National Long-Term Care Services Standard

31 Mar 2021

OTTAWA – The Standards Council of Canada (SCC), Health Standards Organization (HSO), and Canadian Standards Association (CSA Group) are collaborating to develop two new complementary National Standards for Long-Term Care that will be shaped by the needs of residents, families and Canada’s LTC workforce.

HSO’s National Long-Term Care Services standard will focus on resident- and family-centred care practices that value the importance of respect, dignity, trust and quality of life; safe and reliable care based on evidence-informed practices; and a healthy and competent workforce to ensure sustainable, team-based, compassionate care.

The standard will support an organizational culture that is outcome focused and strives towards the safety and well-being of all.

“HSO is Canada’s only Standard Development Organization solely dedicated to health and social service standards that provide the foundation for safe, reliable, high-quality care and services. The National Long-Term Care Services standard will address lessons learned in COVID-19, with an enhanced focus on resident- and family-centred and evidence-informed practices,” said Leslee J. Thompson, CEO of HSO. “The standard will value the importance of respect, dignity, trust and quality of life and will be shaped by the needs of residents, families and the long-term care workforce.”

Excerpts from the Public Notice of Intent

Scope: Health Standards Organization (HSO) is developing a National Standard of Canada (NSC) for the co-design and delivery of integrated, resident-and-family-centred long-term care (LTC) services across Canada. The HSO National Long-Term Care Services Standard (CAN/HSO 21001:2022— Long-Term Care Services) is a revision of the HSO 21001:2020 – Long-Term Care Services standard and will provide LTC homes across Canada with evidence-informed practices that define how LTC homes and LTC teams can work collaboratively to keep people safe, provide safe, reliable, and high-quality care, and demonstrate positive, outcomes-focused change.

The new standard will focus on:  

• Resident-and-family-centred care practices that value the importance of respect, dignity, trust, and quality of life,  

• Safe, reliable, and high quality care based on evidence-informed practices,   

• A healthy and competent workforce to ensure sustainable, team-based, compassionate care, and,  

• An organizational culture that is outcome focused and strives towards the safety and well-being of residents, families, and the LTC workforce

The CAN/HSO 21001:2022 – Long-Term Care Services standard will also: 

• Adopt a “whole person,” holistic approach to the provision of LTC services that are delivered collaboratively with residents and families by LTC care providers in a licensed, congregate care setting; 

• Present how LTC homes and LTC teams can improve quality of care and quality of life for residents and families by moving towards an integrated, resident-and-family-centred delivery of care model that enables LTC services to be delivered at the right time, by the right people and in the right setting; 

• Present the requirements for the coordinated delivery of resident-and-family-centred LTC services, as defined by the needs of residents and their families; 

• Determine how LTC services can be coordinated across the health system, and particularly integration at the level of local community services (e.g., timely access to primary and acute health services); 

• Provide clear, standardized, evidence-informed practices to deliver direct care and services expected for a vulnerable population of Canadians with complex care needs; 

• Outline how LTC homes can support and maintain a healthy LTC workforce, ensuring that staff receive the training they require, that they are provided with decent and safe working conditions, and that they are supported in their day-to-day interactions so they are able to provide the highest quality of mindful and purposeful LTC services to residents and families; 

• Adopt a culturally safe, culturally appropriate and mindful approach to care and service delivery across all LTC interactions;

• Adopt a health equity lens and abide by the principles of equity, diversity and inclusion, advocating for the needs of all residents and families, particularly those relevant to underserved, racialized and/or marginalized communities such as 2SLGBTQ+ peoples, Black, Indigenous, and other People of Colour (BIPOC), refugee, immigrant and other ethno-cultural communities;

• Promote a higher quality of life for residents and their families by developing safe and age-friendly environments that foster autonomy and engagement while valuing the importance of respect, dignity and trust; and, 

• Provide guidance to leadership and policy-makers about how they can support safe, reliable, and high quality LTC services through, for example, policy, regulation and legislation that are informed by the needs of people and communities.

The standard is not intended to duplicate or replicate existing HSO National Standards of Canada, but rather to supplement and complement current standards, guidelines and recommendations used across HSO’s suite of services. 

Project Need: The COVID-19 pandemic has exposed significant gaps in the quality and safety of care within Canada’s Long-Term Care (LTC) and retirement homes, which house close to half a million mostly older Canadians. The Canadian Institute for Health Information (CIHI) reported that, during the first few months of the global pandemic, 81% of Canada’s known COVID-19 deaths were in its LTC and retirement homes, nearly double the average for Organization for Economic Co-operation and Development (OECD) countries. Furthermore, the risk of dying from COVID-19 was found to be 73.7 times greater amongst older Canadians living in LTC and retirement homes than in their own private dwellings in the community.

The provision of LTC is not publicly guaranteed nor insured under the Canada Health Act; rather, it is governed by provincial and territorial legislation resulting in different jurisdictions across Canada offering a variable range of services, eligibility, cost coverage and quality assurance mechanisms for LTC services across the country.  

Given that over 40% of Canada’s LTC and retirement homes have sustained COVID-19 outbreaks and over 12,000 resident and 20 staff deaths to date, there has been significant public attention and continued calls to improve the provision of LTC services for all Canadians. A recent Ipsos Survey of 2,005 Canadians aged 18+ in late 2020 found that 86% said they were concerned about the challenges being faced by Canada’s LTC system, with only 26% agreeing that prior to the pandemic, LTC homes were safe and operating at high standards. In fact, 62% of Canadians agree that challenges to the LTC system are primarily due to a lack of national standards for the sector.

Proposed Timeline: January 2021 to September 2022

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