Insufficient care levels, violence and increasing need in Ontario nursing homes

Toronto- New government figures revealed through a Freedom of Information request show that care levels are stagnant in Ontario’s long term care homes, despite repeated promises by the McGuinty government to improve care and bring in minimum care standards.

Using interviews, research and government statistics, the report, titled “Violence, Insufficient Care and Downloading of Heavy Care Patients: An evaluation of increasing need and inadequate standards in Ontario’s nursing homes” reveals that patients with increasingly complex and heavy care needs are being downloaded into long term care homes, causing an increase in violence, accident and injury.  Despite the evidence of significant unmet care needs the provincial government has delayed regulating the homes to ensure that funding goes to increasing care levels.

The Ontario Health Coalition delivered more than 10,000 signatures on petitions calling for a minimum care standard of 3.5 hours of direct hands-on care per day. This standard would be a minimum average - tied to measured need, so homes with higher need residents would be required to provide more hours, and homes with lower need residents would be required to provide less hours.

Key Findings:

• Government announcements of increased funding and staff have not resulted in improvements to care levels for residents. According to the government’s own figures, there have been no increase in care levels since 2005, even though resident acuity has increased significantly each year. Care levels remain significantly below recommended thresholds to prevent harm.

• Care needs of residents have risen dramatically.  By 2007, 74% of Ontario’s long term care residents were classified as the second highest level of acuity, a substantial increase over the last decade. 60 – 80% of residents have some form of cognitive impairment.  Continued downloading from mental heath facilities and hospitals and aging has resulted in significantly higher care needs.

• The Ministry of Health has delayed publicly releasing the updated care levels data for a year, releasing them only after a Freedom of Information Request. The new data shows that care levels actually fell in 2006.

• Ontario has the second worst long term care staffing levels in Canada, followed only by British Columbia, according to Statistics Canada.

• Currently, the lowest levels of daily care are provided in the for-profit nursing homes. The highest levels are provided in the publicly-owned and operated municipal homes.  Government figures also show that measured acuity of the residents is significantly higher in nursing homes, where the staffing levels are the lowest.

• Staffing shortages are epidemic, with care workers and nurses reporting that they are working “short staffed” regularly across the province.

• Violence, accident and injury rates are alarmingly high with almost 90% of workers reporting physical violence

• .The government has not acted on the recommendations of the Coroner’s Jury in the Casa Verde Inquest of the homicides of two residents by another resident in a nursing home, nor have they acted on the criticisms of the Provincial Auditor regarding the lack of accountability and lack of connection between assessed needs and care levels.

Ontario Health Coalition   ohc@sympatico.ca

For more information: OHC 416-441-2502.  Full report and summary at www.ontariohealthcoalition.ca