How Nova Scotia’s Long-Term Care Sector is Failing to Protect Employees During Covid-19

Written by Clare Yacyshyn, 3L, University of New Brunswick, Faculty of Law

The Covid-19 outbreak has led to a devastating loss of life across Canada. Canadian long term care homes have suffered enormously, with 90% of Covid-19 deaths affecting individuals over the age of 60. To date, Halifax’s Northwood care facility has suffered a devastating 42 deaths as a result of Covid-19. They currently report 326 facility Covid-19 positive cases (231 residents and 95 staff). Failure to uphold safe working conditions in long term care homes has substantially contributed to this devastating loss of life. 

Working conditions in long term care homes contribute to the rapid spread of disease. A Globe and Mail article recently described how spread of communicable disease frequently wreaks havoc on long term care homes. Former SARS Commission Senior Adviser Mario Possamai explained the necessity of protecting long-term care workers in the same article, stating that they need to receive the same protections as nurses working in the ICU. Long-term care workers describe themselves as overworked, with barely enough time to effectively take care of residents, let alone wash their hands and change their gloves. Several also state that they did not wear gowns or masks during previous outbreaks, unlike hospital staff. 

The weaknesses of the long-term care system exposed by the rapid spread of previous communicable diseases and the need to fix the system is now clearer than ever. The National Union of Public and General Employees (NUPGE) points to privatization of long-term care homes as a contributor to lack of safe working conditions in long-term care homes. The Toronto Star reported last week that for-profit nursing homes account for four times as many COVID-19 related deaths as publicly owned homes. NUPGE stated that Canada’s for-profit long-term care facilities aim to increase profits by reducing staff, lowering wages and compromising quality of care. They discuss how stress, burnout and turnover of long-term care home staff leads to low quality of care in nursing homes. 

Legislation Covering Long Term Care in Nova Scotia

Section 92(7) of the Canadian Constitution vests Canadian provinces and territories with the responsibility to manage health care. The standard-governing Canada Health Act does not cover long-term care facilities. Long term care in Nova Scotia is governed by the Nova Scotia Health Authority. Long term care facilities are funded and licensed by the Department of Health and Wellness under the Homes for Special Care Act.

Requirements for Nursing Homes in Nova Scotia are outlined in the Homes for Special Care Act and its regulations, as well as the Long-Term Care Program Requirements. The government’s website explains that “Requirements are broad in type and scope, and it is not unusual for a facility to not meet several requirements upon inspection”. Rather than explaining away over-broad legislation, these requirements should be amended to better protect the living and working conditions of long-term care home residents and staff. 

The COVID-19 Management in Long Term Care Facilities Directive (Schedule A) was implemented on April 6, 2020. Section 4.3 states that symptomatic and asymptomatic residents should live in separate rooms, but that if this is not possible, they should live with a two-meter distance between them. Jenna Clark told CTV News that her asymptomatic father living in Northwood shares a small room with a resident who has tested positive for Covid-19. She describes her difficulty receiving information from Northwood, and frustration that she is being told that residents are being isolated when they are not. This first-hand account indicates the failure to protect individuals living and working in long-term care homes. 

Conflict Between Nova Scotia Government and General Employees Union (NSGEU) and Nova Scotia Health Officer

Concern regarding safety conditions for nursing staff at Northwood have recently been voiced by the NSGEU. The union stated that nurses have complained about lack of personal protective equipment (PPEs), and rooming of positive and negative residents together. The union emphasized concerns about lack of consistent and thorough cleaning and lack of infection control measures within the facility. Nova Scotia’s chief medical officer of health Dr. Robert Strang clashed with the union, stating that they are “fear mongering” and that their claims have no validity. This response is disheartening. Employees of long-term care facilities should have their concerns listened to and taken seriously. 

The Nova Scotia Occupational Health and Safety Act requires that: 

There appears to be strong evidence that these safety requirements are not being met in several long-term care homes. Lack of PPEs and inadequate sanitization measures are putting long-term care employees at risk. It is more important than ever to value the compassionate and life-saving work that long-term care workers provide by ensuring them with safe working conditions. 

Recommendations to Improve Working Conditions in Long-Term Care Homes

Several recommendations have been made regarding how working conditions in long-term care homes can be improved. Senior spokesperson for the Maritime Chapter of the Canadian Association of Retired Persons, Bill Gordner, told Global News that the long-term care system needs to be overhauled, and that staffing issues need to be resolved. 

In its sweeping report entitled “Dignity Denied”, NUPGE made several recommendations, including that the Canada Health Act should include long-term care:

LTC is not included in the Canada Health Act, and it is not a fully insured health service in any Canadian province or territory. Ironically, if a frail and elderly person receives medically necessary services in a hospital, those are provided from the public purse. Yet the same person receiving essentially the same service in a LTC facility must pay for it out-of-pocket. Our system is failing to provide tens of thousands of older Canadians with the affordable care they deserve. 

Including long-term care homes under the purview of the Canada Health Act could be an efficient way to enhance the safety of employment conditions at long-term care homes, because it would presumably lead to increased funding and movement away from the cost-benefit model. 

Possamai told The Globe and Mail that long-term care facility heating, ventilation and air conditioning systems should be updated to include virus-scrubbing technology, and that PPEs should be stocked at all times to ensure that facilities are prepared for virus outbreaks. Long-Term Care facility staff and residents deserve to live and work in safer long-term care facilities. Protection of employee rights constitutes a vital element of these improvements. Implementation of the recommendations could help make long-term care homes safer for all. 

Ways to Help Canadian Health Care Workers

• STAY HOME. Peoples’ lives depend on it. 
• Northwood is accepting donations. 
• The Pediatric IWK Health Centre in Halifax is accepting donations, which will be used to purchase PPE. 
• Donate to The QEII Health Sciences Centre Foundation Covid-19 response fund to directly support health care staff and patients.  
• Partners for Care is accepting offers such as grocery services and coffee for health care workers. 

Clare Yacyshyn, How Nova Scotia’s Long-Term Care Sector is Failing to Protect Employees During Covid-19″ Canadian Law of Work Forum (May 14 2020): https://lawofwork.ca/?p=12497