The Ontario government must conduct more proactive inspections of its long-term care homes and follow up with harsher enforcement measures when homes fail to address concerns, the province’s commission on COVID-19 in long-term care said Friday.

As part of its second interim report, the three-person commission says the province must resume widespread annual Resident Quality Inspections (RQI) of its 626 long-term care homes, which were largely curtailed heading into the pandemic.

In 2019, only 27 homes received an RQI inspection, down from more than 300 in 2018.

“This reduction in RQIs which are intended to provide a holistic review of operations in the homes left the Ministry with an incomplete picture of the state of Infection Prevention and Control (IPAC) and emergency preparedness.”

The commission also said each inspection should check the home’s level of infection prevention and control readiness.

long-term care home

After inspections were completed, the commission says orders to rectify issues often came with little or no follow-up.

“In 2019, the two most common enforcement actions were Written Notification and Voluntary Plan of Correction. Neither require mandatory follow-up or verification from the LTC home to illustrate compliance with the requirement under the Long-Term Care Homes Act (LTCHA).”

The Commission says more effective enforcement of orders must be taken in the future, and the province should hire more inspectors to patrol its long-term care homes.

The panel also recommended that more information be published about the status of each long-term care home, including supply of personal protective equipment, family and resident satisfaction, staff engagement and staffing levels.

As of Friday, 2,357 residents of long-term care homes and 8 employees had died of COVID-19.

The Commission also called for better clarity around who is in charge of resident care at each home, and that responsibility must fall to a single, identifiable and accessible person at each home.

“This individual must be on-site each day in a full-time position and be held accountable forresident quality of care and the Province provide the financial resources necessary toeffectively support the lead for quality of care in carrying out their role and responsibilities.”