Mon Sheong Foundation

Rethinking staffing

Canada’s aging population has been undergoing major shifts for years, but the COVID-19 pandemic pushed longterm care into the spotlight like never before. Beyond the spotlight on infection prevention and infrastructure, one of the most pressing questions that emerged was staffing: how do homes ensure enough trained personnel are available to deliver resident-centred care and meet mandated care hours?

For many directors of care like myself, the pandemic highlighted what had long been a struggle: maintaining reliable staffing levels on the front lines. During COVID-19 outbreaks, long-term care homes leaned heavily on agency workers to fill gaps when in-house staff were sick, resigned, or unable to report for duty. While this stopgap measure kept care moving, it also sparked an important question: how do we solve the staffing crisis? Which led to, what if the agency model wasn’t just a backup, but a core staffing strategy?

A New Model of Care

Some homes are now experimenting with shifting responsibility for staffing frontline care to agencies directly. In this model, personal support workers (PSWs) and nurses are employed by an agency but work consistently within the same long-term care home. Instead of short-term, unfamiliar relief shifts, agency staff could become regular members of the care team, ensuring continuity of care while homes focus on compliance, resident outcomes and capacity building. The idea, proponents argue, could free up administrators to concentrate on resident-centred initiatives, while agencies take on the complex task of scheduling and staffing.

"Instead of short-term, unfamiliar relief shifts, agency staff could become regular members of the care team, ensuring continuity of care while homes focus on compliance, resident outcomes and capacity building."

The Benefits of Outsourcing Frontline Staffing

• Flexibility and Reliability: Agencies can respond quickly to staffing shortages, reducing burnout among permanent staff and ensuring care hours are met.

• Consistency of Care: If structured properly, agency-employed staff can remain assigned to one home long term, developing relationships with residents.

• Administrative Relief: Homes can offload the burden of recruitment, training, and scheduling, potentially reducing turnover stress.

• Capacity Building: Agency staff can be trained and redeployed across facilities, helping to spread best practices and build sector-wide resilience.

The Drawbacks and Risks

• Higher Costs: Agency contracts often come at a premium, which could strain long-term care budgets if not carefully managed.

• Workforce Fragmentation: If the staff is split between multiple homes through agency work, continuity of care may suffer.

• Dependence on External Providers: Relying heavily on agencies could limit homes’ ability to directly shape workplace culture or retain loyalty from staff.

• Resident Experience: Residents and families may perceive agency staffing as less personal if turnover remains high or workers cycle between homes.

Finding Balance

As caretakers of our elderly, it’s important to ensure that any model must put residents first. That means ensuring agency workers are not just temporary “fill-ins,” but integrated, consistent team members who understand the culture and needs of each home. It also means balancing cost considerations with the moral imperative to deliver safe, dignified and personcentred care. The pandemic exposed the fragility of elder care staffing models, but it also opened the door to innovation. However, the choice, in the end, is not about models or budgets alone. It is about dignity. Canada’s seniors and their families are waiting for a system that doesn’t just survive the next outbreak but offers safety, consistency and compassion every day.