Long-term care facilities in Ontario need more trained staff, official says

CBC News Hamilton9:41Long-term care facilities in Ontario need more trained staff, official says

Donna Duncan, CEO of the Ontario Long Term Care Association, says long term care homes in Ontario need more trained staff. She spoke with the CBC's Wei Chen about the crisis facing long term care facilities during the COVID-19 epidemic.COVID-19 cases keep occurring at more and more long term care homes around the provinceputting in danger avery vulnerable senior population.

In Hamilton, there are 27 suspected COVID-19 casesat one facility where two women in their eighties tested positive and died. There have also beenoutbreaks in Bobcaygeonand Toronto while cases have been reported in Perth, Shelburne, Kitchener and elsewhere.

Donna Duncan, the CEO of the Ontario Long Term Care Association, spoke with the CBC's Wei Chen about what she says long-term care facilities need to keep residents safe. You can read an abridged and edited version of the interviewor listen to the full audio interview by hitting the play button above.

Donna Duncan, CEO of the Ontario Long Term Care Association

Clearly the efforts made so far have not been keeping the virus out. What do you think needs to change then to keep the residents and the staff safe?

I do want to say that what's unfoldingreally is a tragedy and it's been a race against time. We monitor the media to see what's happening around the world and we're not existing in a vacuum. So, what we're seeing really emphasizes what an extraordinary time this is. And it's a time for urgency and extraordinary measures. So, our priorities have been the health and safety of our residents and our staff and keeping them safe and stabilizing our homes. Number one priority is trying to keep it out of the homes. We need to isolate staff and make sure that we keep them safe and wrap as many supports around them as we can. We are really grateful, actually, to the government.

Premier Ford and Minister Fullerton and Laurie Scott, in particular, have been great champions in moving forward with an emergency measure that allowed our staff to do whatever it takes in the homes allowing nurses to work to full scope of practice. They've put in measures around 24/7 virtual nursing support allowing primary care providers to do telephone consultations. The premier said they're going to put an iron ring around long term care in and around our seniors and we're going to hold them to that.

Care homes are already used to respiratory outbreaks like influenza every year so why weren't they better prepared for COVID-19?

Long term care sectors exist in the context of other parts of the health care system. This virus has been evolving and evenover the past number of weeks we know more about it than we did when it started. You're right. Our professionals actually do know how to manage outbreaks. They know how to manage influenza andthey've dealt with other outbreaks. This one is a newbie. But we're inspired by the employees who, notwithstanding this in their homes, are coming in each day and doing whatever they can to support their residents. They're the real heroes right now.

So many of them are being infected by COVID-19. Staffing has been an issue even before this with a shortage of personal support workers, for example. So what do you do when all yourfacilities are fighting for the same people?

The emergency order isgoing to enable long term care homes across the province to recruit new employees, not volunteers, who bring with them skills and who will be trained in infection prevention and control and they will be supervised but we need to bring in employees into our homes to free up the time of PSWs and nurses so they can focus exclusively on the care and support of our residents.That's the number one thing.

Personal support workers attend to people at more than one site. So, is there something that can be done to manage that risk or maybe even to stop them from doing that?

This is something where we need consistent direction from government. We know we have a shortage of employees. We also know that our PSWsand our nurses and others are, in large part, part time who do work across multiple sites... are trained not only in how they manage infection and prevention control in the work environment but also how they get screened. How they screen themselves at home, as well. They are professionals. This is something that they've been trained to do. Some homes are putting in a single site order. Some hospitals have put in single site orders where we are looking to the chief medical officer for direction as to what the best practice is, recognizing in many cases that there's a tension between having no staff in and somebody who has been trained to manage infection control in their lives.

There are actually concerns about that. You know the Ontario government put out that emergency order to allow people who may not be adequately trained tohelp out. How do you feel about that?

I had to correct the misinformation. It's not about people who are not adequately trained. The government is allowing long term care homes to recruit employees. And the objective is not to recruit non-qualified people. The objective is to recruit retired people, those who have worked in this case who are retired whosenursing license may have expired, foreign trained professionals who have been certified in their countrieswho aren't working right now in their space who can come in and help and start asPSWs,recruiting hospitality workers who havefood handling skills,who've worked inhomemaking or housekeeping in hotels that are closed right now.

Do you think we should have special facilities where we would transport the seniors who have COVID-19 to separate them from the rest of the residents in long term care?

You have different long term care homes across the province. Some are smaller and older buildings which is why the government has committed to building new beds. The homes have isolation protocols.The order also does allow them to re-purpose non-traditional space in their homes to allow for isolation. Quite honestly, the less people movedthe better. It's certainly my understanding.I'm not a clinician but our teams do have the skills and capacity to manage.

What about this idea that we've seen in New York City, for example, that the military was called in to help out. We have special disaster relief teams. Is it time to call them in, if only to give rest to the staff?

I think that's a really interesting idea. You see these outbreaks. How do we deploy all resources regardless of where they are? One of the things that we're certainly going to be appealing for in the weeks to come is how do we rally around our seniors and our residents in long term care. These are people who made so many sacrifices for their families and their local communities. We need to rally around them and shore up our long term care homes where those people come from as we makesure they've got the skillsand that we get them the appropriate training to support them. That's going to be key as we go forward. As you mentioned these are really vulnerable people.