The global pandemic has shone a light on the unique challenges in Canada’s long-term care (LTC) sector. Recognizing the important role of standards and the guidelines and best practices they provide, in May 2021, CSA Group and Health Standards Organization were called upon by the Standards Council of Canada to develop national standards for LTC homes. Following a 21-month development process, CSA Group has recently published the new standard CSA Z8004:22, Long-term care home operations and infection prevention and control, that aims to help create better and safer LTC homes.

Driving principles of the new Standard

While the Standard was developed by CSA Group members – experts across a range of different areas representing various stakeholders and perspectives, it was informed by insights and experiences of LTC homes residents, their families communities, caregivers, and staff. In the public consultation sessions and surveys, they emphasized that LTC facilities should first and foremost feel like homes for their residents. This notion is reflected in the driving principles of the new Standard: person-centred care balancing residents’ autonomy and safety, equity, diversity, and inclusion (EDI), and gender and sexual inclusivity.

What is in the Standard

The CSA Z8004:22 standard is divided into nine unique clauses covering the following topics:

Organizational commitments

LTC providers and management are encouraged to embrace collaborative decision-making and principles of person-centred care, EDI, and gender and sexual inclusivity in order to create an inclusive and supportive environment for residents and staff. Design, IPAC policies and procedures, and operations in LTC homes should meet the needs of residents and ensure their safety, autonomy, and respect for cultural and religious differences. LTC providers and management should also promote and support positive interactions and relationship-building between staff and residents, their families, and caregivers.

Operations

The guidance for LTC home operations includes recommendations for meaningful activities based on knowing residents and their abilities. The Standard helps establish policies and procedures for visitors, including support for visitation during outbreaks, epidemics, or pandemics, and offers provisions for cleaning, housekeeping, pest control, and other environmental services that contribute to clean and sanitary environments within LTC homes.

Food and nutrition management are also an important part of the Standard. It recommends creating tailored and culturally appropriate meal plans and providing mealtime flexibility and environments that promote quality of life.

The LTC home operations section also covers operational communications, contingency planning, waste management, medication management, and other areas.

Quality improvement

LTC homes should strive for continuous improvement through implementing quality systems, data collection, quality and IPAC auditing, and risk management.

Infection prevention and control (IPAC)

The Standard can assist LTC homes in developing and implementing IPAC programs based on best practices, guidelines, and recommendations from national and international authorities and the scientific literature. It recognizes the importance of hand hygiene and personal protective equipment, as well as cleaning and disinfection policies and procedures.

Design

The Standard promotes the residential design of LTC homes, maximizing the dignity, privacy, and autonomy of residents and connection of LTC homes with surrounding communities. The recommendations apply to residents’ bedrooms and washrooms as well as visitor and outdoor spaces, kitchen, dining, and laundry areas, and also address materials, finishes, furniture, fittings, equipment, signage, and wayfinding systems.

LTC home building systems

Systems such as plumbing, heating, ventilation, air conditioning (HVAC), medical gas systems, as well as electrical and electronic building systems and security systems contribute to a safe and comfortable environment for residents, staff, and visitors of LTC homes. The Standard provides requirements and recommendations for the design and maintenance of these systems.

Information technology (IT)

IT plays an important role in keeping LTC home residents connected with their families and care providers. The Standard guides LTCH homes through the design, selection, and implementation of IT systems, as well as data management and privacy.

Catastrophic event management

Internal and external catastrophic events, from loss of power and extreme weather events to airborne and organic contaminants, can impact the safe operation of LTC homes and the care residents receive. The Standard helps LTC homes develop plans to minimize operations disruptions during such events.

Training and simulation

The Standard also outlines training and education LTC homes staff should receive on various topics, including sexual expression and intimacy, inclusive language, waste management, IPAC, IT systems, and catastrophic event management.

Helping stakeholders understand the requirements

CSA Group is having ongoing conversations with various government and industry stakeholders to help ensure that they have the information and tools needed to voluntarily utilize CSA Z8004:22 and consider it for potential referencing in regulations.

To help operational staff, IPAC personnel, directors of care, architects, engineers, and other stakeholders better understand the requirements and recommendations of the new Standard and their application in the LTC homes design, operations, and IPAC, CSA Group developed a set of online courses. Offered in a self-directed format or led by instructors with extensive industry experience, these courses cover operations, management, and maintenance of LTC homes, person-centered care, and IPAC in LTC homes.

For more information on the new standard CSA Z8004 and training related to LTC homes, visit CSA Group’s website.

CSA Group always strives to provide up-to-date and accurate information. However, no representation or warranty, expressed or implied, is made that this information meets your specific needs, and any reliance on this information is at your own risk. Please contact CSA Group for more information about our services.

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