The Safe Long-Term Care Act Consultation Report
OVERVIEW
All Canadians deserve dignity, safety, and comfort as they age. With an increasing desire to age close to home, quality and safety in long-term care (LTC) facilities are paramount. The Safe Long-Term Care Act is a cornerstone in the Canadian government’s strategy to enhance the quality and safety of LTC across the nation. Understanding the recent national consultation results allows HealthCareCAN members to align their efforts with national priorities and emerging policy.
The proposed Safe LTC Act aims to address long-standing challenges in long-term care facilities, such as workforce shortages, infrastructure inadequacies, and infection prevention, which were highlighted by the COVID-19 pandemic. The Act seeks to ensure safe, high-quality, person-centred care for residents by promoting national standards, supporting workforce stability, and improving care environments. Additionally, it is designed to enhance the quality, safety, equity, and availability of LTC across Canada, supporting these ideals with substantial federal investment:
- $1 billion from the 2020 Fall Economic Statement to enhance safety in LTC.
- $10.7 million allocated since 2020 to implement COVID-19 safety and quality care practices in over 1,500 LTC and retirement homes.
- $3 billion over five years from 2023-24 to bolster workforce stability and strengthen enforcement of standards in LTC.
- $1.7 billion over five years to increase hourly wages for personal support workers (PSWs).
The federal government has made the development of a Safe Long-Term Care Act and national standards for long-term care a priority. As part of this effort, the Ministers of Health and Seniors have been tasked with establishing these national standards and drafting the Safe Long-Term Care Act to improve the safety, reliability, and quality of care provided to long-term care residents across Canada.
In January 2023, the Standards Council of Canada, Health Standards Organization, and Canadian Standards Association introduced two new independent standards. Extensive consultations took place with provinces, territories, stakeholders, Indigenous Peoples, and the public through various forums and an online questionnaire, receiving over 5,000 responses. The feedback will guide the development of the Safe LTC Act, which will emphasize principles supporting quality and safety without mandating standards or regulating LTC delivery.
KEY THEMES FROM THE NATIONAL CONSULTATIONS
PRINCIPLE 1: CONTINUUM OF CARE
The consultation on the Safe Long-Term Care Act emphasizes the need for LTC to be part of a broader continuum of supportive care, highlighting a strong preference of Canadians for aging at home with necessary supports over institutional settings.
Acknowledging LTC as part of a broader spectrum of supportive care, the feedback cited:
- The need for remunerating caregivers, offering tax credits, and providing direct funding for individuals and families to purchase the care and services they want and need.
- Enhancing community and home care options, especially for those with dementia, to prevent premature transitions to LTC.
PRINCIPLE 2: MEANINGFUL QUALITY OF LIFE
This ensures a meaningful quality of life for LTC residents through holistic, person-centred care that respects autonomy, dignity, and individual goals, with a focus on overall wellness.
Feedback highlighted:
- The need for person-centred care that supports residents’ quality of life, independence, dignity, choice, and active participation in decision-making and community life.
- The importance of fostering joy in LTC, allowing residents to live with some degree of risk while balancing safety for all.
- The need for improvements such as single rooms (or shared rooms for couples), private washrooms, better air quality, home-like models, natural light, outdoor spaces, gyms, and modern design to enhance resident comfort.
- Recognition of family and informal caregivers as true partners in care.
PRINCIPLE 3: INCLUSION
There is an emphasis on the need for LTC environments to be culturally safe, non-discriminatory, and trauma-informed, ensuring that care settings are inclusive, respectful, and value the diversity of residents and staff.
Feedback included calling for:
- Creating culturally or identity-specific homes, floors, or “pods” within LTC facilities to cater to the cultural needs and comfort of diverse groups.
- Implementing comprehensive equity, diversity, and inclusion training for all staff, along with policies to address violence, discrimination, and racism.
- Involving residents and their families in decision-making through councils and regular consultations to ensure their voices are integrated into care practices.
- Increasing accessible and affordable LTC options for specialized needs, particularly for people with disabilities and dementia.
- Expanding Indigenous-led LTC services and integrating Indigenous cultures and languages in care settings.
- Addressing the critical need for LTC facilities within Indigenous communities to prevent elders from leaving their cultural environments, which can increase isolation and disconnection.
PRINCIPLE 4: QUALITY CARE AND SAFETY
There is a need for high-quality, safe care in LTC facilities, supported by a diverse, qualified, and well-supported workforce in clean and safe environments. This principle includes integrated, evidence-based care practices that ensure both the physical and emotional well-being of residents.
Feedback included:
- Protecting staff who report inadequate care to encourage accountability without fear of repercussions.
- Streamlining the recruitment of international workers and reducing reliance on temporary or agency staff to improve consistency and continuity of care.
- Treating all staff equitably and involving them in decision-making to improve care outcomes.
- Providing cultural sensitivity training for staff to ensure care practices respect the diverse backgrounds of residents.
- Enhancing access to specialized care providers within LTC facilities to improve the quality of life and safety of residents by addressing their medical and recreational needs.
PRINCIPLE 5: TRANSPARENCY
The importance of transparency and accountability in LTC through comprehensive data collection, regular reporting, and ongoing evaluation became prominent. It aims to ensure that investments and care practices in LTC are both effective and publicly accountable, enhancing safety and quality of life for residents.
Feedback included:
- Support for increased transparency and reporting, though participants expressed concerns that excessive administrative demands could detract from direct patient care.
- A call to define and measure quality of life in LTC based on residents’ perspectives, using indicators that reflect their lived experiences.
- The need for a pan-Canadian framework outlining a clear strategy for monitoring and improving LTC nationwide.
- Stressing the importance of continued collaboration with provincial and territorial authorities, LTC operators, Indigenous communities, families, and healthcare workers to ensure policies are effectively implemented and responsive to real-time feedback.
IMPLICATIONS FOR HEALTHCARECAN MEMBERS
The conclusions from the “What We Heard Report” following the consultations on the Safe Long-Term Care Act suggest several broad implications for the future of long-term care in Canada. Emphasizing person-centred care, the feedback underscores the need for LTC facilities to prioritize resident dignity, autonomy, and personal preferences.
There is a strong call for cultural and linguistic inclusivity, ensuring services cater to the diverse backgrounds of all residents, including religious, francophone and Indigenous communities. Proposed infrastructure enhancements aim to make LTC environments more comfortable and homelike, reflecting modern standards for quality of life. The importance of supporting informal caregivers and integrating their roles into care strategies was also highlighted, recognizing them as crucial partners in the care continuum.
Finally, the collaborative approach in policy development, as outlined in the report, indicates a move towards more inclusive and comprehensive legislative frameworks to improve LTC across Canada, with a legislative goal set for the end of 2024. These implications suggest potential shifts in LTC policy and practice.
NEXT STEPS
The government is considering the perspectives shared by participants as it prepares to introduce the Safe Long-Term Care Act by the end of 2024. Committed to continuous engagement, the federal government is maintaining open discussions with all stakeholders to enhance LTC services across Canada. This collaborative effort aims to ensure that all residents, regardless of their location, have access to high-quality and safe LTC.
PUBLISHED
October 23, 2024
FOR FURTHER INFORMATION
Marissa Persaud
Research and Policy Analyst
mpersaud@healthcarecan.ca
Jonathan Mitchell
Vice President – Research and Policy
jmitchell@healthcarecan.ca
