Experts have released a new set of draft standards for long-term care, this time focused on building design, materials and infection prevention and control.

CSA Group, formerly the Canadian Standards Association, developed the draft in parallel with care-giving standards from the Health Standards Organization, released two weeks ago.

Alex Mihailidis, chair of CSA Group’s technical subcommittee, says his organization's standards are more prescriptive and look at everything from the heating and ventilation systems to the types of technology that should be available to residents. 

He likens HSO's standards to the software of long-term care, whereas CSA Group has looked at the hardware. 

"If we can take any type of silver lining over the past two years when it comes to long-term care homes, it really taught us a significant lesson across many of the aspects in operations," Mihailidis said.

The COVID-19 pandemic highlighted serious systemic problems with infection prevention and control as well as other issues inside long-term care residences across the country.

Data gathered by The National Institute on Aging finds 16,345 long-term care residents had died of COVID-19, as of Feb. 8, since the pandemic began. 

Throughout the process of developing the new standards, Mihailidis said, there has been a focus on improving the operations and safety of the residences while balancing the notion that people live in the spaces and deserve the comforts of home.

"They are not acute-care settings, they're not hospitals. How do we design long-term care homes, having that balance of quality of life versus infection prevention, control and safety?" he said. 

The draft draws on best practices from around the world where increasingly long-term care is being designed as a cluster of neighbourhoods, with separate dining and multi-purpose rooms to help balance safety and quality of life. In the event of an outbreak, neighbourhoods can be contained without affecting the entire residence. 

The standards also spell out specific requirements for such things as plumbing, heating, ventilation, air conditioning and security, he said.

While some of those requirements might sound most helpful for the development of new homes, Mihailidis said the goal is to make the new standards applicable to the more than 2,000 homes that already operate in Canada.

"The way we tried to do that really is by providing options or different approaches that homes can take and try to get as close to the standard as possible," he said. 

The draft has been released for public review, with CSA group accepting feedback until April 11. The experts plan to then refine the standards and release a final version at the end of the year.

It is not yet clear how they will be implemented and enforced.

The HSO's standards for care are expected to be adopted by Accreditation Canada, which sanctions nearly 70 per cent of such homes in Canada. 

That will not necessarily be the case for the CSA Group's more prescriptive look at what needs to be done to improve the residences themselves.

The federal government has promised to develop legislation related to the safety of long-term care, which could enshrine the standards in law. That would require the co-operation of provinces, which have jurisdiction over the homes. 

"Where the enforcement's going to come, though, is from the residents, the families of the residents, the staff who work in these homes, and hopefully the operators themselves," Mihailidis said.

"This is really going to be a groundswell of bottom-up support from all these different stakeholders."

Laura Osman, The Canadian Press