
standards and policies, so there are no misunderstandings. It is also
important that there be effective consequences and sanctions for serious
non-compliance.
We continue to be concerned about financial accountability in the long-term
care facility sector. We hope to see more transparency in this area,
with each facility's audited financial statements reviewed by an auditor
who is on the provincial Inspection Team, as recommended in the report.
Staffing
and Administration
Concerned Friends believes there is a need for increased funding for
nursing and personal care in facilities. But increased resources need
to be tied to outcomes and there must be accountability to ensure that
the funding is used as intended. We applaud the Ministry's promise to
fund more nurses, and urge that Nurse Practitioners be hired and used
to their full capacity.
Better training for all levels of staff in long-term care facilities
is absolutely necessary. We await much needed improvements in this area.
We also urge the Ministry to expand geriatric training as recommended
in the report.
Legislation
and Funding
We are disappointed that we have seen no indication as yet that the
Ministry is considering a better, more consistent and stable approach
to funding, such as the MDS (Minimum Data System).
We also have seen no change in the 60/40 (private/basic) bed split,
even thought there are empty private beds in facilities while there
are waiting lists for basic accommodation. And sadly, there has been
no redirection of bed allocations away from institutions into home care.
Overall, we see
improvements in key areas, but there is much more to be done. Concerned
Friends gives the Ministry a grade B+ at this point. We look forward
to an A+ in the future!
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